Re: skin getting much worse

[Guest guest]

Sschmitz, you've shared with us your frustration but almost no

specific information other than a constant red face -- which is fine,

but something to consider when you gather specific

cyberrecommendations on what next to do.

Several things to think about: first, although they frequently co-

exist, there are different treatments for the vascular manifestions

of rosacea (such as flushing and spiders) and the inflammatory

manifestions of rosacea (such as pustules and their surrounding

erythema). What works for one manifestation is unlikely to work for

the other so if you have both, improvement in one may not mirror

improvement in the other.

Second, regarding the inflammatory manifestions, a response to each

oral antibiotic can take up to six weeks, and may never manifest

without attention to specifics -- most importantly, maintaining a

constant blood level for the weeks it takes the drug to be taken up

into the skin. Also, it's important to aggressively avoid other foods

and drugs if that's part of the instructions from your doctor or

pharmacist.

It's definitely not like taking antibiotics for a strep throat, where

a response is quick and definite. Here, if you miss a single dose

three weeks into treatment, your blood level drops accordingly, and

it will take 1-2 days to get it back -- and if you miss two doses, it

takes that much longer, all the while without seeing any benefits.

Topical antibiotics tend to work quicker but they too may take a few

weeks to show maximal benefit. They also work best on skin that is

mildly inflamed rather than during a fullblown exacerbation.

But if your rosacea is primarily vascular, antibiotics aren't likely

to make much of an impact on your symptoms.

Third, be very attentive to everything that goes on your face -- not

just medications, since rosacean skin is usually sensitive. When you

say that " everything is making it worse " I wonder if that's not at

least part of the problem. I can personally attest to how easy it is

to defeat beneficial treatments with continued irritation from other

sources like so-called sensitive skin care products.

When a topical agent or skin care product makes the skin worse,

that's a reaction to the product, not worsening of the underlying

rosacea. Once skin is irritated, the epitheial barrier is compromised

and it's easier to make it more irritated, and so it is very easy to

get into a vicious cycle. The epithelial barrier needs to be

protected while it heals, and its critical to avoid further

irritation. I benefitted greatly from stopping all topicals and skin

care products except the most benign cleanser and moisturizer, once a

day.

Finally, if there's a history of chronic alcohol use, it may take

many months to begin seeing vascular improvement on that basis. But

it should improve, especially if you prioritize a well-balanced

healthy diet.

Consider discussing with your physician the benefits of a

consultation with an allergist before the " allergy tests. " A

specialist's input before deciding which/if testing is appropriate

might be very helpful.

Good luck!

Marjorie

Marjorie Lazoff, MD

> I have tried several medications from the dermatologist. All made

my

> skin much worse. Dermatologist told me there was nothing left to do

> but cover it up or use lasers. I've tried gold bond, zinco, disks

and

> several other suggestions on this board. Everything just makes it

> worse. I quit drinking and started drinking lots of water. This

has

> not helped either. My face is always bright red. Next week I'm

> going to my regular doctor and get tested for allergies. Any

> suggestions would be much appreciated.