I suffer from severe rosacea which has gotten worse since it started about two years ago. Rozex has had a limited effect.
The symptoms come and go in severity, but recently I have also been getting very large spots combined with smaller bumps and pustules.
I’m probably being paranoid, but I don’t want to run into people who know what I looked like before.
CH, by email.
Rosacea is an inflammatory condition that causes facial redness and redness, pustules, and irritation around the eyes.
Dr Martin Scurr responds: Thank you for your question, which highlights the profound, often overlooked, psychological effect that a chronic facial rash can have.
Rosacea is an inflammatory condition that causes facial redness and redness, pustules, and irritation around the eyes. It can also thicken and distort the skin, commonly around the nose. The cause is not clear.
As you well know, there are times when symptoms appear: these include extreme temperatures, sun exposure, spicy foods, and hot drinks.
Anger, frustration, embarrassment, and other mood changes can also worsen the appearance of the skin, possibly related to changes in the nervous system (adrenaline rush, etc., which raises blood pressure, heart rate, and blood pressure). “blush”), which cause rosacea to appear. ). Fortunately, the symptoms can be controlled with treatment.
Rozex, which you have been taking, is a topical gel that contains the antibiotic metronidazole.
A recent and remarkably effective addition to the arsenal is a topical gel containing brimonidine.
There are other effective topical treatments including azelaic acid, ivermectin, and sodium sulfacetamide (all prescription only). Oral antibiotics can also be surprisingly effective: I usually prescribe oxytetracycline or doxycycline.
A recent and remarkably effective addition to the arsenal is a topical gel containing brimonidine.
This was originally developed in the form of eye drops to treat glaucoma, but then patients who also had rosacea reported that the eye drops cascading down their cheeks cleared up facial redness.
This benefit has since been confirmed in studies and there is now a 0.33 percent brimonidine gel available by prescription. Combining this gel with an oral antibiotic could be the best option for you, as it will help you free yourself from the anxieties about your appearance that have come to dominate your life.
I have a strange sound in my left ear and after an MRI my GP told me I have an acoustic neuroma. I’m now waiting to see a specialist, but since I’ve been told it’s not urgent, I could be waiting a long time. I am a musician and I am worried that in the meantime it will grow and cause me deafness. I am 60 years old and otherwise very fit.
AR, London.
Dr Martin Scurr responds: Few things are more terrifying than being told you have a brain tumor, and for you as a musician, anxiety is made worse by the threat of progressive hearing loss.
The sound you can hear is tinnitus, caused by an acoustic neuroma, a growth on the nerve responsible for carrying information about hearing and balance from the inner ear to the brain.
But let me assure you that “tumor” does not, by definition, mean cancer: it is a lump, which in the case of acoustic neuroma is benign.
These tumors are usually very slow growing and are not inherently life-threatening.
They usually appear around age 50 and 95 percent of patients suffer hearing loss, although usually the first sign is tinnitus or dizziness.
If an acoustic neuroma is large, it can affect other nearby nerves, primarily the trigeminal nerve (which runs along the front of the face), which can cause facial numbness or pain; or the facial nerve (which runs from the ear to the front of the face), affecting facial movement or the sense of taste.
Preserving hearing is of utmost importance, but since all treatment options can lead to further hearing deterioration, it is worth taking a cautious approach.
Radiation therapy may shrink the tumor slightly, although its effectiveness in preserving hearing is variable. In many cases, the tumor can be removed by surgery, but this usually does not improve hearing.
Another option is “watchful waiting,” in which your tumor is monitored periodically with more MRI scans (about 50 percent of patients who choose watchful waiting will undergo treatment within five years).
I suggest you talk to your GP about repeating an MRI and hearing test six months after the initial scan. This will give the specialist additional information about how fast your tumor is growing and whether your hearing is declining to inform decisions about your treatment.
I hope this helps you ensure that rushing into early treatment is not essential for you.
