Mr

I am 28 years old, over the 4-5 years i have noticed on holiday photographs (when the temp is warm) my nose and cheeks appearing red, only appearing like this on photos not looking into the mirror, my eyelids got very dry and flaky often styes appear.  Someone mentioned this may be Rosacea so I went to visit my G.P., the GP gave me a prescription for metronidazole which i used until November but my skin appeared alot worse and when i looked in the mirror my nose (side of nostril appearing red all the time) and cheeks appeared very red and ever since i get flare ups whilst eating chocoloate and sometimes when drinking alcohol.  I went back to the doctor and changed the prescription to Oxytetracycline.  Flare ups slightly decreased and i am starting to get redness at the bridge of my nose and at the side of each nostril. What do you recommend me to do? As this has got alot worse since i have started medication. Are you convinced this is Rosacea?
thanks

[Alan Rockoff, MD]

It might be a mild form of rosacea, but it's possible that all you have are superficial blood vessels that make you look red and which redden further when you eat something that makes you flush (like alcohol.)  medications do little or nothing to change that.  Laser treatments can minimize redness, at least for a time, but that may not be worth your while, if all that's happening is redness.  Rosaca treatments like the tetracyclines and topical antibiotics like metronidazole are directed more at reducing pimples and pustules, which don;t seem to be a large part of your clinical picture.  You may want to consult a dermatologist about this, if you can get a referral to see one.

Best.

Dr. Rockoff