Rosacea attacks eyes as well as skin
DEAR DR. DONOHUE: I have a severe case of rosacea on the right side of my nose, which is red and swollen. My dermatologist has given me MetroGel and tetracycline. I have used these for more than a year, but the problem is getting worse. Two years ago, the left side of my nose was treated with a costly skin graft. Are any other treatments available? — J.C.
ANSWER: Rosacea (row-ZAY-shuh) starts out with a reddening of the skin, mostly on the nose tip, the cheeks, chin or forehead — or all those sites. In time, spiderweblike blood vessels appear on the involved skin, and somewhat later, the skin breaks out in pimples. If neglected, rosacea can lead to thick, deformed skin.
You have to do some things for yourself. Protect yourself from the sun with sunscreens. Stress, hot weather, alcohol, hot beverages and spicy foods make rosacea worse. Anything that causes blushing aggravates it — foods, medicines, embarrassment.
An important but often forgotten part of rosacea is eye involvement. The eyes are dry and gritty. They are part of the picture in half of all patients.
Metronidazole — your MetroGel — and tetracycline are standard treatments, but there are many other medicines, and you should revisit your doctor to let him or her know that your current treatment isn’t working. Finacea gel is an effective medicine. The acne medicines Retin-A and Tazorac frequently are prescribed. Oral Oracea, containing the antibiotic doxycycline, is a somewhat newer agent. Metronidazole also comes in oral form.
Isotretinoin, a powerful acne medicine, is another useful treatment.
Lasers have a place as a rosacea remedy.
Want to do yourself a big favor? Contact the National Rosacea Society at 888-NO-BLUSH or at its Web site, www. rosacea.org. The society will keep you abreast of any new developments in treatment and provide you with useful information on taking care of this common skin disorder.
DEAR DR. DONOHUE: How much weight should a woman gain during pregnancy? I am pregnant for the first time, and I have heard conflicting opinions. I am 5 feet, 4 inches tall and weigh 128 pounds. — L.U.
ANSWER: The Institute of Medicine, a panel of experts, has issued new guidelines for weight gain during pregnancy. For underweight women (a body mass index, BMI, of less than 18.5), the pregnancy weight gain should be between 28 and 40 pounds. For women of normal weight (a BMI between 18.5 and 24.9), the weight gain is between 25 and 35 pounds; for overweight women (BMI between 25 and 29.9), a weight gain between 15 and 25 pounds is advised; for obese women (BMI greater than 30), the gain should be limited to 11 to 20 pounds.
BMI is calculated by dividing weight in pounds by height in inches squared and multiplying that number by 703. For those proficient in metric units, divide weight in kilograms by height in meters squared.
L.U., your BMI is 22, normal. You can gain 25-30 pounds.
DEAR DR. DONOHUE: In the past couple of months, three of my friends have been diagnosed with a chemical imbalance. This is something new to me. What does it mean? — R.J.
ANSWER: “Chemical imbalance” refers to brain messenger chemicals with names like serotonin, dopamine and norepinephrine. Imbalances of those chemicals cause many psychological problems, such as depression. Medicines and talk treatment often are successful in restoring a normal chemical balance and ending the psychological problem.
In former times, a chemical imbalance pertained to an upset of the levels of things like sodium, potassium bicarbonate and chloride. The term no longer applies to them.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.