how to recognise rosacea

[tedstriker]

Hello....I need advice on rosacea as I am at my wits end!
I have always been in perfect health up until May last year when I developed a facial injury which sensitized a nerve, which the doctors are trying to treat.
When this happened I was passed pillar to post between doctors as they couldn't work out the problem, we only realised what the problem was 8 months after the injury.
In that time I have been constantly stressed, suffered from anxiety, I could not stop looking for answers as nobody knew what the problem was.
At one point a dermatologist put we me on accutane because the injured area turned red when pressure was applied so he thought it might be rosacea; he put me on 10mg per day.
I did explain that I had never flushed or had red skin in my life; the only area what is red is where the irritated nerve is.
since I started the accutane I was suffering strong flushing reactions roughly once or twice a week whilst I was on it (approx 4 months); The only time I flushed was when I was sitting around doing nothing.
Since I have come of the accutane I am still getting flushing reactions but it only appears when I am anxious; I went on holiday last week and my skin looked normal all week, the one time it did flush was when we was sat in a pub with a meal.
Also if i soak in a hot bath my skin will look its normal pale colour for about half hour after the bath.

When I am activily thinking about flushing majority of the time I will flush; if I have a beer when anxious I will flush yet when I am not thinking about it I can drink all day. same goes with spicy food, if I eat spicy food I can flush yet if I eat spicy food after a few pints I won't flush.
If I stroke the skin on my face it turns a faint red instead of normal skin tone, and its been like that since second month of the accutane.
I am extremely confused as to whether this is rosacea, or will it turn into rosacea; or is it anxiety which is causing the flushing which needs to be brought under control.
My face is constantly warm like it is in a permanent state of rediness to flush.


I have suffered from anxiety for nearly 10yrs but no where near as bad.
My previous anxiety was to sweating; if I started getting anxious about sweating a would pour with sweat.

Any advice would be appreciated.
Rob

[Bhupinder Kaur, MD]

Hello,
It does not look like rosacea but can be due to flushing. The treatment of severe flushing includes anti anxiety medicines and beta blockers. Severe cases may need endoscopic thoracic sympathectomy(ETS). Also then possibilities of lupus which may present with a butterfly malar rash needs to be ruled out.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.

[tedstriker]

Hi Dawn
Thanks for the reply; I have had a number of blood tests done nothing has come up; I have seen 4 dermatologists - 1st had no idea what caused the injury and I wasn't flushing then, passed to second who decided rosacea without flushing symptoms (started me on accutane); 3rd dermatologist told me the flushing was only a side effect; the 2nd derm who I saw after the accutane treatment told me it wasn't rosacea and just a side effect.
I have seen acupuncturists who have said its not rosacea because when i start freaking out my cheeks and sides of the face flushs and not the T-zone.
I don't suffer from any of the problems you have mentioned altough I have joint ache but I think thats from Lyrica.
I don't have redness anywhere else other than my face, although the acupuncturist mentioned my hands and feet are very warm?????

I am always on edge needing to look at the internet, constantly asking the missus (am I going red); getting nervous and uncomfortable in pubs (unless im drunk); always needing to look in the mirror to check if I'm going red.

Thing is, I can sit out in cold or hot weather, have hot baths, exercise at the gym (although I will go red if I am thinking about flushing), drink beer (most times) eat spicy foods (most times) without going red or even looking pinkish.

The only time I seem to flush is when I am activly thinking about it, like now my face feels really hot and my hands are clammy because I feel unsettled.



Kind Regards
Rob

[dawnzlight]

also, should consult with a dermatologist to diagnose rosacea----

[dawnzlight]

rob---has any dr. checked you for lupus or Fifths disease?----Lupus presents with a red rash like area on the face and Fifiths disease presents with a reddness also--like if someone had just slapped your face....Do you have redness anywhere else on your body?--With fifths disease usually there is redness on the arms and legs also----with lupus other symptoms are fatigue/fevers/hair loss/sensitivity to sunlight/joint pain/arms and legs and hands will get reddish in cold weather.....and other symptoms-----Look up both of these illnesses----and yes anxiety can cause flushing----but when u get to the point ur becoming "flushed" usually ur anxiety is pretty bad and u'd be feeling other things like heart racing/pounding----/shaky/feeling like u cant breathe-------
I would talk to ur doctor and i would consult with a Neurologist.

Goodluck and let me know how things go
dawn