Rosacea??

[BMBM]

Hi

A couple of photos of me here:

http://i444.photobucket.com/albums/q..._/DSC03882.jpg

http://i444.photobucket.com/albums/q..._/DSC03864.jpg

I've had general redness & flushing for several years but have never been to doctor or dermatologist so I'm not sure if it's rosacea or something else. It's not constant and is mainly triggered by heat or stress/anxiety. Before I head off to the GP I thought I'd post my pics here and see what other thought.

Thanks in advance.

[Melissa W]

Hi BMBM,
I just responded to one of your RLT questions.

It's hard to diagnose from a pic as rosacea can look like many different diseases but I would say flushing from heat and anxiety could be signs of rosacea. The doctor may want to do some blood testing to rule out other conditions that may mimic rosacea so definitely a good idea to go and get a proper diagnosis.

Welcome to the forum!

Best wishes,
Melissa

[phlika29]

I is going to be impossible to give a definitive diagnosis over the internet. Perhaps you could describe a bit more about your flushing-where you it occur? what does it feel like? how long it lasts?

Many people who dont have rosacea can get red when they are stressed or hot.

[Brady Barrows]

BMBM,
Yes, it is improbable for even a physician to diagnose rosacea over the internet with two photos and your brief history. Rosacea is a very confusing disease that may be a catch all diagnosis for any facial redness. Flushing is usually associated with rosacea and is therefore the one sign or symptom that distinguishes it from a plethora of skin diseases that mimic rosacea. Basically, a physician will prescribe some prescription medication to see if you respond well to it or if it irritates your condition further. Ruling out skin conditions that mimic rosacea is quite an art and a good dermatologist even has difficulty distinguishing rosacea from a host of other skin diseases that seeing your GP will probably just mean your GP will refer you to a good dermatologist. I have come up with a list of over 54 skin conditions and diseases that look like rosacea so there is no way to diagnose over the internet. There are probably more skin diseases that look like rosacea that I don't know about! A typical visit to a dermatologist will take an hour waiting and you might see the physician for 5 minutes depending on how busy he is and if he has patients waiting after you. From your history he may immediately diagnose you with rosacea and give you some prescription meds either topical, oral or both. It may be that you have rosacea. If you respond well to what he prescribes then you will know. However, if you do have rosacea, you should read as much as you can about it since you may want to learn what all the alternative, as well as the conventional treatments are for this bewildering disease.

[BMBM]

Thanks all for your responses.

My flushing occurs pretty much all over my face and neck and my ears! Sometimes it's on my upper chest also. It's not a bright red but a deeper/darker red and I get a real intense heat in most of my upper body. It generally lasts a long time - several hours some times but luckily it's not like that all the time and I can have a "normal" pale complexion although it tends to be slightly pinkish the majority of the time.

I guess it mainly occurs as a response to heat (hot shower, hot weather), anxiety to social situations (it's a vicious circle!) and certain foods/drinks.

I've taken a number of steps before finding this forum in order to try and improve the condition. I've eliminated a lot of food/drinks (tea/coffee, cheese, processed junk, alcohol) and try to eat as much fruit & vegetables and drink as much water as well. All my shampoos, deodrants etc are chemical free. None of this may have made much difference but I feel better for it.

I also take probiotics and HCl. I found exercise is useful as well. I'm also contemplating RLT.

Thanks again and I'll head off to my GP with lots of knowledge from this forum.

Regards

BMBM

[Peter]

Hello BMBM

Difficult to tell from your pictures whether you have rosacea or not, so worth checking with your GP or if necessary ask for a referral to a dermatologist. A good dermatologist worth his salt should be able to tell you immediately if you have the condition from a visual check and also from your history and symptoms you describe. If you have rosacea then early diagnosis and treatment is essential and should enable you to control it and have normal looking skin.

This is an extract taken from a report on rosacea I posted on the RSC and you might find it helpful especially chapter 2. As you will read there can be other skin conditions that might be confused with rosacea but it will be obvious to an expert dermatologist with a proven track record of treating the condition.

Good luck

Peter

Chapter 1 - What Rosacea Is

Rosacea (pronounced Row-say-sha) is a chronic skin disorder involving abnormal reddening of the skin of the face. The blood vessels become dilated and congested which may cause a permanently flushed appearance which makes the sufferer look as if he/she has spent too long in the sun.

It is punctuated by episodes of acute inflammation with acne-like eruptions. The cheeks and nose are particularly affected though the chin,forehead, ears and neck can be involved. Usually both sides of the face are affected fairly equally. Sometimes the bald area of the scalp in a man may develop rosacea and occasionally patches can appear on other areas such as wrists, legs, chest and back.

Rosacea is very common with an estimated one in a hundred of the general population and one in ten of middle-aged women suffering to some degree though many will only have it mildly.

It is less common in men though it is also probably true that men are less likely to go to their doctor about it unless the condition has become very troublesome. It can affect all age groups including even children but it is most common in the thirty to fifty-fives.

It isn't a serious disorder in that it isn't life­ threatening but it can cause sufferers a lot of embarrassment and distress and may affect their enjoyment of life and possibly work opportunities if they are unwilling to put in for promotion or apply for jobs that would involve direct contact with the general public due to lack of confidence about their appearance.

Rosacea is not infectious and so cannot be passed on to anyone else. It tends to be progressive and may start in the teens with bouts of intense flushing which come and go in response to various triggers but which last longer than a normal blush. They may last for hours. The face will burn and feel uncomfortable but, in the early stages, the skin will return to normal. These bouts may become more persistent in the twenties and some sufferers may develop a permanently flushed appearance.

In the thirties there may be more episodes of inflammation and swelling and the appearance of papules (small raised bumps) and pustules (small white blisters). These may look rather like acne which is why rosacea used to be called adult acne or acne rosacea though the two disorders are not in fact related.

Small blood vessels may become more noticeable as thin red lines known as thread veins or spider veins (or medically as telangiectasia).

Sometimes the nose will redden, swell and enlarge with irregular bumps. This is called rhinophyma and affects mainly men in their late fifties onwards. The ratio of men to women is about twelve to one. This swelling of the nose may be the only sign of rosacea. It usually starts with the tip of the nose and may spread to the rest with the skin becoming thicker and coarser. The colour may vary from red to purple or may remain normal. The skin can become greasy. Occasionally the chin and ears are similarly affected.

There may be eye symptoms too with irritation of the lids and sore, blood-shot eyes which feel gritty. One report estimated that up to 50% of patients have some eye involvement though usually mild. A more serious eye complaint, keratitis, is painful and if not treated could lead to corneal scarring and even blindness. It is important therefore that you get medical advice if you begin to experience eye discomfort.

Another uncommon feature is rosaceous lymphoedema where one or more areas of the face become persistently swollen with a firm feel and possibly only slight reddening. It may fluctuate from day to day and is difficult to treat.

Rosacea tends to be a disease of remissions and flare-ups though these may become less frequent and less severe with time and the redness may become less noticeable. Sometimes it will burn itself out.

Chapter 2 - And What It Isn't

There are several other causes of reddening of the face and it is important to differentiate them from rosacea.

Weather

Exposure to strong winds, sun and cold can cause redness and thickening of the skin giving a weather beaten appearance. This can account for the ruddy complexion of outdoor workers such as farmers.

Alcohol

Heavy drinkers can develop a facial flush which is very similar in appearance to rosacea and some sufferers may be falsely accused of being too fond of the bottle.

Seborrheic Dermatitis

This is a kind of eczema where the skin becomes dry and flaky. It affects the scalp where there is redness and diffuse scaling (dandruff). Red scaly patches can also appear on the face, especially the eyebrows and the sides of the nose, also behind the ears. Often other parts of the body are also affected.

Perioral Dermatitis

This is usually caused by using a steroid cream around the mouth which causes the skin to become inflamed in that area.

Systemic Lupus Erythematosis

This is an auto-immune disorder and can cause a butterfly-shaped rash across the nose and cheeks. There will however be other symptoms such as joint pains, fever, weight loss and muscle weakness.

Drugs

Some medication such as sulphonamides can make the skin sensitive to light which may result in an itchy rash on the face after exposure to the sun.

Allergy

An allergic reaction, possibly to make-up, can also result in an itchy dermatitis with subsequent redness and blistering.

Acne

This chronic inflammatory disorder also affects the face but differs from rosacea in the development of black­heads (comedones) as well as red papules and pustules. Blackheads aren't found in rosacea. Acne tends to affect a younger age group and usually improves spontaneously even without treatment whereas rosacea tends to be progressive.

The sun usually improves acne but for many with rosacea the sun will exacerbate the rash.

It is possible to have both acne and rosacea as they are both common skin disorders.

[phlika29]

You may also like to look at this link:
http://rosacea-research.org/wiki/index.php/Main_Page

[BMBM]

Update

I went to the doctor today and asked if she would refer me to a dermatologist but she said there wouldn't be much benefit in me seeing one! She said it might be the early stages of rosacea but that I should wait and see if it gets worse. She offered me Clonodine instead.

I'm going to have a read up on Clonodine and see if it might be suitable for me. In the meantime I'd still like to see a dermatologist even if I have to go privately.

This might not be the best part of the forum to ask but can anyone recommend a derm in London who will accept a private consultation?

Many Thanks

BMBM

[phlika29]

I think the person you would be best seeing is Dr Chu at Hammersmith Hospital. You can be referred to see him privately (as many of us have) however there are 2 snags-firstly the waiting list for a private consult is about six months and secondly you see have to get your doctor to sort out a private referral for any derm. he really has a great reputation for acne and rosacea.

[BMBM]

Thanks philka. I'll have to try and persuade my doctor to refer me. It's not likely given her response today