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'W C Fields Nose' Nothing to Sneeze at

Rosacea: Early Treatment Best

Shakespeare called alcohol “nose paint,” but drinking isn’t the only thing that can give you a red nose. Rosacea can make even the sternest abstainer flush.

The symptoms of rosacea range from gentle to severe. Flushing is the mildest one, possibly accompanied by acne-like pustules on the nose and chin. As rosacea gets worse, it can cause a thickening and swelling of the skin; red, itchy eyes in rare cases; and obstructed vision.

Rosacea can have devastating effects on self-esteem. It strikes adults in the prime of life. Many patients feel it affects their work and social life,” says Allison Vidimos, MD, of Cleveland Clinic’s Dermatology & Plastic Surgery Institute.

W.C. Fields: case study

Since the 1930s, the unofficial “poster boy” for rosacea has been comedian W.C. Fields. His lumpy red nose advertised the condition at its most disfiguring.

Rosacea can affect both men and women, with middle-aged men being most at risk of acquiring the “W.C. Fields nose.” Women’s symptoms, while often less severe, are sometimes observed to wax and wane according to the hormonal fluctuations of menstruation or menopause. Fair-skinned individuals are most susceptible to rosacea.

Cause is a mystery

Rosacea is not simply a skin condition, but a systemic disorder with no known cause. There is speculation that rosacea might be caused by an autoimmune response or bacterial infection, or may be associated with microscopic mites found at the base of hair follicles.

Whatever the trigger, the result is inflammation and consequent swelling of hundreds of minuscule blood vessels in the center of the face.

Because more serious conditions, such as carcinoid syndrome, can cause repeated facial flushing, a thorough history and physical exam are essential to make the correct diagnosis.

Early treatment critical

While rosacea has no cure, its symptoms can be treated. “It's important for individuals with rosacea to seek treatment early to avoid progression of the condition,” stresses Dr. Vidimos. “Today’s dermatologists offer a variety of treatment options that can achieve successful results and fit into even the busiest lifestyle.”

Treatments include topical and oral medications, cleansers, superficial chemical peels and vascular lasers (to zap and collapse dilated blood vessels).

What you can do

Meanwhile, rosacea may flare in response to anything that causes you to blush or get red in the face. So if you are prone to rosacea, it’s wise to:

  • avoid nervously touching your face or nose
  • use a broad-spectrum sunscreen daily
  • forgo harsh facial cleansers
  • consume the following in moderation: spicy foods, hot soups and hot beverages
  • avoid drinking to excess (alcoholic beverages don’t cause rosacea, but they can aggravate symptoms)

A note for women

Any treatment that addresses anxiety, “hot flashes,” PMS or depression associated with menopause may indirectly improve symptoms of rosacea.

Related content:

Read our rosacea overview to learn more about this condition.