lumpy/bumpy skin with smaller pics this time

[nimbuszero]

***(reposting this as I couldn't edit the former one once it had been replied to)

So I do have rosacea, although I don't get much in the way of persistent redness other than my ears and a little on my cheeks. My main concern is treating the bumps and whatever else is all over my nose and to some extent, my cheeks. I'm not really sure how to go about this. I don't know if I have the start of rhinophyma or what, I do have the orange peel texture all over my nose though.

What do people recommend? I know some people will say accutane, but if I can smooth out with lasers first then do accutane, that would be great. I just can't see accutane taking that large raised portion away from the red side of my nose all by itself. Any helpful advice would be great, I'm getting fairly desperate here as the bumps seem to be popping up at an alarming rate, and I'm terrified of going to the derm anytime soon, as 80mg daily accutane a few years ago is likely the root of all of this.

Thank you
Justin

http://www.geocities.com/jg_zero/rosacea1.jpg

http://www.geocities.com/jg_zero/rosacea4.jpg

http://www.geocities.com/jg_zero/rosacea5.jpg
Here you can see the elongated persistent lump on the side of my nose, starting near the tip and moving laterally across my nose

http://www.geocities.com/jg_zero/rosacea6.jpg
Same lump on my nose, different angle. Obviously, my skin texture is pretty uneven on my nose

http://www.geocities.com/jg_zero/rosacea2.jpg
You can see here I'm not much of a flusher. Sometimes I flush, especially on the ears and bridge of the nose, but almost nowhere else

http://www.geocities.com/jg_zero/rosacea3.jpg
Not the worst ear flush of all time, but you can see it does exist. When I wake up in the morning, the ear I wake up on stays like this for hours.

It was suggested in the other post that this isn't necessarily an indication of rhinophyma. I really don't know either way. The largest, elongated lump has been there for almost a month now with very little change, which makes me think it isn't the typical papule.

I do not use any creams on my nose, just Neutrogena gentle daily face wash. I've never really had P&P, red anyway, I don't know if some of what is present on my nose my be papules but it doesn't appear to be

[Munch Ausen]

The easiest.

Make an appointment with a Derm and see what they say. From the pictures that you've submitted, I don't see anything wrong at all. Now if you had red cheeks and a red nose, then I'm sure a bunch of people would have some ideas for you.

[nimbuszero]

my nose does get reddish and it does have tenaglastacia on the bridge just below my eyes, but generally it's just super oily with giant pores, and now, bumps. i do have rosacea, i've been burning in my face for a few years, the redness just isn't too bad, more like pinkness.

i am going to hit another derm up soon, they just always seem to make things worse. last time i was put on accutane 40mgsx2 daily and after about three weeks my face had actually swollen up purple. had to go to the emergency room and get some kind of shot to bring the swelling down, and this derm was supposedly a rosacea specialist.

This sucks.

[Quench]

It's very hard to tell from a photograph so I agree that you should see a derm to get a proper diagnosis.

[phlika29]

Well for rosacea I would defintely say that 40mg accutane twice a day is way too high. It shoud be more like 10mg a day or every other day.

Most people have enlarged pores on their nose and its usually abit oilier there aswell not just those with rosacea. If I were just going on your photos I would say that you have very good skin generally and because of that the enlarged pores on your nose probably stand out more.

If you were not getting red on your nose then I would say that perhaps a retinoid gel would help but this can have a real impact on rosacea and so not something I would generally reccomend.

So I saw a derm today and got pretty much the nonsense I was expecting. The large lump on my nose went undiagnosed, which was really the only reason I was there. She was more interested in my seb derm. She figures it is causing swelling to such an intense degree that the large persistent lump on my nose is the result...riiiiiiight. I really don't know what to do. Indianapolis is supposed to be so great for rosacea sensitive dermatologists, but I've tried at least 8 over the past 2 years and they're all either ineffective or making it worse. The tip of my nose doesn't really swell, I just have lumps on the soft tissue away from the cartilage on either side, and the burning is almost unbearable. The redness and capillaries suck, but at least I know I can do something about them. Advice anyone? Should I just head to a laser derm and hope they don't tell me I need a procedure that I don't?

[moomy]

Hi Nimb,

It could be worth seeing a laser doc who has done a lot of work with rosacea. Have your read the q&a with dr crouch. He seems to suggest IPL as a possibility for early nose lumps.

I think most derms are pretty rubbish. Perhaps see if you can find one that someone else with rosacea has found good.

Are you using any topicals??

best wishes
moomy