QUESTION THE GP: How to deal with & # 39; painful & # 39; rosacea, DR MARTIN SCURR answers your health questions
I have been diagnosed with rosacea and find it very, very painful. I use different creams and antibiotics, but the condition does not improve. I'm desperately low and can't go out.
You have my sympathy, because you are clearly concerned about this situation. It is easy for others to expect that people with a cosmetic condition such as rosacea will just tolerate it. But things like this can be a big blow to self-confidence, and we would all want to get rid of it if we could.
Rosacea causes persistent redness and acne-like inflammation spots on the cheeks, nose, chin and forehead. This can be exacerbated by blushing caused by anxiety – setting up a vicious circle, where the suffering of having the condition worsens its appearance.
Rosacea causes persistent redness and acne-like inflammation spots on the cheeks, nose, chin and forehead. Stock photo
Rosacea is a chronic (long-term) condition. For some patients, the symptoms may decrease periodically and then flare up again. Stock photo
Other flushing triggers include hot and cold weather, sunlight, spicy food, alcohol, hot drinks, and caffeine.
Rosacea is a chronic (long-term) condition. For some patients, the symptoms may decrease periodically and then flare up again.
By the way … Nasal medicine will reduce the number of deaths from brain damage
Our brain is the most complex machine ever studied, with more than 86 billion nerve cells and sufficient information processing capacity to store the data of three million hours of TV.
But the brain is not physically stronger than a blank in a tin box; and when shaken properly, blood vessels will rupture and cause bleeding in the closed container of the skull.
This is why any significant influence on the head causes bleeding in the brain, or between the brain and the skull, with an increase in pressure that can be fatal. (It was confirmed last month that "minor" but accumulative damage caused by football can increase the risk that professional players develop dementia.)
Now it seems that there may be a safe, reliable and effective treatment for sudden traumatic brain injury – for example after an accident.
Tranexamic acid has been used for decades in the treatment of nosebleeds, bleeding after tooth extraction and in women with heavy menstruation.
It works by making blood clots more stable and durable, which stops the bleeding,
The same drug that is administered by injection is effective when it is used in patients suffering from blood loss due to a serious trauma. And the sooner it is administered, the better.
Last month, researchers reported that tranexamic acid reduces death from head injury.
Road accidents and falls are the main causes, and although bleeding starts from the moment of the collision, it continues for hours after the injury.
The study, conducted in 175 hospitals in 29 countries, has shown that the death rate of patients with this type of injury is significantly reduced by the drug.
This means groundbreaking progress and paramedics will soon use tranexamic acid for brain injury.
A brilliant but simple find that will save many lives.
The cause is not fully understood. Some experts believe that abnormalities of facial blood vessels are the core of the condition; others think that the skin's immune system has failed.
Another possibility is that the symptoms are caused by a microscopic mite called Demodex folliculorum, which lives harmlessly in the pores of the skin. People with rosacea have unusually high numbers of mites and it is speculated that the symptoms are due to the fact that their skin responds to the mite's waste.
Considering what you are going through, it will feel hard to hear this, but there is no cure, although there are long-term treatments that are usually successful in suppressing the symptoms.
Oral antibiotics are often effective and you say in your longer letter that you are already using one, doxycycline.
There is also a long history of success with the topical drugs metronidazole and azelaic acid.
More recently, brimonidine gel (brand name Mirvaso) – originally designed to treat glaucoma – has also been shown to be effective in reducing and even eliminating the redness of rosacea by narrowing blood vessels and thus reducing blood flow to the face.
Patients with rosacea have a very sensitive facial skin and therefore have difficulty tolerating many skin care products. So wash your face with a non-soap cleaner (for example Cetaphil, which is available at most pharmacies) and avoid toners, astringents or alcohol-based gel or lotion.
Use a mild emollient twice a day for hydration – a medical moisturizer.
Research suggests that softening agents containing glycyrrhetinic acid from licorice root have an anti-inflammatory effect that will help with redness (for example, Atopiclair, available without a prescription).
I also recommend avoiding anything that you notice worsens your symptoms, whether it is direct sunlight, hot drinks or alcohol.
Your doctor can agree to refer you to a dermatologist for advice on the best treatment combination.
I also urge you to discuss the possibility of referral to a therapist such as a psychodermatologist for cognitive behavioral therapy to help you deal with emotional trauma.
Since your redness in the face is undoubtedly exacerbated by your emotional stress, this is a perfectly reasonable request and will almost certainly lead to an improvement in your skin.
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