Dr. Arlen Brownstein had beautiful skin. In part, it was because she hated being in the sun so she avoided it whenever possible. No wrinkles or leathery skin for her! As far as she was concerned, she was destined to look young and lovely forever.

Then she hit her forties and rosacea struck.

Brownstein is a naturopathic physician. Before she realized she had rosacea, she worried that her symptoms indicated lupus or some fatal disease. When, at last, she got tested and found out it was rosacea--hardly life-threatening but nonetheless a threat to her lifestyle--she began looking for natural ways to treat it. She found little and thus started on a quest that would eventually result in the book Rosacea: Your Self-Help Guide, which she co-authored with Donna Shoemaker.

The book begins with short chapters on what rosacea is and what causes it. Actually, no one knows what causes it, so the authors lay to rest the outmoded fiction that too much alcohol is the culprit. (It can, however, trigger symptoms in many people.) They mention some of the risk factors such as age (40-60) and genetic links that make it more likely a person will get rosacea. They do an excellent job of explaining the medical terms, such as rhinophyma (thickening of the nose) and telangiectasia (dilated tiny blood vessels that show up on the skin as thin red lines), that rosacea sufferers hear about frequently.

Next, the authors describe the various treatments available for rosacea. They mention antibiotics such as tetracycline and ointments and creams containing metronidazole that doctors typically prescribe. They add that there are options in naturopathic, homeopathic and Chinese medicine and they describe what you'll experience if you visit a practitioner in each of these alternative medical fields. Even more useful are their descriptions of some of the do-it-yourself treatments that people have found helpful: zinc oxide ointment, washing your face with chamomile tea (which is supposed to have anti-inflammatory properties), and swallowing borage oil capsules and using methylsulfonyl-methane (MSM) eye drops to ease optical rosacea--to name a few.

Other chapters discuss stress management, common triggers that produce flare-ups, and ways to cover up or remove the effects of rosacea on your face, such as dermabrasion and pulsed dye lasers. Each chapter is interesting and full of useful material.

Perhaps a third of the book deals with the value of nutrition in treating rosacea. This is to be expected from a naturopathic physician because the discipline emphasizes a holistic approach to health, with nutrition playing a key role. The authors recommend a diet high in vegetables with moderate amounts of other foods--an approach that most people would agree is healthful, though difficult to follow in our culture. They discuss the role of supplemental vitamins and minerals while recommending that we get most of our nutrition from our food rather than relying on pills to cure our ills.

I've always wondered why certain foods, such as wheat, chocolate, dairy foods, sugar, soy, beef and alcohol, could be rosacea triggers. The authors suggest the hypothesis, based on immunological theory, that people who are allergic or sensitive to these foods don't digest them effectively. Undigested molecules pass through the intestinal wall, activate the immune system and result in inflammation. The authors suggest tried and true methods, such as an elimination diet, for determining what foods affect you individually. They also mention a method, called the "pulse method" that is based on purely anecdotal evidence but may be useful. The pulse method consists of counting your pulse before eating a particular food to which you suspect you're sensitive. Then you count it again ten, twenty, sixty, ninety, 120 and 180 minutes later. If your pulse rate rises by ten beats per minute, but you haven't done anything else--exercising or watching a horror movie, for example--to explain the rise, you may be sensitive to the food.

Like most books nowadays, this one directs you to a web site: www.rosaceaworld.com. However, at the moment, there's almost nothing there beyond a home page, a "buy this book" offer and the option to email questions to Dr. Brownstein.

Despite efforts to research causes and cures for rosacea, my impression is that we don't know a great deal more today than we did in 2001, when Brownstein and Shoemaker published their book. Each chapter is full of information for rosacea patients that is as useful now as it was a few years ago. In my view, the nutritional information and natural treatments suggested by the authors make Rosacea: Your Self-Help Guide an excellent source of things to try for managing the disease.

Update: 16 September 2007

I emailed Dr. Brownstein, asking if she had plans to bring out a new edition of the book. Here is her response:

"I am meeting with the publishers of my book next week to talk about a new edition or possibly a new book. I have learned so much in the past 6 years that I would like to pass on. My goal for my face actually changed. It went beyond having my skin look "normal" to having it look great. And, through what I put in my body and through what I put on my skin, I think I have achieved this goal."

It sounds like she has encouraging news for rosacea sufferers. We'll look forward to her new or revised book. Until then, Rosacea: Your Self-Help Guide provides a great deal that's worth trying today.