Q: I am 64 and have had rosacea since my 40s, which causes acne and flushing in my face. It seems to be getting worse and I’m starting to feel embarrassed. At times my face is covered in tiny pustules too. I intermittently take low-dose antibiotics for a few months, with limited success.
Having spots and inflammation on your face can be upsetting at any age. People with rosacea often feel cheated – they may have escaped teenage acne, only to find they get spots as an adult. However, rosacea is quite different to acne and affects as many as one in ten people in the UK, mainly in their 30s to 50s.
It can appear in various forms but mostly as persistent facial flushing, visible blood vessels and small bumps or acne-like pustules affecting cheeks, forehead, nose and chin. In some cases it can cause skin thickening, resulting in a slightly bulbous nose with an orangepeel texture. In some cases it affects the eyes and eyelids.
It’s more common in women and those with fair skin, but can affect men as well. Although the cause is not fully understood, we know it’s often triggered by things that tend to cause flushing such as sunshine, exercise, stress and extremes in temperature.
I’m sorry to hear that it is distressing you. In your longer letter you say that sometimes you feel low, as people keep pointing it out and commenting that you’ve had too much to drink or must be too hot. Rosacea can have an impact on mood and enjoyment of life, so it may be worth mentioning this to your GP.
I asked dermatologist Dr Sharon Wong for advice on managing symptoms. Here are her suggestions…
Try to keep a diary to identify what makes it flare up. avoid fragrances and irritants such as some soaps – use products for sensitive skin. emollients for dry skin and oil-free products, such as la roche-posay’s effaclar range, may help. try to avoid rubbing your face – gently pat it dry instead. use an oil-free non-chemical sunscreen of at least spF 30, such as heliocare 360 gel. wear a hat on sunny days. lifestyle triggers such as hot drinks, spicy food, caffeine, alcohol or strenuous exercise can exacerbate flushing. also look at ways to get enough sleep and manage stress.
Try topical treatments
Metronidazole gel is commonly used and azelaic acid, in products such as Differin gel, can ease clogged pores and reduce acne. a new cream called Soolantra (containing ivermectin) can reduce inflammation and pimples.
Cosmetic camouflage such as slightly green-tinted make-up can counteract redness. The charity Changing Faces offers a free skin camouflage service in clinics across the country. Microskin is a new coverup product that’s available at Transform Clinics. It lasts about five days, behaves like skin, doesn’t rub off and is waterproof.
Take oral medication
Antibiotics such as tetracyclines (which reduces inflammation) may help. Betablockers and clonidine work by reducing the tendency to flush. Roaccutane can reduce the size and number of spots, but needs monitoring for side effects.
Have laser treatment
This can reduce or remove visible blood vessels, scarring and disfigurement. It’s rarely available on the NHS but can be done privately.
For more information, go to rosacea.org. For more on microskin, visit transforminglives.co.uk/microskin
Why it’s time to ditch the peeler
I noticed that our potato peeler has made its way to the back of the drawer and that we hardly use it any more.
These days we rarely eat potatoes as they are so high in carbs – we enjoy the less starchy root veg such as swede, carrots, parsnips and celeriac instead. And when we do, we eat the skin, too – even in mash as this is where all the best nutrients are stored. Since carrots have been bred not to have bitter-tasting skin, they no longer need peeling either.
Simply give your veg a good scrub and cut off the odd knobbly bit, then benefit from the extra gut-friendly fibre, leaving your peeler to rust at the back of the drawer.
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