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Dermatology  (Expert Forum)
 | 
Rosacea? Confused...
Answered by
Alan Rockoff, MD - dermatology, Child Skin Problems
The Rockoff Dermatology Center Brookline - MA
This forum is for questions regarding Dermatology issues, such as: skin rashes, acne, birthmarks, skin infections, rosacea, and general skin care.

Rosacea? Confused...

by Martin04, Feb 26, 2004 12:00AM
I'm a 19 year old male who's very athletic but have suffered from having nearly-constant red cheeks and nose as well as dark redness at either side of my nose for the last year or so. Plus, at times, the area just below my eyebrows can be red. This condition can really blow my self-confidence at times, especially the redness on the sides of my nose (nasal folds?).



Also, if I don't wash my nose for a day or two, dry-flaky like skin forms on the top. Plus my nose tends to get oily.



Previous to this condition, I've always had clear skin. I mean, up until 16 or so I didn't even get any spots.



Anyway, having researched on the 'net for a while, I figured it could be rosacea or seb. dermatitis, so I went out and bought several products including a 1% hydrocortisone cream, aloe vera gels/washes, Nizoral and Emu Oil. None of them have really made much a difference, although I haven't used any of the products for more than a week at a time. I'm just confused.



By the way, I'm not a person with really light skin but I don't have dark skin either.



Thanks.

by Alan Rockoff, MD, Feb 26, 2004 12:00AM
Some people with light skin have redness as part of their skin type.  At 19 you're too young for rosacea.  The flaking may indeed be seborrhea--I suggest using the hydrocortisone, which will knock down the scaling, though of course it will come back.  If the redness makes you embarrassed, you may want to ask a dermatologist about laser treatment--this is safe and can make a big difference in redness.



Take care.



Dr. Rockoff
Member Comments (7)

by cocochula, Feb 26, 2004 12:00AM
I am 20 years old [almost 21] and I have a very similar problem.  I just have the red cheeks, though.  Sometimes it even gets to a purple color.  The flushing is triggered by the standard elements [ie. hot temp, sun, hot drinks & food, exercise, ect].  It also has a sort of burning sensation to it, or I can at least tell that it’s going on.  I can feel stuff moving around in my face, as it were.



I’ve been to a dermatologist and I’ve tried a few things so far, none of which have been very effective.  



He first gave me an antihistamine and some hydrocortisone cream.  It seemed to do something the first few days but quickly became ineffective.  



Second was an Aclovate Ointment, .05%.  It worked a few times, but left my face greasy looking.  Other times it just caused the red to glow.



I am currently using MetroCream [topical cream .75%].  I’ve been using it for a few weeks and it hasn’t really done much yet.  The first few days went well with it.  It didn’t really eliminate the red, but controlled it and kept it constant at a low red, which was fine.  But now it’s not even doing that.  Hopefully it gets better.



If the current cream doesn’t work, my doctor said that Laser Surgery is another option.



He told me that it’s possible that I have early Rosacea.  He’s also told me that younger people have a tendency to go through chemical changes, causing over-active body functions [ie. face activity and armpit activity].  He told me that it’s very possible that I will grow out of it.  This is something that has been happening for several years and has only seemed to have gotten worse, so I don’t seem to be growing out of it just yet.



My skin tone is pretty in the middle as well.  Not fair, but not tan either.



Any additional information/advice would be most appreciated.  



Thanks.

by Martin04, Feb 27, 2004 12:00AM
Thanks for the write-up, it's appreciated.



OK, so you're saying that what I have may just part of my skin type. So why has it only come about in the last year or two badly? Fair enough, I've had a bit of color in my cheeks for a number of years but that just looked normal; I didn't even notice it was there much really. I've always blushed easily though.



Anyway, to tell you the truth, I can live with the red cheeks, but what really annoys me is the redness on either side of my nose. This has definitely only come about in the last year or so. Have you seen anything like this before?



Thanks in advance.

by cocochula, Feb 27, 2004 12:00AM
I’ve generally had a more rosey complexion as well, but it seems to have gotten worse within the last year.  Now my cheeks seem to always be, at least, somewhat red if not fairly red.  And of course they can get extremely red; sometimes one side worse than the other.



Are many of these symptoms normal body changes, ect?  Or temporary, overactive body chemicals?



How many treatments of laser surgery are generally needed?  How expensive is the surgery?  And what type of laser/surgery would you recommend?



Thanks.

by Derma, Mar 15, 2004 12:00AM
HI, i seem to have the exact same thing as you. I am fair skinned, and have RED cheeks. I've had them for as long as i can remember and it's really given me a hard time. It's given me low confidence, self esteem, and i even get paranoid. I blush very easily and RED. I'm 20 (will be 21 soon)and i've had this since my early teens. It's gotten noticeably worse and i have to cover it up with makeup which i despise. i have no choice, and even with the makeup i have a rosy complexion. my mother supposedly had it when she was young (so she says) but i think she just says it too make me feel better. I dunno..she said it went away by itself. mine has gotten worse and dont expect it to go away any time soon. i just can't picture it happening seeing as how it's sooooo red. i'm also sensitive to light (artificial bright lights) whether it be in a class room or anywhere else. after being exposed to that light, i get a sun burned effect on my cheeks...it's soooo embarrassing. Anyways, if mine sounds worse or the same as what you guys have, i know how you feel...it's literally something that can ruin your life...if you're as self conscious as i have become. Thank God i found a dermotologist and will be seeing her next month. i don't know what to expect. all i know is that if she tells me it's nothing, i'll be more than upset! I won't be leaving until i get the answer i want! (diagnosis)I'll let you guys know what she recommends, or what she told me etc..



Btw, i also have tiny visible red blood vessels on my cheeks which is another sign of rosacea...



~ "derma"

by bill85, Mar 25, 2004 12:00AM
To: Dermatologist
Hello, I too am a 19 year old male, and have started to develop a skin condition that sounds very similar to what the topic starter mentioned. My upper cheek, about an inch or so below my eyes has,  become red in color and burns at times. It seems to be most inflamed or irritated after being outdoors in the sun, on dry windy days, or right after taking a shower. At the same time that I developed this condition, I also started to experience extremely dry and flaky skin over my entire face, predominately on my upper cheeks ,where its red, and on my nose and my lower forehead above my eyes. This too, becomes worse after showers or in the sun, as well as when i wake up in the morining. I should note that I am still recovering from my adolescent acne, which I had to vary degrees since I was 15, it was at its worst when I was about 16.



When the drying and redness first started, I used Lubriderm Advanced Therapy Lotion to reduce the symptoms, and I had to use it at least a couple times a day. About a week ago, I started using a pure Aloe Gel (99.7% Aloe Vera), applying it about 2-3 a day. This seems to work the best so far, it keeps the redness and inflammation down and my skin is soft and moisturized.



Will continually use of the Aloe eventually stop the redness and drying? Or should I seek treament from a dermatologist? I see people mentioning laser skin treament, but I know nothing about it, and not sure if I should go to that extent. However, I also have a many small acne scars which I would also like to rid myself of, and if laser treatment can do both, maybe its worth it. What is the risk involved with laser treatment and are there any long-term side effects? Also which method/type of laser treatment is the best, and what does this procedure cost on average?



I would be very grateful for any information you can give me, my facial condition has left me with very low self-esteem over these past few years, and if I could finally rid myself of this, i would be overjoyed.

by TheDodge, Mar 29, 2004 12:00AM
Hello to all who suffer from Red Face Syndrome.  Trust me, I understand.  I am a person who has achieved high degrees of success in life, who considers himself intelligent, action oriented and persistent (As a partner in a business consulting firm, my clients pay me $6,000 a day and millions a year to come help in their businesses because I have a knack for ferreting out the truth within a complex matter or system).  I know personally the severe negative impact that Rosecea can impart on a person’s life, young or old.  Please let me relate to you a list of Myths about Rosecea, which you may want to print out and carry with you to help you avoid the endless useless information and cold rabbit trail mistruths about red faces out there. Hopefully this might help you short circuit the long search that I had to undergo as I weeded my way through all the people who knew all about Rosecea, but actually knew nothing. Be persistent in your search for remedy in this matter.



Myth #1:  Having a Red Face is not that big a deal, just accept yourself and move on.  Why should insurance cover a thing like that?



TRUTH: The condition of our faces is a critical part of our maintaining an emotional and functional mental health.  Having a red face is a SIGNIFICANT detraction from quality of life.  I have lost client jobs (and taken major income hits) because ignorant people thought I must have gone drinking the night before a presentation in which I showed with a red face.  I have had people tell me that I loose credibility because I looked like I did not take care of myself.  My family used to gasp at times when they saw me at reunions, my grandmother asks me if I am alright, and everyone has a cure they are pushing.  When I was younger I mistakenly hurt a young woman who was a bit heavy by implying she was “Porky” in a note that was not meant for her eyes.  Nonetheless she found the note and it destroyed her.  I regret this action to this day, and she even mentioned it at our 10 year high school reunion.  Even though her finding out about it was an accident, I will never, ever cut a person as deeply as that again in my life.  That being said, I would gladly trade a broken leg and three months in a cast for having to put up with Rosecea.



Myth #2:  Rosecea is caused/aggravated by specific bad consumption habits (the usual suspects), or by not taking care of yourself, or carrying unresolved anger.



TRUTH: The things listed below DO NOT CAUSE Rosecea.  Some of them may cause you to temporarily flush and of course if you get sunburned or windburned you will have a red face from sunburn or windburn, but all these things are NOT Rosecea causes and the redness they generate are separate issues from Rosecea.  Do not listen to the “experts” or medical, dietary or dermatologic generalists who have not had at least a couple of decades in treating Rosecea.  The things that DO NOT CAUSE Rosecea include:



“Louis, round up the usual suspects:”

1. Alcohol consumption, excessive or otherwise.  Medical texts even to today if they mention Rosecea at all (as I write this my spell checker does not even recognize it as a word), only list Rosecea as “commonly found in individuals as a side effect of heavy to alcoholic drinking habits.”  Forgive the stark truth here: In short, Bullcrap.  Important principle: Never underestimate the depth of human ignorance.

2. Coffee consumption.  More BS (I will forgo the editorials at this point)

3. Acidic foods…..

4. Peppers

5. Chocolate/mints

6. Hot drinks/hot cider

7. Cold weather

8. Windy conditions

9. The Sun

10. Sodium

11. Harsh soaps

12. Unsettled personal anger or angst

13. Lack of personal enlightenment and peace

14. Bohemian slime worms



Myth #3  The things listed below can, with discipline and good cleaning and personal habits, help reduce and eliminate your Rosecea.



TRUTH:  Please skip the following ineffective “treatments” for Rosecea,  It will save you a LOT of time and money and decades of pain spent spinning your wheels suffering in the proverbial mud.



1. Metrogel

2. Sulfur topicals

3. Regular face cleansing

4. SPF 30 or higher sunblock

5. Retin A

6. Acne Statin

7. Avoidance of the entire list in Myth #2

8. Oxy and Phiso based cleaners

9. Antibacterial soaps

10.   Topical Isopropyl Alcohol