DEAR DR. DONOHUE: I am a 78-year-old male who recently experienced a breaking out on my face and around my nose. Pimples came up. My physician diagnosed it as rosacea. He prescribed tetracycline and MetroGel ointment. The area cleared up.
I wonder if I can stop taking the prescriptions?
Perhaps you might explain what rosacea is. — O.L.
ANSWER: Rosacea (rose-A-shuh) can happen to anyone, but it particularly singles out people who were or are prone to blush easily. The tip of the nose, the cheeks and the chin are the places where the skin stays red and on which pimples break out. In time, tangles of small blood vessels also appear on those places.
Without treatment, the nose can become disfigured. For an image of end-stage rosacea, think of the nose of W.C. Fields.
Eye involvement is an unappreciated aspect of rosacea. The eyes feel gritty, water and become bloodshot. In a few cases, the eyes are the only manifestation of this disorder.
Most often, rosacea is a chronic illness requiring chronic treatment. You can stop your medicines if your doctor agrees. The worst that can happen is that it will return.
Stay out of the sun, and always wear sunscreen when going outside. Don’t drink alcohol. Stay away from spicy foods. Hot beverages encourage breakouts.
Contact the National Rosacea Society. The society is more than willing to answer any questions that might arise about rosacea. Its toll-free number is 888-NO-BLUSH, and its Web site is rosacea.org.
DEAR DR. DONOHUE: I have been suffering from pain that spreads from my left shoulder blade, around my side and to just below my left breast. There is no skin rash. I wonder if this could be shingles. Do the shingles ever not come to the surface?
If it is shingles, what is the treatment? — B.K.
ANSWER: A rare form of shingles called zoster sine herpete causes shingles pain without any skin rash. Its diagnosis is difficult. Proof lies in documenting a rise in antibodies to the shingles virus. A blood specimen has to be taken at the onset of the pain and again one or two weeks later. If the level of antibodies has risen, that’s evidence that shingles has occurred without a rash.
How long have you been suffering from the pain? Shingles pain that continues for more than a month after the appearance of the rash is postherpetic neuralgia and comes from nerve damage.
Even though you never had a rash, if your pain has been going on for six weeks, you might have postherpetic neuralgia.
The Lidocaine skin patch can often alleviate this pain. Oral medicines like amitriptyline, Neurontin and Lyrica are also effective for some people.
The shingles story is told in the booklet on that subject. Readers can obtain a copy by writing: Dr. Donohue — No. 1201W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Canada with the recipient’s printed name and address. Please allow four weeks for delivery.
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.
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