What did former President Bill Clinton have to blush about? We all know the answer to that delicate question! Like Princess Diana, Rosie O'Donnell, and the comedian W.C. Fields, he also suffered from rosacea.
This April is designated Rosacea Awareness Month in an effort to alert people to the warning signs of this condition and the importance of early treatment. Red may be the color of love, but this is one flush people would prefer not to show.
The general public and sometimes doctors, confuse rosacea with acne, seborrheic dermatitis, or lupus. Fortunately, rosacea is not life threatening, but the flushing episodes are socially embarrassing, and in some instances, their psychological impact can be devastating.
Some patients shy away from social contacts when pustules appear on their face, conscious that this facial disfigurement makes them less attractive. Or they believe their unsightly appearance will impede their career.
It's estimated that about 25 million North Americans suffer from rosacea and that many cases go undiagnosed. The condition develops slowly, occurring in people between 30 and 50 years of age, who are fair-skinned and usually of northern and European descent. Neither sex is immune, but women are more susceptible than men. Rosacea tends to increase over time, with males more likely to suffer from W.C. Fields's red bulbous nose.
The first sign of rosacea is the appearance of rosy cheeks. In some cases the face, nose, and forehead develop red patches that eventually fail to subside. Later, as the disease progresses, small red, solid pimples appear that may resemble acne. But blackheads and whiteheads are not present as in acne. There are often periods of remission, followed by flare-ups and a worsening of the condition. Later, enlarged blood vessels called telangiectasia form on the face and may have a web-like appearance.
W. C. Fields, the late comedian, used to say, "I've no use for water. Water's for flowing under bridges." It was a good line, implying that he was a heavy drinker and it triggered a lot of stage laughs. Since that time, his huge bulbous nose has been linked with excessive drinking. Alcohol can aggravate rosacea, but a flaming red nose can also occur in those who do not consume alcohol.
Exposure to sunlight, extreme cold, wind, spicy foods, hot liquids, and especially red wine may cause a flare up of rosacea. Stress is also believed to be a factor.
If you suspect you have rosacea, be sure to consult your doctor. The early stages of rosacea are deceptive. Many people write off the facial flush simply as a complexion problem and fail to receive early treatment. Unfortunately, there is no cure for rosacea, but there are a number of ways to tame the symptoms.
Treatments vary from topical antibiotics to more natural means.
Dr. Gifford-Jones is a medical journalist with a private medical practice in Toronto.
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