Please help me with this (rosacea at nose)

[Bonefish]

I decided to put my pictures here, because "picture tell more than thousand words" Im 18 and I've had this rosacea on my nose now about 4 years (im really starting to doubt is this even rosacea because all the other rosaceapictures i've seen doesn't look like this :o). I've tryed already tetracyclines (3 months), metrogel and some natural products but for those metrogel seems to be only thing which cleared up little bit that upper rosacea-area. Now I am currently taking accutane 20 mg/day and im on second month, but I really can't see difference yet Besides that redness there is lot of sebum inside there. Accutane seems to stopped production of sebum from everywhere else but not at nose :?

Here are the pictures (you really cant see whole thruth for these pictures)

http://personal.inet.fi/clan/bonefish/11.9.2005.jpg
11.9.2005 (still some summer tanning)

http://personal.inet.fi/clan/bonefish/8.1.2006.jpg
8.1.2006 (I sniff my nose that the redness would show up)

http://personal.inet.fi/clan/bonefish/29.1.2006.jpg
29.1.2006

All those triggers gets my nose annoyingly red and it starts to swell. After all my nose looks in any case bigger than it would normally look. Anyone has had same kind of nose or symptoms and got rid of it? Please tell me how. Could I get to surgery for this, because im really already thinking about it. Please help!

[IowaDavid]

The redness and enlarged pores does look like the beginning of phymatous rosacea....but this started when you were 14? Your nose responds to "typical" rosacea triggers by getting red?

20mg accutane/day sounds a bit high for a low-dose treatment course--it may be slowly promoting redness at that dosage. Whatever may be your optimal dose, it can take some people several months to see results from low-dose accutane, so don't be discouraged just yet.

I don't know too much about low-dose accutane, but there are others on this site that have posted about it. Also, you can search the rosacea-support archives Here.

Another option is to go see an IPL doctor and get a test-patch done on your nose--if it's localized right now, treatments for just your nose shouldn't cost too much.

Of course, DON'T get IPL treatments while you're taking accutane because accutane tends to slow wound-healing.

[Bonefish]

Thank you David. Ok, ill talk to my dermatologist about that lower accutanedose and possible IPL treatment if this accutane regiment wont work.

I got this about age 14. And yes, my nose responds those triggers by getting red and also those pores get bigger (I think) which make my nose look even more ugly I really hope that this is not going to be that phymatous nose. Although my father got rosacea and only rosacea at nose area also.

I would like to hear if anyone has had same kind of "noseproblem" and got rid of it because this is really destroying my life

[Bob Bear]

Id go see a good doc, try to get an official diagnosis.

Also, try Dr Nase's book. Full of easy to digest info about rosacea of all flavors.

BB

[Bonefish]

I tryed to find out what laser would be the right one at my nose but couldn't (bad english :?). There are so many lasers.. What laser would you reccomendate? Maybe some kind of "surgic" laser to "destroy" this rosacea? Is this YAG-laser that kind of surgic laser? Of course im going to speak about this with my dermatologist.

[redhotoz]

Hi Bonefish

I don't know a lot about Accutane or lasers. Haven't gone down that path yet. One thing that I have noted from the people who have posted about Accutane is that it has not helped so much with the nose area. Of course, this is different for everyone, but I have noticed quite a few posts like that, when other people also have Rosacea on the rest of their face. That is, Accutane helped with the main part of the face and not so much with the nose.

I don't mean to be pessimistic but it may be worth considering. As IowaDavid suggested, do a search in the archives of the RSG or here in the Forum to see what others have had to say about Accutane and the nose. Maybe something like "Accutane nose" as the key words?

Best of luck!

Jen

[adyus]

Hi Bonefish

I don't know a lot about Accutane or lasers. Haven't gone down that path yet. One thing that I have noted from the people who have posted about Accutane is that it has not helped so much with the nose area. Of course, this is different for everyone, but I have noticed quite a few posts like that, when other people also have Rosacea on the rest of their face. That is, Accutane helped with the main part of the face and not so much with the nose.

I don't mean to be pessimistic but it may be worth considering. As IowaDavid suggested, do a search in the archives of the RSG or here in the Forum to see what others have had to say about Accutane and the nose. Maybe something like "Accutane nose" as the key words?

Best of luck!

Jen

Actually, I know that accutane is among the few options for rhinophyma.

A quick google search for "rhinophyma" and "accutane" will get alot of search results. For example:
http://www.nlm.nih.gov/medlineplus/e...cle/001037.htm

Bonefish, you should also search this forum and the R-S yahoo group for factual cases of accutane used for rhinophyma. Like Jen said, good search terms are "accutane" and "nose".

I have saved some articles and posts on another computer, send me a PM if you want me to mail them to you.

Best wishes,

Adrian

[Lisa M]

Hi B, after 3.5 weeks of Accutane 10 mg/day, my nose was 75% back to normal.

Do it. It's like nothing else.

Just don't let your dermatologist mess around wi/dosage.
You'll be able to get a sense of what's working for people under the Accutane thread.

[Bonefish]

Thank you all lot of your answers. For Lisa M, maybe you didn't notice but I mentioned at my starting post that im already taking accutane. I've been accutane exactly 2 months now but I can't see any difference. Was your nose looking same as mine? How long you had that rosacea at nose before starting accutane? And did you use any other products while taking accutane? That 3,5 weeks (or months?) is really amazing time for healing so much. But congratulations for you anyway

I found lots of posts of those using accutane also at nose area and most of them were taking low-dose. It's hard to believe that it would work, because at this 20mg/day -dose, I haven't see any difference. If that low-dose (5-10 mg?) would work, I would believe that this dose would show even a little bit signs of healing. But no.. Im considering that anyway.

I don't think my derm can help me much at this decision because he seems like really unprofessional at rosacea-patients. At first visit many months ago, he ordered me cortisone! Maybe because that sebum..

Maybe this is not rosacea but some kind of pre-stage rhinophyma... dont know.. But im really starting to think that some kind of surgic operation (laser) is going to be my only change

[adyus]

I found lots of posts of those using accutane also at nose area and most of them were taking low-dose. It's hard to believe that it would work, because at this 20mg/day -dose, I haven't see any difference. If that low-dose (5-10 mg?) would work, I would believe that this dose would show even a little bit signs of healing. But no.. Im considering that anyway.

To make an analogy: When you have a flu and you take antibiotics, you take 500mg/day for 10 days for example. If you were to take 5000 mg in just one day, that would be very messy. It's not a perfect analogy, but you see the point.

From what I understand, the idea behind accutane for rosacea treatment is to take it low-dose for a long period of time. Some doctors started testing and they saw that low dose yielded the best results, and the high dosage used for acne made some people worse than before. I guess that is what happenned.

If I were you, I would lower my dosage and see what happens. You haven't anything to lose. I think you'll find in that archive, text abstracts from clinical trials regarding low dose accutane. You could show them to your doctor. Like I said in the PM, I'll send it tomorrow.

Best wishes,

Adrian