From our GP
For the last three years, I have been getting recurring red spots around my chin and nose. I cleanse my skin thoroughly and I have tried various topical treatments, but nothing works. Please help!
Diagnosing any skin lesion is always a challenge without being able to see it or knowing the person’s medical history. However, spots around the nose and chin that appear in adulthood may well be caused by rosacea, a condition sometimes called acne rosacea. It occurs in one in 10 adults and mostly affects the nose, cheeks and forehead, but can appear on your chin, too.
The first symptom is usually flushing, which often comes and goes to begin with, but becomes more constant over time, leaving you with a red face. Tiny blood vessels called telangiectasia, which look like thin red pieces of wiggly thread, can also appear in the same region. In addition, you may get small lumps and cysts that resemble acne. These are often the most troublesome symptom for women, because they can’t easily be covered with make-up. Finally, rosacea can affect your eyes, leading to dryness, burning, stinging and light sensitivity.
Although the condition is often referred to as acne rosacea, the cause of it is very different to traditional acne. Plus, unlike acne, it doesn’t affect the upper chest or back and almost never occurs during your teenage years – it usually starts in your 30s to 50s. There may be a genetic element, although recent research has focused on the presence of a mite, which lives harmlessly on the skin in many people. An increase in numbers of mites, possibly along with an overreaction by your immune system, may be to blame.
Sun damage may also play a role, so avoid strong sunlight if you have rosacea. Steering clear of spicy foods, hot drinks, excess heat or stress and alcohol may reduce flushing. You may find that cleansing makes matters worse – doctors recommend avoiding cleansers containing abrasives or alcohol, as well as oil-based make-up.
Antibiotics, either in topical or oral form, have traditionally been used to treat the condition. Metronidazole is the usual topical preparation, but Ivermectin cream, which kills skin mites, is quickly becoming my treatment of choice.