Santa's Affliction with Rosacea

Jeffrey Sassmannshausen, MD

When you see Santa, please give him my card. His rosy cheeks are a tell-tale sign of rosacea. Rosacea is a common acne-like facial rash that is made up of flushing redness, red papules and pustules and tiny blood vessels called telangiectasias. What is interesting is that rosacea is one of the skin diseases that is directly stimulated by the foods you eat. While the typical triggers for rosacea are alcohol, spicey foods, and hot drinks. It could be aggravated by the carbohydrates in all the cookies Santa eats. This is linked to the diabetes that Santa likely has due to his weight. Insulin resistance will lead to stimulation of the hormonal pathways in the body. This in turn, causes an increase in the hormones which will stimulate inflammation—and rosacea.

Rosacea is very common and will present in many different ways. Most will find easy flushing and acne. It will usually present after the age of 30, though it can be present at any age. In most individuals, the treatment is very simple and works well. There are many topical medications that will often clear the pimples and lessen the redness. Oral antibiotics are used though I have found these are only needed on rare occasions.

Interestingly, rosacea can affect the eyes. Ocular rosacea is often missed or treated as dry eyes or allergies. It presents with continually red irritated eyes where they feel sandy or grainy. You can have frequent sties or tiny white bumps along the lid margin. The irritation continues even after allergy season. Ocular rosacea responds quickly to doxycycline, an antibiotic pill. Often, a low dose is all that is needed to get relief from the chronic irritation.

Don’t forget that red bulbous nose of Rudolph! Rhinophyma is the lobular enlargement of the nose. W. C. Fields, for those of you mature enough to know who he is, had rhinophyma. Fortunately, this is not very common. There are some very good treatments now if you do happen to develop the large nose. Please ask.

As we enter the new year, make a point to come into the office for a skin check. Prevention is the key. And never forget your sunscreen! Santa is always watching...