might flushing itself worsen rosacea?

[Guest guest]

I exercise 3-4 days a week (step aerobics class). My face turns red as a beet

from the exertion, and doesn't return to normal for an hour or more after

exercise. I have seen no short-term adverse effects from this. That is, my

face returns to its pre-exercise look within a few hours after I exercise, and

the exercise does not trigger a rosacea flare-up.

My question is this - am I causing any permanent damage to my skin? Could I be

damaging my blood vessels, or causing any other long-term damage whose effects

are not yet visible to me? I'm wondering if flushing itself could be causing

long-term problems that might not be apparent now - I am not having any

short-term problems with severe flushing 3-4 times a week. Any opinions on this?

Naomi

-----Original Message-----

From: nightrun22

-I agree with a lot said in the above posts,excercise is very

important,I excercise in a very cold gym with fans blowing on me,and

I lift heavy weights, 4 times a week.I prefer to do my cardio at

home,I flush more during cardio.excercise is so good for overall

health,and self esteem ,many people without rosacea flush while they

excercise too!!!!!!!!!! so you can kinda blend in.

[Guest guest]

I exercise 3-4 days a week (step aerobics class). My face turns red as a beet

from the exertion, and doesn't return to normal for an hour or more after

exercise. I have seen no short-term adverse effects from this. That is, my

face returns to its pre-exercise look within a few hours after I exercise, and

the exercise does not trigger a rosacea flare-up.

My question is this - am I causing any permanent damage to my skin? Could I be

damaging my blood vessels, or causing any other long-term damage whose effects

are not yet visible to me? I'm wondering if flushing itself could be causing

long-term problems that might not be apparent now - I am not having any

short-term problems with severe flushing 3-4 times a week. Any opinions on this?

Naomi

-----Original Message-----

From: nightrun22

-I agree with a lot said in the above posts,excercise is very

important,I excercise in a very cold gym with fans blowing on me,and

I lift heavy weights, 4 times a week.I prefer to do my cardio at

home,I flush more during cardio.excercise is so good for overall

health,and self esteem ,many people without rosacea flush while they

excercise too!!!!!!!!!! so you can kinda blend in.

[Guest guest]

Naomi: Wow, you must be in great shape You can certainly

exercise, but may want to modify your routine. According to Dr. Nase

and in my experience, flushing and blushing are the heart of rosacea

and may slowly cause it to worsen. The basic strategy for slowing

progression is to avoid as many flushing/blushing triggers as you

can. You may want to drink cold water while exercising or try

exercises that dont make you beet red. Some try swimming or just

take a few breaks while exercising. I find weight bearing exercise

is just as beneficial as cardio at keeping my metabolism up and

feeling healthy. Maybe you could do just a short 15 minute cardio,

then some weights for a while, then more cardio. Some also spray

cool water on the face while exercising.

Patty

> I exercise 3-4 days a week (step aerobics class). My face turns

red as a beet from the exertion, and doesn't return to normal for an

hour or more after exercise. I have seen no short-term adverse

effects from this. That is, my face returns to its pre-exercise look

within a few hours after I exercise, and the exercise does not

trigger a rosacea flare-up.

>

> My question is this - am I causing any permanent damage to my

skin? Could I be damaging my blood vessels, or causing any other

long-term damage whose effects are not yet visible to me? I'm

wondering if flushing itself could be causing long-term problems that

might not be apparent now - I am not having any short-term problems

with severe flushing 3-4 times a week. Any opinions on this?

>

> Naomi

>

> -----Original Message-----

> From: nightrun22 [mailto:nightrun22@y...]

>

> -I agree with a lot said in the above posts,excercise is very

> important,I excercise in a very cold gym with fans blowing on

me,and

> I lift heavy weights, 4 times a week.I prefer to do my cardio at

> home,I flush more during cardio.excercise is so good for overall

> health,and self esteem ,many people without rosacea flush while

they

> excercise too!!!!!!!!!! so you can kinda blend in.

>

>

>

[Guest guest]

Naomi: Wow, you must be in great shape You can certainly

exercise, but may want to modify your routine. According to Dr. Nase

and in my experience, flushing and blushing are the heart of rosacea

and may slowly cause it to worsen. The basic strategy for slowing

progression is to avoid as many flushing/blushing triggers as you

can. You may want to drink cold water while exercising or try

exercises that dont make you beet red. Some try swimming or just

take a few breaks while exercising. I find weight bearing exercise

is just as beneficial as cardio at keeping my metabolism up and

feeling healthy. Maybe you could do just a short 15 minute cardio,

then some weights for a while, then more cardio. Some also spray

cool water on the face while exercising.

Patty

> I exercise 3-4 days a week (step aerobics class). My face turns

red as a beet from the exertion, and doesn't return to normal for an

hour or more after exercise. I have seen no short-term adverse

effects from this. That is, my face returns to its pre-exercise look

within a few hours after I exercise, and the exercise does not

trigger a rosacea flare-up.

>

> My question is this - am I causing any permanent damage to my

skin? Could I be damaging my blood vessels, or causing any other

long-term damage whose effects are not yet visible to me? I'm

wondering if flushing itself could be causing long-term problems that

might not be apparent now - I am not having any short-term problems

with severe flushing 3-4 times a week. Any opinions on this?

>

> Naomi

>

> -----Original Message-----

> From: nightrun22 [mailto:nightrun22@y...]

>

> -I agree with a lot said in the above posts,excercise is very

> important,I excercise in a very cold gym with fans blowing on

me,and

> I lift heavy weights, 4 times a week.I prefer to do my cardio at

> home,I flush more during cardio.excercise is so good for overall

> health,and self esteem ,many people without rosacea flush while

they

> excercise too!!!!!!!!!! so you can kinda blend in.

>

>

>

[Guest guest]

Good question, Naomi. I have just read Patty's response to your post, where

is quotes Dr. Nase, but even without reading his book, my own suspicion is

that it is like any other chronic condition and it is best not to aggravate

it.

However, that said, it is not that easy in reality, at least for some of us.

I am very fair- skinned, and I always got very red from exercise or any

physical activity. As much as I try to avoid it, it is almost impossible for

me. Even gardening makes me flush, and it is usually takes me a while to

return to my normal much paler self. I would say between half an hour to an

hour, depending on how serious it is. I got pretty red this morning - and

all I did was cut the grass (though on a rather large and steep area, where

I have to navigate carefully and hold the lawn mower at an angle for which

it definitely was not designed.

A few months back, I tried hard to avoid getting red, but for me it is

Mission Impossible. So I just do what I need to do, and then wait for my

face to get back to normal. Fortunately, if I get flushed from physical

activity, it doesn't affect my face for the rest of the day (I mean it

doesn't cause me to flush more easily after the inital flush) - though of

course I would have preferred to completely eliminate it.

Alena

might flushing itself worsen rosacea?

> I exercise 3-4 days a week (step aerobics class). My face turns red as a

beet from the exertion, and doesn't return to normal for an hour or more

after exercise. I have seen no short-term adverse effects from this. That

is, my face returns to its pre-exercise look within a few hours after I

exercise, and the exercise does not trigger a rosacea flare-up.

>

> My question is this - am I causing any permanent damage to my skin? Could

I be damaging my blood vessels, or causing any other long-term damage whose

effects are not yet visible to me? I'm wondering if flushing itself could be

causing long-term problems that might not be apparent now - I am not having

any short-term problems with severe flushing 3-4 times a week. Any opinions

on this?

>

> Naomi

[Guest guest]

Good question, Naomi. I have just read Patty's response to your post, where

is quotes Dr. Nase, but even without reading his book, my own suspicion is

that it is like any other chronic condition and it is best not to aggravate

it.

However, that said, it is not that easy in reality, at least for some of us.

I am very fair- skinned, and I always got very red from exercise or any

physical activity. As much as I try to avoid it, it is almost impossible for

me. Even gardening makes me flush, and it is usually takes me a while to

return to my normal much paler self. I would say between half an hour to an

hour, depending on how serious it is. I got pretty red this morning - and

all I did was cut the grass (though on a rather large and steep area, where

I have to navigate carefully and hold the lawn mower at an angle for which

it definitely was not designed.

A few months back, I tried hard to avoid getting red, but for me it is

Mission Impossible. So I just do what I need to do, and then wait for my

face to get back to normal. Fortunately, if I get flushed from physical

activity, it doesn't affect my face for the rest of the day (I mean it

doesn't cause me to flush more easily after the inital flush) - though of

course I would have preferred to completely eliminate it.

Alena

might flushing itself worsen rosacea?

> I exercise 3-4 days a week (step aerobics class). My face turns red as a

beet from the exertion, and doesn't return to normal for an hour or more

after exercise. I have seen no short-term adverse effects from this. That

is, my face returns to its pre-exercise look within a few hours after I

exercise, and the exercise does not trigger a rosacea flare-up.

>

> My question is this - am I causing any permanent damage to my skin? Could

I be damaging my blood vessels, or causing any other long-term damage whose

effects are not yet visible to me? I'm wondering if flushing itself could be

causing long-term problems that might not be apparent now - I am not having

any short-term problems with severe flushing 3-4 times a week. Any opinions

on this?

>

> Naomi

[Guest guest]

Yes, it's impossible to prevent all flushing/blushing, I agree.

I should say that in my post I was going on memory as to what I

learned from Dr. Nases book. After reading it I simply understood

that preventing flushing/blushing as much as possible would help slow

the progression.

Patty

> Good question, Naomi. I have just read Patty's response to your

post, where

> is quotes Dr. Nase, but even without reading his book, my own

suspicion is

> that it is like any other chronic condition and it is best not to

aggravate

> it.

> However, that said, it is not that easy in reality, at least for

some of us.

> I am very fair- skinned, and I always got very red from exercise or

any

> physical activity. As much as I try to avoid it, it is almost

impossible for

> me. Even gardening makes me flush, and it is usually takes me a

while to

> return to my normal much paler self. I would say between half an

hour to an

> hour, depending on how serious it is. I got pretty red this

morning - and

> all I did was cut the grass (though on a rather large and steep

area, where

> I have to navigate carefully and hold the lawn mower at an angle

for which

> it definitely was not designed.

> A few months back, I tried hard to avoid getting red, but for me it

is

> Mission Impossible. So I just do what I need to do, and then wait

for my

> face to get back to normal. Fortunately, if I get flushed from

physical

> activity, it doesn't affect my face for the rest of the day (I mean

it

> doesn't cause me to flush more easily after the inital flush) -

though of

> course I would have preferred to completely eliminate it.

>

> Alena

> might flushing itself worsen rosacea?

>

>

> > I exercise 3-4 days a week (step aerobics class). My face turns

red as a

> beet from the exertion, and doesn't return to normal for an hour or

more

> after exercise. I have seen no short-term adverse effects from

this. That

> is, my face returns to its pre-exercise look within a few hours

after I

> exercise, and the exercise does not trigger a rosacea flare-up.

> >

> > My question is this - am I causing any permanent damage to my

skin? Could

> I be damaging my blood vessels, or causing any other long-term

damage whose

> effects are not yet visible to me? I'm wondering if flushing itself

could be

> causing long-term problems that might not be apparent now - I am

not having

> any short-term problems with severe flushing 3-4 times a week. Any

opinions

> on this?

> >

> > Naomi

[Guest guest]

Yes, it's impossible to prevent all flushing/blushing, I agree.

I should say that in my post I was going on memory as to what I

learned from Dr. Nases book. After reading it I simply understood

that preventing flushing/blushing as much as possible would help slow

the progression.

Patty

> Good question, Naomi. I have just read Patty's response to your

post, where

> is quotes Dr. Nase, but even without reading his book, my own

suspicion is

> that it is like any other chronic condition and it is best not to

aggravate

> it.

> However, that said, it is not that easy in reality, at least for

some of us.

> I am very fair- skinned, and I always got very red from exercise or

any

> physical activity. As much as I try to avoid it, it is almost

impossible for

> me. Even gardening makes me flush, and it is usually takes me a

while to

> return to my normal much paler self. I would say between half an

hour to an

> hour, depending on how serious it is. I got pretty red this

morning - and

> all I did was cut the grass (though on a rather large and steep

area, where

> I have to navigate carefully and hold the lawn mower at an angle

for which

> it definitely was not designed.

> A few months back, I tried hard to avoid getting red, but for me it

is

> Mission Impossible. So I just do what I need to do, and then wait

for my

> face to get back to normal. Fortunately, if I get flushed from

physical

> activity, it doesn't affect my face for the rest of the day (I mean

it

> doesn't cause me to flush more easily after the inital flush) -

though of

> course I would have preferred to completely eliminate it.

>

> Alena

> might flushing itself worsen rosacea?

>

>

> > I exercise 3-4 days a week (step aerobics class). My face turns

red as a

> beet from the exertion, and doesn't return to normal for an hour or

more

> after exercise. I have seen no short-term adverse effects from

this. That

> is, my face returns to its pre-exercise look within a few hours

after I

> exercise, and the exercise does not trigger a rosacea flare-up.

> >

> > My question is this - am I causing any permanent damage to my

skin? Could

> I be damaging my blood vessels, or causing any other long-term

damage whose

> effects are not yet visible to me? I'm wondering if flushing itself

could be

> causing long-term problems that might not be apparent now - I am

not having

> any short-term problems with severe flushing 3-4 times a week. Any

opinions

> on this?

> >

> > Naomi

[Guest guest]

Yes! I also " do what I need to do " . I'm not ready to give up the form of

exercise I love. I've changed my diet, I avoid alcohol completely, I'm

extremely careful about what I put on my face, I avoid the sun, I don't let my

face get to where it's *painfully* flushed when I exercise, but I'm not ready to

give up aerobic exercise and some amount of flushing that occurs with it.

Aerobics is keeping the whole rest of my body healthy (except for maybe making

the blood vessels in my face worse) and is certainly wonderful for my mental

health as well. Over all, even if it worsens my face, in balance I'm still

ahead of where I'd be without aerobics.

Still, I'm going to hate to be 65 with a permanently red, raw face, and to

regret not having known that all the aerobic exercise years earlier caused it.

I'm still not sure whether I need to cut back on the exercise-induced flushing.

Right now, my rosacea is only moderate. I hope I'm not doing something that

might make it severe.

-----Original Message-----

From: Alena Coufalova

Good question, Naomi. I have just read Patty's response to your post, where

is quotes Dr. Nase, but even without reading his book, my own suspicion is

that it is like any other chronic condition and it is best not to aggravate

it.

However, that said, it is not that easy in reality, at least for some of us.

I am very fair- skinned, and I always got very red from exercise or any

physical activity. As much as I try to avoid it, it is almost impossible for

me. Even gardening makes me flush, and it is usually takes me a while to

return to my normal much paler self. I would say between half an hour to an

hour, depending on how serious it is. I got pretty red this morning - and

all I did was cut the grass (though on a rather large and steep area, where

I have to navigate carefully and hold the lawn mower at an angle for which

it definitely was not designed.

A few months back, I tried hard to avoid getting red, but for me it is

Mission Impossible. So I just do what I need to do, and then wait for my

face to get back to normal. Fortunately, if I get flushed from physical

activity, it doesn't affect my face for the rest of the day (I mean it

doesn't cause me to flush more easily after the inital flush) - though of

course I would have preferred to completely eliminate it.

Alena

----- Original Message -----

> I exercise 3-4 days a week (step aerobics class). My face turns red as a

beet from the exertion, and doesn't return to normal for an hour or more

after exercise. I have seen no short-term adverse effects from this. That

is, my face returns to its pre-exercise look within a few hours after I

exercise, and the exercise does not trigger a rosacea flare-up.

>

> My question is this - am I causing any permanent damage to my skin? Could

I be damaging my blood vessels, or causing any other long-term damage whose

effects are not yet visible to me? I'm wondering if flushing itself could be

causing long-term problems that might not be apparent now - I am not having

any short-term problems with severe flushing 3-4 times a week. Any opinions

on this?

>

> Naomi

[Guest guest]

Yes! I also " do what I need to do " . I'm not ready to give up the form of

exercise I love. I've changed my diet, I avoid alcohol completely, I'm

extremely careful about what I put on my face, I avoid the sun, I don't let my

face get to where it's *painfully* flushed when I exercise, but I'm not ready to

give up aerobic exercise and some amount of flushing that occurs with it.

Aerobics is keeping the whole rest of my body healthy (except for maybe making

the blood vessels in my face worse) and is certainly wonderful for my mental

health as well. Over all, even if it worsens my face, in balance I'm still

ahead of where I'd be without aerobics.

Still, I'm going to hate to be 65 with a permanently red, raw face, and to

regret not having known that all the aerobic exercise years earlier caused it.

I'm still not sure whether I need to cut back on the exercise-induced flushing.

Right now, my rosacea is only moderate. I hope I'm not doing something that

might make it severe.

-----Original Message-----

From: Alena Coufalova

Good question, Naomi. I have just read Patty's response to your post, where

is quotes Dr. Nase, but even without reading his book, my own suspicion is

that it is like any other chronic condition and it is best not to aggravate

it.

However, that said, it is not that easy in reality, at least for some of us.

I am very fair- skinned, and I always got very red from exercise or any

physical activity. As much as I try to avoid it, it is almost impossible for

me. Even gardening makes me flush, and it is usually takes me a while to

return to my normal much paler self. I would say between half an hour to an

hour, depending on how serious it is. I got pretty red this morning - and

all I did was cut the grass (though on a rather large and steep area, where

I have to navigate carefully and hold the lawn mower at an angle for which

it definitely was not designed.

A few months back, I tried hard to avoid getting red, but for me it is

Mission Impossible. So I just do what I need to do, and then wait for my

face to get back to normal. Fortunately, if I get flushed from physical

activity, it doesn't affect my face for the rest of the day (I mean it

doesn't cause me to flush more easily after the inital flush) - though of

course I would have preferred to completely eliminate it.

Alena

----- Original Message -----

> I exercise 3-4 days a week (step aerobics class). My face turns red as a

beet from the exertion, and doesn't return to normal for an hour or more

after exercise. I have seen no short-term adverse effects from this. That

is, my face returns to its pre-exercise look within a few hours after I

exercise, and the exercise does not trigger a rosacea flare-up.

>

> My question is this - am I causing any permanent damage to my skin? Could

I be damaging my blood vessels, or causing any other long-term damage whose

effects are not yet visible to me? I'm wondering if flushing itself could be

causing long-term problems that might not be apparent now - I am not having

any short-term problems with severe flushing 3-4 times a week. Any opinions

on this?

>

> Naomi

[Guest guest]

Does Dr. Nase present any evidence, any studies, that flushing itself can worsen

rosacea? I have not read his book, but his Web site, as well as things people

have posted to this board about his book, gave me the impression that his book

contains theories based on his knowledge of the vascular system, and anecdotal

evidence. I certainly may be mistaken, but that is the impression I have.

Naomi

-----Original Message-----

From: aaclouti

Yes, it's impossible to prevent all flushing/blushing, I agree.

I should say that in my post I was going on memory as to what I

learned from Dr. Nases book. After reading it I simply understood

that preventing flushing/blushing as much as possible would help slow

the progression.

Patty

[Guest guest]

Does Dr. Nase present any evidence, any studies, that flushing itself can worsen

rosacea? I have not read his book, but his Web site, as well as things people

have posted to this board about his book, gave me the impression that his book

contains theories based on his knowledge of the vascular system, and anecdotal

evidence. I certainly may be mistaken, but that is the impression I have.

Naomi

-----Original Message-----

From: aaclouti

Yes, it's impossible to prevent all flushing/blushing, I agree.

I should say that in my post I was going on memory as to what I

learned from Dr. Nases book. After reading it I simply understood

that preventing flushing/blushing as much as possible would help slow

the progression.

Patty

[Guest guest]

is there any real way to prevent it? i get a nose flush every day at

10 am no matter where i am or what ive eaten. then around 6 or 7 pm

i get a face flush no matter where i am/what ive eaten . and from

8:30pm-3:30 AM i get a nose flush (sometimes nose swelling too)that

lasts for at least 4 hours and sometimes accomodating facial flush.

honestly its really hard to concentrate on anythign when my nose

feels that way because even bREATHING seems to prolong it. ive tried

nose sprays, antihistamines, tagamet, zantac , etc. even when i

practice doing meditation, biofeedback , deep breathing, or even

praying, ill get these flushes no matter what. for me its far beyond

just being " red " or pink anymore...its the physical discomfort thats

the most unbearable.

my naturopath seems to think my adrenals might be off. i need to get

this thing under controlb efore i go back to school . thinking of

turnin gto chinese medicine... ive found about 20 posts from

different people in the archives and i'd say its 50/50 success rate.

some swear by it, others absolutely hated it and was a waste of

money. but i guess it all depends on the individual. (As well as the

practitioner)

grumble .

> > Good question, Naomi. I have just read Patty's response to your

> post, where

> > is quotes Dr. Nase, but even without reading his book, my own

> suspicion is

> > that it is like any other chronic condition and it is best not to

> aggravate

> > it.

> > However, that said, it is not that easy in reality, at least for

> some of us.

> > I am very fair- skinned, and I always got very red from exercise

or

> any

> > physical activity. As much as I try to avoid it, it is almost

> impossible for

> > me. Even gardening makes me flush, and it is usually takes me a

> while to

> > return to my normal much paler self. I would say between half an

> hour to an

> > hour, depending on how serious it is. I got pretty red this

> morning - and

> > all I did was cut the grass (though on a rather large and steep

> area, where

> > I have to navigate carefully and hold the lawn mower at an angle

> for which

> > it definitely was not designed.

> > A few months back, I tried hard to avoid getting red, but for me

it

> is

> > Mission Impossible. So I just do what I need to do, and then wait

> for my

> > face to get back to normal. Fortunately, if I get flushed from

> physical

> > activity, it doesn't affect my face for the rest of the day (I

mean

> it

> > doesn't cause me to flush more easily after the inital flush) -

> though of

> > course I would have preferred to completely eliminate it.

> >

> > Alena

> > might flushing itself worsen rosacea?

> >

> >

> > > I exercise 3-4 days a week (step aerobics class). My face

turns

> red as a

> > beet from the exertion, and doesn't return to normal for an hour

or

> more

> > after exercise. I have seen no short-term adverse effects from

> this. That

> > is, my face returns to its pre-exercise look within a few hours

> after I

> > exercise, and the exercise does not trigger a rosacea flare-up.

> > >

> > > My question is this - am I causing any permanent damage to my

> skin? Could

> > I be damaging my blood vessels, or causing any other long-term

> damage whose

> > effects are not yet visible to me? I'm wondering if flushing

itself

> could be

> > causing long-term problems that might not be apparent now - I am

> not having

> > any short-term problems with severe flushing 3-4 times a week.

Any

> opinions

> > on this?

> > >

> > > Naomi

[Guest guest]

is there any real way to prevent it? i get a nose flush every day at

10 am no matter where i am or what ive eaten. then around 6 or 7 pm

i get a face flush no matter where i am/what ive eaten . and from

8:30pm-3:30 AM i get a nose flush (sometimes nose swelling too)that

lasts for at least 4 hours and sometimes accomodating facial flush.

honestly its really hard to concentrate on anythign when my nose

feels that way because even bREATHING seems to prolong it. ive tried

nose sprays, antihistamines, tagamet, zantac , etc. even when i

practice doing meditation, biofeedback , deep breathing, or even

praying, ill get these flushes no matter what. for me its far beyond

just being " red " or pink anymore...its the physical discomfort thats

the most unbearable.

my naturopath seems to think my adrenals might be off. i need to get

this thing under controlb efore i go back to school . thinking of

turnin gto chinese medicine... ive found about 20 posts from

different people in the archives and i'd say its 50/50 success rate.

some swear by it, others absolutely hated it and was a waste of

money. but i guess it all depends on the individual. (As well as the

practitioner)

grumble .

> > Good question, Naomi. I have just read Patty's response to your

> post, where

> > is quotes Dr. Nase, but even without reading his book, my own

> suspicion is

> > that it is like any other chronic condition and it is best not to

> aggravate

> > it.

> > However, that said, it is not that easy in reality, at least for

> some of us.

> > I am very fair- skinned, and I always got very red from exercise

or

> any

> > physical activity. As much as I try to avoid it, it is almost

> impossible for

> > me. Even gardening makes me flush, and it is usually takes me a

> while to

> > return to my normal much paler self. I would say between half an

> hour to an

> > hour, depending on how serious it is. I got pretty red this

> morning - and

> > all I did was cut the grass (though on a rather large and steep

> area, where

> > I have to navigate carefully and hold the lawn mower at an angle

> for which

> > it definitely was not designed.

> > A few months back, I tried hard to avoid getting red, but for me

it

> is

> > Mission Impossible. So I just do what I need to do, and then wait

> for my

> > face to get back to normal. Fortunately, if I get flushed from

> physical

> > activity, it doesn't affect my face for the rest of the day (I

mean

> it

> > doesn't cause me to flush more easily after the inital flush) -

> though of

> > course I would have preferred to completely eliminate it.

> >

> > Alena

> > might flushing itself worsen rosacea?

> >

> >

> > > I exercise 3-4 days a week (step aerobics class). My face

turns

> red as a

> > beet from the exertion, and doesn't return to normal for an hour

or

> more

> > after exercise. I have seen no short-term adverse effects from

> this. That

> > is, my face returns to its pre-exercise look within a few hours

> after I

> > exercise, and the exercise does not trigger a rosacea flare-up.

> > >

> > > My question is this - am I causing any permanent damage to my

> skin? Could

> > I be damaging my blood vessels, or causing any other long-term

> damage whose

> > effects are not yet visible to me? I'm wondering if flushing

itself

> could be

> > causing long-term problems that might not be apparent now - I am

> not having

> > any short-term problems with severe flushing 3-4 times a week.

Any

> opinions

> > on this?

> > >

> > > Naomi

[Guest guest]

Just my 2p here. I found that when I took Moxonidine, flushing to

exercise (swimming) was reduced...

Nearly all rosacea experts (I'm thinking Wilkinson as well as Nase

here) advokate flushing avoidance as a way of reducing the progress

of rosacea.

.

> Does Dr. Nase present any evidence, any studies, that flushing

itself can worsen rosacea? I have not read his book, but his Web

site, as well as things people have posted to this board about his

book, gave me the impression that his book contains theories based

on his knowledge of the vascular system, and anecdotal evidence. I

certainly may be mistaken, but that is the impression I have.

[Guest guest]

Just my 2p here. I found that when I took Moxonidine, flushing to

exercise (swimming) was reduced...

Nearly all rosacea experts (I'm thinking Wilkinson as well as Nase

here) advokate flushing avoidance as a way of reducing the progress

of rosacea.

.

> Does Dr. Nase present any evidence, any studies, that flushing

itself can worsen rosacea? I have not read his book, but his Web

site, as well as things people have posted to this board about his

book, gave me the impression that his book contains theories based

on his knowledge of the vascular system, and anecdotal evidence. I

certainly may be mistaken, but that is the impression I have.

[Guest guest]

> My question is this - am I causing any permanent damage to my

> skin? Could I be damaging my blood vessels, or causing any other

> long-term damage whose effects are not yet visible to me? I'm

> wondering if flushing itself could be causing long-term problems

> that might not be apparent now - I am not having any short-term

> problems with severe flushing 3-4 times a week. Any opinions on

> this?

You're right, it is just opinion, Naomi, no one knows. For Dr. Nase

and others who believe that rosacea is primarily a progressive

vascular disorder, limiting flushing episodes is critical because

flushing actively damages rosacean vessels.

But even they must acknowledge that there's no documentation

supporting the relationship between continued flushing and worsening

rosacea. It doesn't seem to follow clinically either, since the

active symptoms of rosacea often become less of a problem after

middle age rather than -- as one would expect from this theory --

continuing to worsen into one's senior years. (Although this may well

be attributed to age-related factors counterbalancing the progression

of rosacea, such as decreased nerve sensation, decreased immune

response, and less aggressive changes in blood flow).

And even if there is a relationship, no one knows to what extent, in

other words, how much flushing is too much. It may be a linear

relationship -- the more one flushes, the more rosacea progresses. Or

it may be a threshold situation, where flushing up to several times a

day is OK, but no more than that. Or, it may be the degree of

flushing, where hundreds of tiny blushes is fine, but one major flush

is not. It may be that judiciously avoiding 99% of flushing makes no

difference if one good flush a year is all it takes to progress the

condition for that year. Or, it may be that continued flushing does

worsen rosacea but only in the presence of xxxxx, or it is only a

minor factor compared with yyyyy (where everyone fills in the x's and

y's according to one own's belief system, because we don't know the

answers to that either. <g>)

This group is very strongly focused on the above theory, so that's

all that's being discussed here. But consider another view: flushing

as a manifestation of rosacea, not a cause or contributing factor?

As an analogy, consider someone who keeps falling down and bruising

their knees. Would preventing their knees from bruising help their

clumsiness if it were due to a progressive cerebellar disease, or

poorly fitting high heels, or a rocky terrain?

(As an aside, this may explain why even successful photo treatments

need to be repeated throughout one's life. Those who treat flushing

with lasers and related technology may want to believe -- and/or have

their patients believe -- they are treating the underlying condition.

That's the heart of the theory discussed above. But even if

effective, it may be no different than the success of laser therapy

for telangiectasias -- treating the manifestation of rosacea, not the

condition itself. That's not necessarily bad, esp for those who are

hypersensitive about their flushing, but it takes it out of the realm

of medical therapy and into the world of cosmetic treatments.)

From a mainstream medical perspective, the recommendation is to avoid

triggers that cause flushing, though there is no data I can find

supporting that recommendation. But this is not deep knowledge, it

probably springs from the same common sense reflected in the joke:

Patient: Doc, it hurts when I do this

Doctor: So stop doing it

In other words, if you want to stop flushing when eating spicy foods,

stop eating spicy foods. <g>

Seriously, for those whose sole manifestion is flushing, such as pre-

rosaceans, it makes intuitive sense to avoid unnecessary flushing

because continual flushing theoretically encourages telangectiasias,

one of the end-stage features of rosacea. In other words, in

individuals predisposed to developing telangectiasias (no one knows

why rosaceans are so predisposed), it makes sense not to overload the

vasculature unnecessarily with added blood flow. But again, who knows

how much blood flow is too much? Plus, telangectiasias are common on

non-rosaceans who don't flush easily or even at all. But in any case,

for rosaceans, telangiectasias in themselves are only a cosmetic

issue and can usually be erased with laser surgery if there's enough

concern and money.

Even in the worst case scenario, avoiding flushing will never be in

the same league as avoiding high blood pressure, because the latter

clearly leads to potentially life-threatening conditions.

Here's my take on the relationship between flushing and rosacea: I

can't know the relationship at this point in time, but I do know that

flushing can in the short term worsen edema and probably the

inflammatory components of rosacea, both of which makes skin less

healthy and worsens one's appearance and comfort. Since swelling and

papules are a component of my rosacea, it makes sense to me to limit

flushing whether or not that impacts ultimately on the progression of

rosacea.

Continued flushing may make the edema and inflammatory components of

rosacea so bad that those symptoms become increasingly difficult to

manage, but that still doesn't mean that flushing progresses the

pathophysiology behind rosacea itself. Telangiectasias are so common

in middle aged and older people, and correctable in most causes, that

it's hard to talk about lifestyle changes beyond avoiding triggers

for that reason alone, esp since we don't know for certain whether

even just avoiding triggers has any effect.

So the key point to me, professionally and personally, is to keep it

in perspective and not avoid, or recommend avoiding, enjoyable

activities because one flushes during or in response to them. To

limit edema and perhaps some papules and eventually telangiectasias,

one might try to mitigate unavoidable flushing by following some of

the excellent suggestions discussed here; the air conditioner and

cool towel are a rosacean's best friends. <g> And if flushing is

more than a periodic problem, there are medications that many find

helpful with tolerable if any side effects.

But if flushing continues, so it continues. My personal goal isn't to

have the absolute healthiest, palest skin I can have every second,

but to adapt a reasonable approach to my rosacea for longterm

management, including the unexpected and unexplained exacerbation and

remissions, and fluctuating edema and papules and flushing. I know I

can do some things to mitigate, but ultimately I can't control my

flushing or my rosacea like I can control my blood sugar or my temper.

(...or my verbosity. <g>)

Marjorie

Marjorie Lazoff, MD

[Guest guest]

> My question is this - am I causing any permanent damage to my

> skin? Could I be damaging my blood vessels, or causing any other

> long-term damage whose effects are not yet visible to me? I'm

> wondering if flushing itself could be causing long-term problems

> that might not be apparent now - I am not having any short-term

> problems with severe flushing 3-4 times a week. Any opinions on

> this?

You're right, it is just opinion, Naomi, no one knows. For Dr. Nase

and others who believe that rosacea is primarily a progressive

vascular disorder, limiting flushing episodes is critical because

flushing actively damages rosacean vessels.

But even they must acknowledge that there's no documentation

supporting the relationship between continued flushing and worsening

rosacea. It doesn't seem to follow clinically either, since the

active symptoms of rosacea often become less of a problem after

middle age rather than -- as one would expect from this theory --

continuing to worsen into one's senior years. (Although this may well

be attributed to age-related factors counterbalancing the progression

of rosacea, such as decreased nerve sensation, decreased immune

response, and less aggressive changes in blood flow).

And even if there is a relationship, no one knows to what extent, in

other words, how much flushing is too much. It may be a linear

relationship -- the more one flushes, the more rosacea progresses. Or

it may be a threshold situation, where flushing up to several times a

day is OK, but no more than that. Or, it may be the degree of

flushing, where hundreds of tiny blushes is fine, but one major flush

is not. It may be that judiciously avoiding 99% of flushing makes no

difference if one good flush a year is all it takes to progress the

condition for that year. Or, it may be that continued flushing does

worsen rosacea but only in the presence of xxxxx, or it is only a

minor factor compared with yyyyy (where everyone fills in the x's and

y's according to one own's belief system, because we don't know the

answers to that either. <g>)

This group is very strongly focused on the above theory, so that's

all that's being discussed here. But consider another view: flushing

as a manifestation of rosacea, not a cause or contributing factor?

As an analogy, consider someone who keeps falling down and bruising

their knees. Would preventing their knees from bruising help their

clumsiness if it were due to a progressive cerebellar disease, or

poorly fitting high heels, or a rocky terrain?

(As an aside, this may explain why even successful photo treatments

need to be repeated throughout one's life. Those who treat flushing

with lasers and related technology may want to believe -- and/or have

their patients believe -- they are treating the underlying condition.

That's the heart of the theory discussed above. But even if

effective, it may be no different than the success of laser therapy

for telangiectasias -- treating the manifestation of rosacea, not the

condition itself. That's not necessarily bad, esp for those who are

hypersensitive about their flushing, but it takes it out of the realm

of medical therapy and into the world of cosmetic treatments.)

From a mainstream medical perspective, the recommendation is to avoid

triggers that cause flushing, though there is no data I can find

supporting that recommendation. But this is not deep knowledge, it

probably springs from the same common sense reflected in the joke:

Patient: Doc, it hurts when I do this

Doctor: So stop doing it

In other words, if you want to stop flushing when eating spicy foods,

stop eating spicy foods. <g>

Seriously, for those whose sole manifestion is flushing, such as pre-

rosaceans, it makes intuitive sense to avoid unnecessary flushing

because continual flushing theoretically encourages telangectiasias,

one of the end-stage features of rosacea. In other words, in

individuals predisposed to developing telangectiasias (no one knows

why rosaceans are so predisposed), it makes sense not to overload the

vasculature unnecessarily with added blood flow. But again, who knows

how much blood flow is too much? Plus, telangectiasias are common on

non-rosaceans who don't flush easily or even at all. But in any case,

for rosaceans, telangiectasias in themselves are only a cosmetic

issue and can usually be erased with laser surgery if there's enough

concern and money.

Even in the worst case scenario, avoiding flushing will never be in

the same league as avoiding high blood pressure, because the latter

clearly leads to potentially life-threatening conditions.

Here's my take on the relationship between flushing and rosacea: I

can't know the relationship at this point in time, but I do know that

flushing can in the short term worsen edema and probably the

inflammatory components of rosacea, both of which makes skin less

healthy and worsens one's appearance and comfort. Since swelling and

papules are a component of my rosacea, it makes sense to me to limit

flushing whether or not that impacts ultimately on the progression of

rosacea.

Continued flushing may make the edema and inflammatory components of

rosacea so bad that those symptoms become increasingly difficult to

manage, but that still doesn't mean that flushing progresses the

pathophysiology behind rosacea itself. Telangiectasias are so common

in middle aged and older people, and correctable in most causes, that

it's hard to talk about lifestyle changes beyond avoiding triggers

for that reason alone, esp since we don't know for certain whether

even just avoiding triggers has any effect.

So the key point to me, professionally and personally, is to keep it

in perspective and not avoid, or recommend avoiding, enjoyable

activities because one flushes during or in response to them. To

limit edema and perhaps some papules and eventually telangiectasias,

one might try to mitigate unavoidable flushing by following some of

the excellent suggestions discussed here; the air conditioner and

cool towel are a rosacean's best friends. <g> And if flushing is

more than a periodic problem, there are medications that many find

helpful with tolerable if any side effects.

But if flushing continues, so it continues. My personal goal isn't to

have the absolute healthiest, palest skin I can have every second,

but to adapt a reasonable approach to my rosacea for longterm

management, including the unexpected and unexplained exacerbation and

remissions, and fluctuating edema and papules and flushing. I know I

can do some things to mitigate, but ultimately I can't control my

flushing or my rosacea like I can control my blood sugar or my temper.

(...or my verbosity. <g>)

Marjorie

Marjorie Lazoff, MD