I’M SUFFERING FROM ‘RED FACE’
Q I’m a 55 years old, Swedish, and have been suffering from ‘red face’, which has started to develop yellowish pimple-like lesions. My forehead, nose and cheeks are more intensely affected. My lower inner eyelids are also becoming itchy, sore and red, while my nose is starting to look disfigured. Is there anything I can do to stop the process? A From your letter and the description of your skin complaints, there appears to be a clear indication of inflamed papalopustular rosecea.
This condition affects all of the areas you have mentioned in your letter.
Involvement of the eyelids is called conjunctival rosecea, while the condition’s effect on the nose is known as rhinophymatous rosecea.
Through a range of clinical variations in its presentation, it can cause prominent broken/ dilated blood capillaries on cheeks and upper neck, in which case it will be labelled as tellengiactatic rosecea.
In the normal course of events, it starts as transitory episodes of severe facial redness (blushing or flushing).
This can later turn into a more persistent feature and subsequently starts developing pimple-like papules and yellowish pustules. It can mistakenly be identified as inflamed acne.
Rosecea is one of many complex dermatological issues. There is global consensus among researchers that rosecea is a vascular disorder of cutaneous blood vessels, where these vessels tend to overreact in the form of vasodilatation, either through thermal stimulation, excessive sun exposure or certain foods.
Dietary triggers include alcohol, extra-spicy food or the consumption of certain food additives. This can trigger redness of the facial skin.
Similarly, any neuropsychological stimulus in the form of severe stress or anxiety can precipitate such vascular reactions.
Rosecea has a significant genetic and racial predisposition. White-skinned individuals constitute the majority of the sufferers.
To treat your skin condition effectively, I would advise you to consult a dermatologist for a detailed examination. Among the routinely used treatment options, oral antibiotics such as tetracyclines, together with topical metronidazole creams or gels and lotions, are widely prescribed.
However, I must mention here that the rhinophymatous rosecea is a most resistant and clinically challenging situation. In its early stages, a course of oral isotritinoin is usually beneficial. In its advanced stage, lasers have offered successful results in many cases.
Finally, avoidance of the triggering or precipitating factors remains the only effective remedial tool to prevent further recurrence of rosecea.
DR IKRAMULLAH AL NASIR is a Dubai-based dermatologist