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Steve asked...

Tags: skin

I have roseacea which manifests itself as postules and papules over my face, around my nose and mouth (as well as redness, which I am less worried about). When it is bad, it looks terrible and I am literally ashamed and embarassed to show my face.

I have tried antibiotic tablets (doxycycline) which improved it for a while, but the effect wore off and the tablets made me feel sick (regardless of when I took them, and with or without food). So I switched to a cream which I apply twice a day. But often it is not enough. Are there any other treatments available to me?

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The Answer

I’m so sorry to hear of the embarrassment that your condition is causing you. It is well-known that rosacea can cause feelings of frustration and low self-esteem because of its chronic nature and because it affects the face.

As I’m sure you have experienced yourself, rosacea is also a relapsing condition and so there are times when the symptoms are particularly bad and then others when they are much less of an issue.

Rosacea is a condition that is poorly understood but it is known that there are several triggers that can cause it to worsen. These include exposure to sunlight, cold and windy weather, stress, alcohol and certain foods etc. Limiting exposure to such triggers is a starting point in reducing the severity of flare-ups.

It is difficult to give you specific information tailored to you because I don’t know which cream you are using and whether you are under the care of a dermatologist etc. Certainly there are several types of creams that can be helpful. Most of these require regular and persistent use for you to gain the best from them.

As you already know, antibiotics are also used, either alone or in combination with a cream. They are particularly used in cases where spots and pustules are more severe. Doxycycline does not suit everybody but there are other possible antibiotics that could be used that you might tolerate better. I think a discussion regarding this with your GP would be worthwhile.

If these types of treatments are not successful, even if used correctly, then in some cases patients are referred to a dermatologist who may consider other options such as isotretinoin. This is a treatment which is more commonly used for severe acne but is sometimes used in rosacea. Due to its side effect profile it can only be prescribed by a consultant. They also sometimes use Laser and Intense Pulsed Light (IPL treatment) which can be useful for severe cases of flushing, redness and visible blood vessel.

If you would like to discuss this in more detail please do not hesitate to contact our Health at Hand team on 0800 003 004.

Answered by Health at Hand nurses.

 

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