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Dr. Nair
Dr. Nair, Dermatologist
Category: Dermatology
Satisfied Customers: 8487
Experience:  MBBS, MD (Dermatology, Venereology & Leprology)
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I am 60 years old. I have acne....around my forehead, nose

Resolved Question:

I am 60 years old. I have acne....around my forehead, nose and under my eyes and smile lines on my cheeks......right side more dominant than left side. At times I am tired and need to rest at other times I have a burst of energy. I eat carefully ie., no processed foods and am a vegan for 25 years. It seems like I have food sensitivities to many foods including mushrooms, onions,sugars and anything sweet, tomatoes, yeasts, dairy and many other foods as I have had the food sensitivities testing. My main concern is the food intolerance and how they give me acne. Also I am worried because even if I start eating animal products the food possibilities are still quite limited. I am not sure why my body is rejecting these foods and what can be done about this as there are very few foods I can eat. What can be done about this and what is wrong with me. My medical doctor says there is nothing that can be done and to just live with it and avoid the foods.
Submitted: 3 years ago.
Category: Dermatology
Expert:  Dr. Nair replied 3 years ago.
Hi,

Do you have the acne now? Would it be possible to take a photograph of the affected areas at your convenience?
Customer: replied 3 years ago.
Yes I have acne now....just took a pic on the webcam and figured out how to send it to myself....how would you like me to send it to you.....Not a complimentary pic of me.........
Expert:  Dr. Nair replied 3 years ago.
Great! You can upload the pictures to the question box by clicking on the paper clip or tree icon in the question box toolbar. This toolbar does not display in google chrome and safari so an alternate browser may be required.



Another option is to upload pictures to www.photobucket.com or www.picasa.com and send me the link.
Customer: replied 3 years ago.
I can send it to you through email.......please have one for me to send it to as i will not do the alternative options and i use google chrome....and i have had probs with my computer and do not want to fool around with it.......i can email it to you
Expert:  Dr. Nair replied 3 years ago.
Unfortunately JustAnswer policy prevents direct email communication between customer and expert.

If you don't mind waiting however then you can email the pictures to experts@justanswer.com with my name (For Dr Nair dermatology expert) in the subject line and they usually forward the mail to me within 12-24 hours. If you choose this option please make sure you ask for an acknowledgment from JustAnswer that they have received your mail.
Customer: replied 3 years ago.
ok i sent it to experts and hopefully we will connect soon.....since it may take some time i will leave now and check up in a few hours.....do you think you can help me with the problem i am having with food sensitivities and how they manifest in acne....it is really worrisome and frustrating....thanks Sandi
Expert:  Dr. Nair replied 3 years ago.
Though food can cause acne I am not convinced your problem is acne and therefore the request for the pictures. I shall get back to you as soon as they send me the pictures. Regards.
Customer: replied 3 years ago.
i am really curious to hear what you have to say because i have to tell you that i get acne after eating certain foods.......the naturalpath is treating me for leaky gut as well as metal toxicity and some kind of adrenal response pill......so far i am still breaking out after almost two months of treatment......even though i am staying away from the foods she suggested ....... if you would like the list i will write it out for you
Customer: replied 3 years ago.
also please do not include my pic on the website....for others to see.....i did not realize that these pics would be posted
Expert:  Dr. Nair replied 3 years ago.
Thank you for the photograph. Just a few final questions if I may:

When did you start breaking out like this?

Do you flush easily?

Is your facial skin oily or dry?

Have you noticed any thread veins on the face?
Customer: replied 3 years ago.
I started breaking out like this about 7 years ago......to begin with with the intermittent single huge pimple that either looked like a third eye in the middle of my forehead or a second nose at the side of my nose....then it became more rampant over the 7 years....especially these last three years........
I break out worse it seems after I have had foods that I am sensitive to like mushrooms or something that may have been sweetened by sugar and for sure something with fructose in it etc.
I flush easily if you mean blush...which is embarrassing at times
If I have any thread veins on my face they are not obvious maybe a few very faint ones on my right cheek.
Expert:  Dr. Nair replied 3 years ago.
I hope you find our interaction helpful. If you are satisfied with my response(s) please remember to press the ACCEPT button.

Thank you for the information. Your history is suggestive of a diagnosis of Acne Rosacea. This is characterized by facial erythema (flushing) and acne like bumps. Thread veins may or may not be present. You do not have regular acne because it is very rare at your age and is not triggered by foods like you have described. Rosacea on the other hand often is.

There are numerous medical options for treatment. I usually start with Capsule Doxycycline 100 mg twice a day for 1 month and then once daily for 2-3 months + Metronidazole gel applied over the affected area in the morning and Tacrolimus ointment at night. + an SPF 50+ sunscreen. Resistant redness benefits from laser treatment with the pulsed dye laser. Sun protection is extremely important during therapy.

NOTE: All of the above are prescription drugs however. I would recommend seeing your dermatologist/GP/Family physician and discussing my recommendations with him/her.

There is no hard and fast rule of foods to avoid in Rosacea apart from very hot food like hot tea or coffee, alcohol (particularly beer and wine), foods high in histamine like bananas and spicy food. Mentioned below is a list of common food triggers in Rosacea. However please note that all of these do not apply to every single Rosacea patient, so only avoid those that actually cause flares in your particular case.

Foods:

Liver
Yogurt
Sour cream
Cheese (except cottage cheese)
Chocolate
Vanilla
Soy sauce
Yeast extract (bread is ok)
Vinegar
Eggplant
Avocados
Spinach
Broad-leaf beans and pods, including lima, navy or pea
Citrus fruits, including tomatoes, bananas, red plums, raisins or figs
Spicy and thermally hot foods
Foods high in histamine

Beverages:

Alcohol, especially red wine, beer, bourbon, gin, vodka or champagne
Hot drinks, including hot cider, hot chocolate, coffee or tea

For a more complete list of other triggers and general measures useful in Rosacea please visit:

http://www.rosacea.org/patients/materials/coping/tripwires.php


Hope this information is useful, please feel free to ask if you have any queries.
Customer: replied 3 years ago.
being a vegan i do not eat a lot of these foods......I was looking up foods with histamine in them and there is some conflicting info eg one website says a food then another says do not eat that food......it seems that foods with yeast including breads and crackers seem to cause a breakout for me.....i do not drink alcohol and haven't in years.....but i do drink green tea......my diet is pretty pure......here are my questions:
can i drink green tea?
will i ultamatley be able to eat those forbidden histamine foods?
what will the drugs do for me?
will i need these drugs for the rest of my life?

Expert:  Dr. Nair replied 3 years ago.
I hope you find our interaction helpful. If you are satisfied with my response(s) please remember to press the ACCEPT button.

Yes you can have green tea. It contains potent antioxidants and should actually help with the redness in your case. As I said this list does not apply to all patients of Rosacea. Ultimately what works best is to keep your own food diary and note down foods that trigger a flare and then avoid them You will not be able to take these foods in the future as well.

The drugs will help control the Rosacea and clear these bumps. They are usually required for 6 months or so after which many patients are fine even without the drugs. They can then be used on an as and when basis if you have a flare in the future.
Customer: replied 3 years ago.
ok last question then i will accept answer.....does that mean that the problem is cured and that i can digest regular foods without problems or do i need to avoid all hot foods/histamine foods for the rest of my life.......green tea question also related to the ban on teas and hot drinks....thanks Sandi
Expert:  Dr. Nair replied 3 years ago.
I hope you find our interaction helpful. If you are satisfied with my response(s) please remember to press the ACCEPT button.

Good Morning,

The drugs target the skin problem not the food triggers. The foods which cause flares in your case will always continue to do so and will need to be avoided in the future as well. Regarding the tea and hot drinks - as I said there are no hard and fast rules, try them and see if there is any flare of the skin problem. If not you can take them. Regards.
Dr. Nair, Dermatologist
Category: Dermatology
Satisfied Customers: 8487
Experience: MBBS, MD (Dermatology, Venereology & Leprology)
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MBBS, MD (Dermatology, Venereology & Leprology)