From:  gnas_@_.edu 
Date:  Wed Mar 3, 1999  8:50 pm 
Subject:  [rosacea] Re: Help - Dr. Nase

For the record, I would like to change that sentence to 'pleasantly' surprised.
Most doctors do not realize the potential benefit of antihistamines.
Especially the newer zyrtec or claritin brands.  Histamine is involved in most
forms of flushing.  However, it is not the instigator of most flushes.  So many
may see some improvement while on antihistamines. You can take these
medications for the rest of your life with no noticeable side effects.

Word of caution: If you decide to just take them for brief periods of time (ie
1 to 10 days or during special occasions, that is great).  However, I strongly
recommend that if you start taking it for a couple months and then decide to
cycle every once in a while (ie a month on and a month off), this is probably a
bad idea.  When you go off these medications after having taken it for a while,
you may experience more flushing or dilation than pre-antihistamines.  This is
because:

Antihistamines block the receptors for histamine such that histamine can't bind
and therefore can't cause an effect. After 20 to 40 days of continual use, the
body thinks that it needs more histamine receptors -- it makes them and places
them with the pre-existing receptors. Now if you all of a sudden stop blocking
these receptors, then histamine is able to bind to the normal histamine
receptors and to the newly formed receptors. So either decrease the dose slowly
or don't cycle on and off for extended periods of time.

Antihistamines will be a daily ritual until the day I die. Even then, I will
ask my family to place an extended release tablet under my tongue before they
bury me.

Geoffrey
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Dr. Geoffrey Nase