rosacea/rhinophyma

HELLO,
I AM A 68 YR. OLD FEMALE WHO HAS NEVER HAD  ACNE OR OTHER SKIN PROBLEMS UNTIL APPROX. 5 YEARS AGO WHEN I SUDDENLY NOTICED SMALL RED HARD BUMPBS. THE DIAGNOSIS WAS ROSACEA. I BEGAN TAKING AMPHICILLIAN AND USED A TOPICAL ANTIBIOTIC CREAM, WHICH BY-THE-WAY SEEMS TO MAKE THINGS WORSE.  I HAVE DEVELOPED A MILD CASE OF RHINOPHYMA WHICH IS EXTREMELY DISTRESSING TO ME.  IT COMES AND GOES BUT EACH TIME IT LEAVES AREAS, ALBEIT SMALL PLACES, THAT ARE SIMILAR TO SCARS.  UNFORTUNATELY I DID NOT REALIZE THAT I SHOULD BE ON ANTIBIOTICS ALL THE TIME AND NOT JUST WHEN SYMPTOMS APPEAR.  I AM RECENTLY SEEING A DOCTOR WHO  PRESCRIBED ORACEA (40 MG.1/ADAY). I HAVE HAD 4 IPL'S, 4 WEEKS APART WHICH HAS HELPED WITH THE FLUSHING..  I READ THAT AN ANTIHISTIME MIGHT HELP SO I HAVE STARTED TAKING ZYRTEC ONCE A DAY.  ALSO IN RESEARCHING THIS CONDITION, I USE A 45 SPF SUNCREEN THAT IS A ZINC OINTMENT.  I AVOID THE SUN, SPICY FOODS AND OTHER SUGGESTIONS BUT IN THE MORNINGS MY MID[FACE LOOKS SWOLLEN.  I WILL SAY, I BELIEVE THE ZYRTEC IS HELPING SOMEWHAT.   NOW, AFTER ALL THE ABOVE, I AM FINALLY COMING TO MY QUESTION:
WHAT DO YOU THINK OF ACCUTANE IN SMALL DOSE (10 MG) FOR RHINOPHYMA.?   I KNOW THE CO2 IS SOMETIMES USED BUT I WOULD PREFER SOMETHING LESS DRASTIC IF POSSIBLE.   I ALSO READ THAT ACCUTANE COULD BE TAKEN LONG TERM WITHOUT SIDE EFFECTS.  DO YOU AGREE? PLEASE TELL ME YOUR OPINION ON TREATMENT.  I AM DESPERATE NOT TO LET THIS GET ANY WORSE .  
THANK YOU FOR THIS FORUM.
KIT

[Dr_Aparna]

Hi,
Rhinophyma is considered an extreme form of acne rosacea, which  occurs late in the course of acne rosacea.

The causes of acne rosacea and rhinophyma are not clear. Rosacea has a hereditary component although intestinal bacteria in the digestive tract, demodex mites, medications like topical or nasal steroids are all implicated in the causation.

Triggers that cause episodes of flushing and blushing like strenuous exercise, heat from sunlight, severe sunburn, stress, anxiety, cold wind, moving to a warm or hot environment from a cold one can play a part in the development of rosacea.

Antibiotics are the mainstay of treatment for acne rosacea; this suggests that bacterial infection is the cause. However, antibiotics do not cure rosacea; the rosacea patient must continue to use oral antibiotics or a topical antibiotic, metronidazole gel (Metrogel), to prevent recurrence.

Oral isotretinoin (Accutane) can be used to treat severe acne rosacea and rhinophyma. Accutane is a form of vitamin A which reduces the amount of oil released by oil glands in your skin, and helps your skin renew itself more quickly.
So you can consider using it to treat your condition. However it has certain side effects which are potentially harmful. You could check this out on the website listed below.

It does not mean that you might experience all or even some of them , so if you are willing to try it, go ahead with it. Inform your doctor about other medications that you may be on.

ref:http://en.wikipedia.org/wiki/Rosacea
ref:http://www.drugs.com/accutane.html
ref:http://yourtotalhealth.ivillage.com/growth-on-nose-rhinophyma.html