Acne what?

Too many world problems get too little press. Since other people seem to have taken charge of climate change and hunger and world peace, I’m going to take this opportunity to raise my voice for acne rosacea, the plague of people-who-flush-easily everywhere. Also I have it, and everyone keeps asking me about it.

No, it’s not pimples—that’s acne vulgaris. Rosacea is a condition in which your natural blush areas—cheeks and nose, and eventually chin and forehead—suffer constant or sporadic inflammation, so that you wander the world looking as if you’ve drunk too much, though in some cases having rosacea is a good cover story. You might develop rashes, or splotches, or pestilential red bumps. In its most benign form it can pass off as a healthy post-exercise pink glow, but when it’s acting up you can look like a lumpy beetroot. If I had a buck for every time someone has said, ‘That’s quite a sunburn’, or ‘Are you embarrassed or something?’ or ‘Hey, your skin is red and rashy!’ I wouldn’t have to write this column.

Women develop rosacea more frequently than men, but on the upside (from my perspective) it’s the men who develop the more virulent cases, like rhinophyma, in which the nose becomes bulbous, like that of sufferer WC Fields.

Nobody knows what triggers it. It could be your genes, or overexposure to the sun, or a critter that lives in hair follicles, or another critter associated with ulcers, or emotional stress. What we do know is that once you have it, you’re stuck with it. Furthermore, it will flare up if you do pretty much anything remotely joyous—smoke, drink, hang out in the sun, exercise, or eat spicy food.

When I first got a diagnosis, I asked what I could do about it. “Nothing. Relax?” said the doctor weakly. Other people will prescribe topical ointments, tetracycline, or laser treatment. But if you do all that, you give up the kind of conversation I had at a restaurant the other day.

There I was, stuffing my face with mutton curry and wine preparatory to a smoke, when a slightly batty old lady stopped by the table.

“I was admiring your complexion,” she quavered. “Is it natural or did you get it at the chemist’s?”

“Well,” I said wearily, “actually—”

“Let me tell you, you’ve got to use Johnson’s Baby Soap,” she barreled on, turning on a dime. “I’m much older than you, but what would you say about the state of my skin?”

“Pretty good,” I said dutifully. (It was, too.)

“Johnson’s Baby Soap!” she trilled. “I make all my servants wash their hands with liquid Dettol soap when they walk into the house, and then with Lifebuoy before they touch anything. But on my face, only Johnson’s Baby Soap.”

Right. Thanks.

In the grand scheme of things, of course, rosacea is just wonderful. I could have been that poor 19-year-old woman who had an allergic reaction that, and I quote, “gripped her entire body, causing her skin to burn up and scab over before falling off.” (PTI) You’d think it would take some vile biochemical weapon to cause this, but no: what made Eva’s skin burn up and scab over and fall the hell off was a paracetamol tablet she took for a fever. Yes, paracetamol. The plucky girl grew her whole skin back—a pretty hard act to follow however you slice it—but 40 percent of the one in a million people who suffer this reaction do not survive (the scientific term for ‘die’).

I’m happy to say that paracetamol isn’t on the long list of (completely futile) treatments prescribed for acne rosacea. Every cloud has an inflamed, bumpy lining.