ASK SARAH

From our GP

Good Housekeeping (UK) - - Contents - Dr Sarah Jarvis an­swers your health ques­tions this month

Q

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!

A

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.

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