| Seeing Red The Standard (St. Catharines) | |
Bill Clinton has it. Clint Eastwood and Cameron Diaz are showing signs of it, too. Princess Diana and Jimmy Cagney also had it. And it became W.C. Field's trademark, even more than his wit. That's likely little consolation for the two million Canadians and counting who also have it and are getting increasingly red in the face about it. It is rosacea, a chronic and progressive facial skin disorder that starts out innocently enough in one's 20s or 30s as the occasional flushing of the nose, chin, forehead and cheeks. If left unchecked, though, it can turn into a permanently ruddy complexion later in life and may distort facial features -- think W.C. Field's large, red, bulbous nose. Rosacea is characterized by visible blood vessels, bumps that resemble pimples and the thickening of skin on the nose. It's often confused with adult acne. And like adult acne, rosacea also appears to be on the rise. According to The Medical Reporter, an online independent health magazine, the aging population in the U.S. could take rosacea from a common skin affliction to an illness of epidemic proportions. Rosacea tends to affect people between the ages of 30 and 60. With about one-third of the American population -- about 77 million -- falling into that demographic, the National Rosacea Society predicts the disorder will only increase. Derek Lepage, spokesman for Face Doctor, a line of skin care products used to treat rosacea, doesn't deny aging and the weakening immune system that comes with it play a role. But there's something else underlying rosacea: parasites that live in our hair follicles and our skin's sebaceous glands. Everybody has millions of these mites called human demodex living in our skin. People with rosacea just have more of them. Three to four times as many, to be exact, Lepage said. "Aging is a big part of it because it takes until later in life for the infestation rate to develop. It takes that long for the parasites to develop into an infestation," he said. However, getting old doesn't mean a parasite infestation and rosacea are inevitable. "Not everyone is going to develop an infestation. Our bodies are meant to fight these parasites and we should. We should be able to fight this but we're not. It's because we're an aging population," Lepage said. We're also an unhealthy one, too, particularly when it comes to diet, he added. The modern diet is lacking in nutrients to keep our immune systems strong and able to fend off nasty critters like demodex. "Just the overall general health of children, the rising obesity rates in children, I think a lot of reasons why we're seeing more disease is because we're not getting enough nutrition," he said. "I would almost say 100 per cent that diet has a lot to do with skin problems." Dr. Kevin Smith, a Niagara Falls dermatologist who sees as many as three patients each day with rosacea, isn't entirely convinced demodex is to blame for rosacea's prevalence. "I don't think that's a large part of it," he said. Some rosacea sufferers do react more severely to the demodex parasite, but it's a small group, Smith explained. "I think there's a much larger group where demodex isn't really playing a role." In those cases, genetics may have something to do with rosacea's appearance. Exposure to extreme weather and showering in very hot water may only worsen conditions. People who blush easily may be prime candidates for the disease. And those prone to feeling flushed after eating spicy food or drinking alcohol may also have a tendency toward it. "Sometimes it gives people the wrong impression because you see people with a larger nose and you think they're a drinker and that's so unfair," Smith said. Those assumptions by the clear-skinned folk of the world can result in damage to rosacea sufferers that's more than skin deep. Lepage, who has battled cystic acne most of his life, said skin conditions like rosacea have more of a social impact than a medical one. "Many people with rosacea won't even leave their home," he said. A survey conducted by the National Rosacea Society found low self-esteem was an issue for 75 per cent of those with rosacea. About 60 per cent said they avoided face-to-face contact. "There can be quite a broad range of effects," Smith said. "Some men are quite stoical and are sent in by their wives. Some coming in are more self-conscious." Despite predictions by the National Rosacea Society, Smith isn't seeing more cases of the disorder than he was when he started his Morrison Avenue clinic in 1988. However, he is seeing cases earlier. People are more aware of the disease and what it is, he said. Before, sufferers would wait "until they were a complete mess" because they may not have even been aware of the problem. "It waxes and wanes and it's not really obvious to them until someone points it out to them or they look back at old photographs and notice their face has gotten considerably redder," Smith said. Treatment can involve the use of topical antibiotics. Oral antibiotics, such as tetracycline and the acne medication Accutane, can also be prescribed for their anti-inflammatory properties. Laser and intense pulse light therapy, both of which target blood vessels, are also options. But some treatments, antibiotics in particular, may be part of the problem, Lepage explained. "A lot of these medications have side effects as well. We know with antibiotics, they fight off good bacteria as well, which leads to a weakened immune system and it becomes a vicious cycle." Another part of the problem is the demodex theory is relatively new, he noted. "I'm sure there's still quite a bit of theory out there and there are doctors who don't acknowledge it because many studies only look at it as a bacterial infection and not what causes the infection," Lepage said. Lepage and Face Doctor tout the benefits of seabuckthorn oil in the fight against parasites and rosacea. It contains fatty acids and proteins present in healthy skin and kills up to 80 per cent of the demodex infestation, Lepage said. The bad news is the battle against rosacea is a never-ending one. "Unfortunately, there is no cure for it," Smith said. "There's no specific diet, no 1-800 rip-off that's going to cure rosacea so don't even waste your time." THE FACTS Symptoms of rosacea:
Source: rosaceaguide.ca and the Rosacea Awareness Program The Standard (St. Catharines)
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