Is spring too hot for your skin to handle?


SPRING MAKES OUR BLOOD RACE, our skin flush with the pleasure of being alive, sometimes too much so. If warming temperatures turn you more ruddy than rosy, or if they trigger stubborn facial breakouts, resist the temptation to dab on makeup or acne treatments, and call your dermatologist instead. You may have rosacea, a chronic, potentially scarring disorder that's aggravated by many skin care products--and is striking baby boomers in vast numbers.

Researchers haven't figured out what causes rosacea, which affects 13 million Americans, mostly fair-skinned people aged 30 to 60. (The suspects range from skin mites to bacteria.) But the result is obvious: repeated blushing and flushing that leads to permanent changes in facial blood vessels and tissue if untreated. Women seem to develop the condition more often than men do, frequently in the years before menopause, when declining estrogen levels may touch off hot flashes. Anything that makes skin flush can trigger a flare-up.

SYMPTOMS The first signs may appear as early as adolescence, with pronounced blushing in a T-shaped zone from the forehead and cheeks to the nose and chin. Over time flushing permanently dilates blood vessels, giving skin a florid appearance. The eyes may also burn, water, or feel gritty or dry.

The next stage is characterized by outbreaks of angry red bumps or tiny pimples. In contrast to acne vulgaris, "acne rosacea" doesn't bring blackheads or whiteheads and is confined to the face. Untreated skin eventually thickens from the combination of scar tissue and overproduction of collagen, says Mark V. Dahl, chairman of dermatology at the University of Minnesota Medical School. Called fibroplasia, this condition can lead to rhinophyma in men--a W. C. Fields-like nose.

MEDICATION Rosacea responds well to antibiotics, which seem to work by bringing down inflammation. Full-blown cases are usually treated with oral tetracycline for two to six months, mild ones with a metronidazole topical gel or cream (also precribed for long-term control). In addition, birth control pills or clonidine, a drug that relaxes blood vessels, can control flushing by lessening premenopausal hot flashes, as can sucking on ice chips, says Jonathan K. Wilkin, head of dermatologic and dental drugs at the Food and Drug Administration.

TRIGGERS It's essential to steer clear of anything that sets off extreme flushing, such as sun and heat. (Dermatologists report that rosacea tends to flare up during spring and summer.) Avoiding strong sunlight is especially important because photodamage predisposes blood vessels to dilate and remain enlarged. Alas, sunscreens may not be reliable protection; they may contain ingredients that provoke outbreaks in some people.

Alcohol and certain foods are also common triggers. The most troublesome are hot spices, vanilla, soy sauce, vinegar, marinated meats, and histamine-releasing foods such as chocolate, cheese, yogurt, tomatoes, spinach, and eggplant, according to surveys by the National Rosacea Society (for more information, call 88 8/662-5874). Sensitive people may react to even moderate amounts of alcohol, especially red wine, which contains chemicals called vasodilators that expand veins, increasing blood flow to the face.

SKIN CARE Mildness is the key. Anything that tingles, burns, or even invigorates skin--from rough washcloths to acne treatments--can worsen the condition. Products with alcohol are particularly irritating.

The good news: A recent survey by the National Rosacea Society found that 96 percent of sufferers are able to control flare-ups with changes in diet and lifestyle. And scars need not be permanent; a plastic surgeon can remove swollen tissue and enlarged blood vessels. "I love to see patients with rosacea," Dahl says, "because I can get them well."




Healthy Looks by Karmen Butterer, Jennifer Preuss, and Mandy Behbehani

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