Rosacea: Facial redness, acne and patches of tangled blood vessels
DEAR DRS. DONOHUE AND ROACH: My father and I have rosacea. I have it worse. I get acne on my face, along with redness, and now I have scarring. I never had acne when growing up. I was diagnosed three years ago with rosacea. Sometimes I don't leave the house because it's so bad. I have tried a lot of medicines, but nothing has been a solution so far. Is there anything you can suggest? I'm sick of dealing with this. -- J.O.
ANSWER: Anyone can come down with rosacea (row-ZAY-she-uh), but people with fair skin who blush easily are the ones most likely to develop it. Redness of the nose, cheeks and chin, an outbreak that resembles acne and tangles of tiny blood vessels that have the appearance of small spiderwebs (telangiectasias) are the predominant signs of this chronic skin condition. Hot drinks, emotional situations, spicy foods and alcohol bring on an outbreak, but the most troublesome influence is the ultraviolet rays of sunlight. People with rosacea should never go outside without applying sunblock to their face.
An often-overlooked aspect of rosacea is eye involvement. The eyes dry and redden. Without proper attention, permanent eye damage can occur. An eye doctor should be involved in treating rosacea patients whose eyes are affected by it.
I don't know the treatments you have had. MetroGel is a preparation of the antibiotic metronidazole that's applied directly to the face, often with good results. Oral antibiotics have their place in treatment, too. Periostat (doxycycline) comes in a reduced dose marketed specifically for rosacea. Laser treatments obliterate the spiderweb aggregations of blood vessels.
It sounds like you're not seeing a dermatologist. You need to. You can't fight rosacea without one. In addition, contact the National Rosacea Society. The toll-free number is 800-NO-BLUSH, and its website is www.rosacea.org. The society will keep you up to date with new developments and provide a number of useful tips for controlling rosacea.
DEAR DRS. DONOHUE AND ROACH: I am a 91-year-old male and have a blood test every year in our town's medical center. Last December, my hemoglobin was 13.8, within the normal range of 12.6 to 17.6. I had a recent test, and it was 13.7 -- out of the 14-18 range. Can you explain this? -- C.C.
ANSWER: Hemoglobin is a large protein inside every red blood cell. It's a magnet for oxygen, picking it up as the red blood cells pass through the lungs and delivering it to all body sites in need of it. The hemoglobin value is an estimate of the number of red blood cells a person has. A drop in hemoglobin indicates loss of blood or a decreased production of it. You have a couple of different values for normal. Let me give you one used by a trusted medical reference. It is 13.3 to 16.2 grams/dL for a male. You're safely within the normal range. Furthermore, the change from last December to the present is so small that it should not be a concern. It's within the acceptable error range of the test. If your doctor isn't upset, you don't need to be.
DEAR DRS. DONOHUE AND ROACH: You wrote about dizziness. I had dizziness and was examined by a specialist, who found nothing wrong. My ophthalmologist also checked me and found nothing wrong. At my annual blood test, the platelet count was high, and I saw a hematologist, who diagnosed essential thrombocytosis. I am under treatment and feel much better. People with dizziness should not give up until a cause is found for it. -- C.V.
ANSWER: Essential thrombocytosis is a fairly uncommon condition. It can cause dizziness. Your experience is well worth telling. I'm sure others will follow your lead and pursue the symptom of dizziness until a diagnosis is made. Thank you.
TO READERS: Chronic fatigue syndrome is a mysterious condition that's often overlooked. The booklet on it explains it in detail. To obtain a copy, write to Dr. Donohue -- No. 304, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6. Can. with the recipient's printed name and address. Please allow four weeks for delivery.
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Drs. Donohue and Roach regret that they are unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may write the doctors or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475 or email ToYourGoodHealth@med.cornell.edu with medical questions. Readers also may order health newsletters from www.rbmamall.com.
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