[rosacea] accutane swollen nose and zyrtec antihistamines
From: gnas_@_.edu
Date: Wed Mar 3, 1999 3:54 am
[rosacea] accutane swollen nose and zyrtec antihistamines
Hello Sha,
Although growth and swelling of the nose is usually seen in the men with
severe rosacea, it is not uncommon to see women with milder cases of this
form. In many cases, nose growth is related to three things:
1. Increased blood flow to the nose -- ie. chronic red nose
2. Increased growth of sebaceous gland size, number and activity -- ie.
physical alteration in size and shape of nose, increased oil production
and enlarged pores.
3. Tissue swelling and growth of new tissue
Accutane, taken in the right dose and for the right amount of time is
usually extremely beneficial. Sometimes it takes a second or third trial
with accutane to see results. Bill recently found a nice article on
accutane. There are over 20 well done studies showing that accutane (when
used properly) can result in significant clearing of certain forms of
rosacea -- especially nose involved.
However, once you stop accutane, some growth may reoccur -- however, it is
usually not nearly as bad as pre-accutane. Accutane alters the disease
process in many rosacea sufferers -- enough so that they can use the
topicals again.
There are also many recent articles that suggest that accutane has a mild
antiinflammatory effect.
Caution: This may cause your eyes to be more dry -- it shrinks the oil
glands in your eyes. So you should also moisturize during treatment with
thick lubricant eye drops like celluvisc. Ironically, it helps those
rosacea sufferers who have ocular rosacea associated with oily discharge
(thick white sebum build up).
Laser surgery is also a wonderful option. But it must be done right!
In my experience (as well as my experience with over a thousand others),
the nose is the hardest to treat due to the anatomy, the nerves, the
sebaceous glands and many other variables. This just means that you may
have to be a little more aggressive than the others in your treatment.
It also sounds like you have a nerve-mediated flush component to your
rosacea. This can also be very complex. I would need 5 hours to type in
all the possible causes and treatments. The first line of defense is
usually some form of beta blocker. More recently, doctors have had success
with clonidine. These are not cures for this component, but it may be a
good starting place.
Please stop using hydrocortisone.
I would also like to see that you don't use any facial cleansers,
cosmetics or treatment creams that contain alcohol. Even if it is the new
moisturizing alcohols (benzyl and cetyl) made for sensitive skin. My book
will explain in detail that these alcohols (found in metrocreme) can cause
immediate and delayed facial redness in 65-80% of rosacea sufferers.
I strongly suggest that you try 24 hr non sedating antihistamines --
zyrtec. I am very suprised that this group learned about this medication.
These newer antihistamines do not cross the blood brain barrier -- no
drowsiness (or very little). Antihistamines may block the action of
histamine (powerful dilator of blood vessels) in the facial blood vessels
as well as in the facial skin where mast cells release gobs of histamine.
This is just a start.
By the way, my worst component was also the nose.
Geoffrey
========
Dr. Geoffrey Nase
Ph.D. Microvascular Physiologist