Treatment

About a year and a half ago, I noticed that my facial cheeks would get red.  On occasion, I would develop small red "bumps".  My GP prescribed Hydrocortisone Valerate Cream USP, 0.2%.  My condition seems to come and go.  I have not been able to link the redness or bumps to a particular food or circumstance.  I do  notice that we I go out in the sun, my face gets very red and it takes a day or two for the condition to finally get back to normal. Normal is defined as some red areas, especially over the cheek bones near the outside end of each eye.

This week, I went to my family doctor and described my problem. Unfortunately, it always seems that when I have the time to go to the doctor, my condition improves.  I told the doctor that I think that I might have rosacea.  He said that the condition is commonly called "adult acne".  I told him that I had read on the internet that rosacea was treated with tetracycline or metronidazole.  He prescribed Novacet or Sodium Sulfacetamide 10% and Sulfur 5% Lotion.  He said to try this for a while.

Everything that I read indicates that rosacea can get worse if left untreated.  I know it is difficult to diagnose by e-mail, but will the newly prescribed lotion have any useful effect?  I probably need to see a dermatologist, but my insurance company is an HMO, so I need my primary physician's referral.

Any comments?

[Alan Rockoff, MD]

Rod:

Yup.  It sounds like you have rosacea, possibly aggravated by the steroid cream.  What your doctor recommended is a good idea, as long as you 1) stop the betamethasone and 2) keep up the Novacet for 4-weeks.  Please ignore daily fluctuations, as they never make much sense (everything red gets redder in the sun, because more blood flows in warm skin.)

If you're not much better in 4-6 weeks, I'd advise seeing a dermatologist.  There are other creams, as well as pills you can take for a short while.

Roscaea, incidentally, is not progessive; it fluctuates.  And it does not get worse if you don't treat it; it just doesn't get consistently better.

best.

Dr. R

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