DEAR DR. DONOHUE: The tip of my husband’s nose and his cheeks have become noticeably red this past year. People ask me — half kidding, half serious — if he’s been drinking heavily. He doesn’t touch alcohol. This doesn’t bother him, but it bothers me. What is this? — N.D.
ANSWER: The probable culprit is rosacea (rose-A-she-uh). It starts as a reddening of the nose and cheeks, and sometimes can affect the forehead. The skin also develops webs of tiny blood vessels. Pimples — which look much like acne — break out. The final stage, which should never be reached these days, is the bulbous nose of W.C. Fields.
Rosacea is common. Fair-skinned people with light hair are the most susceptible. So are those who blush easily. The actual cause is a bit unclear. Some believe the skin mite Demodex is involved. It lives in hair follicles. But people without rosacea also have the mite, so a cause and effect is not certain.
People with rosacea often have eye involvement, something that’s often overlooked but needs consideration. The eyes feel gritty and might burn. They, too, can become red.
Rosacea isn’t a curable condition, but it is highly treatable. Your husband ought to steer clear of spicy foods, sunlight and extremes of heat and cold. That he doesn’t drink alcohol is in his favor.
Metronidazole cream, gel or lotion, or Azelex (azelaic acid) cream can bring gratifying results. Over-the-counter benzoyl peroxide often works for an acne breakout. Sometimes oral metronidazole or an oral antibiotic is added to the program.
You or your husband would do well to contact the National Rosacea Society, which can provide you with informative literature and keep you abreast of the latest changes in treatment. The society’s website is www.rosacea.org, and its phone number is 888-NO-BLUSH.
DEAR DR. DONOHUE: Is it possible to have had a heart attack and not know it?
I am a 59-year-old man and had my first-ever EKG this past week. The doctor tells me I had a heart attack. I have never had anything that felt like a heart attack. I don’t smoke and never have. Heart attacks don’t run in my family. My mother and father are alive at 85. I weigh 155 pounds and have weighed that since I was discharged from the Army, more than 35 years ago. Could this be a mistake? — R.S.
ANSWER: As many as 20 percent of heart attacks are silent, producing no pain or other symptoms. Those attacks are discovered when an EKG happens to be taken at a later date. It’s also true that the EKG might show the pattern of an old heart attack without one ever having occurred.
If you want to settle the matter, consult a cardiologist. It’s probably the wise thing to do.
The booklet on heart attacks explains why they happen and how to recognize them. Readers can order a copy by writing: Dr. Donohue — No. 102W, 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.