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Ask Dr. Mike: Rosacea Treatments, the Reason You Bruise Easily & More

Here you'll find the answers to a wealth of health and wellness questions posed by Healthy Talk fans. Listen in because what you know helps ensure healthy choices you can live with. Today on Healthy Talk, you wanted to know:

Do you know anything about headbutting in pets?

Unfortunately, Dr. Mike doesn't know the exact answer to this question. However, he suggests speaking to your vet about this issue if it's worrisome.

I'm a 45-year-old adult male. I thought I was past the acne stage, but my skin continually breaks out. My dermatologist says it's rosacea. What is the cause of this condition, and is there any treatment or cure?

Rosecea is a skin condition that causes redness, and tiny bumps on your face. Sometimes rosecea can flare up for long periods of time and then slowly go away on its own. The exact cause of rosecea is unknown, but doctors believe it's a combination of both environmental and hereditary factors.

There's no known cure for rosecea, but treatments do help reduce the symptoms. You may want to consider adding diaosmine or white peony into your diet.

I frequently get black and blue marks and bruise very easily. Can you explain why this happens?

If this is chronic problem, you may have blood clots and want to consider seeing a hematologist to get a bloodwork assessment done. If you're not getting enough vitamin C, this can cause you to bruise easily. If it doesn't happen that often, Dr. Mike suggests looking into your diet to make sure you have no nutrient deficiencies.

If you have a health question or concern, Dr. Mike encourages you to write him at This email address is being protected from spambots. You need JavaScript enabled to view it. or call in, toll-free, to the LIVE radio show (1.877.711.5211) so he can provide you with support and helpful advice.

RadioMD Presents: Healthy Talk | Original Air Date: February 20, 2015
Host: Dr. Michael Smith

You’re listening to RadioMD. It’s time to “Ask Dr. Mike” on Healthy Talk. Call or email to ask your questions now. Email: This email address is being protected from spambots. You need JavaScript enabled to view it. , or call: 877-711-5211. The lines are open.

So, I have a question here about rosacea and then another one I wanted to answer about blue marks and bruising easily, but before I did that, what I do is I just print out my emails. I mean, you can send your question to This email address is being protected from spambots. You need JavaScript enabled to view it. . You can send one right now. But, I just print them out. I just pretty much do them in order for the most part and I was skimming through and I came across this one and I have no idea how to answer it, but I’m going to. I have a dog. I’m a dog lover. I’ve always had dogs my whole life. Right now, I have a dog. Her name is Edie. She’s about 6 years old. She’s a border collie mix. Just awesome. So, I saw this and it caught my eye. So, I’m going to read this question, but I have no answer. Is that okay?

Here’s the question: Do you know anything about head butting? Yeah. Do you know anything about head butting in pets?


So, I’m going to have to look that one up and respond through email. Maybe have some of the life extension health advisors help me. I actually just pulled it up on Google real quick and there’s a picture. Okay. See? It’s not even what I thought. I’m thinking head butting in pets means your pets are head butting each other. But, that’s not what this image shows. Where is the image from? Well, anyway, it’s a picture of a dog with its head down against a wall and they call that “head butting”. Apparently, maybe they just kind of bounce their head off the wall. And, well, just the brief description there is, it is worrisome. So, if your dog or your cat does that—head butts walls, I guess—in that kind of position with the head down, you need to go have the vet check that out. It could be a neurological thing. So, I’ve never even heard of that. Thank God, Edie does not do that. She does other things, but she does not head butt a wall. But, if your pet does that, no, I don’t know anything about it, but it does look like something a vet needs to check out.

God. Oh, isn’t Google wonderful? Thank God for Google. What did we do before Google? We went to the library and it took us two weeks to answer one question. So, we couldn’t do “Ask Dr. Mike” without Google.

Let’s go to the rosacea question.

“I’m a 45-year-old adult male. I thought I was past the acne stage, but my skin continues to break out. My dermatologist said it’s actually rosacea. What is the cause and nature of this condition and is there any treatment or cure?”

So, it could be both. I’ll describe what rosacea is here in a second, but when you have a rosacea flare-up, the flare-up itself increases skin inflammation which can clog some of the pores and that can cause, actually, a breakout. So, you can get acne breakouts within a rosacea breakout. So, you could have both, okay? So, the question, though, is more focused around the rosacea, Again, remember, I’m not a dermatologist. I’ve mentioned that before. My medical training is “if it’s wet, dry it and if it’s dry, wet it”. Don’t laugh. It works. So, I have to do some research with the dermatology questions.

The cause of rosacea remains unknown. Inherited factors may play a role. Some research suggests that rosacea sufferers have blood vessels that dilate too easily resulting in a flushing or redness of the skin and, basically, if that happens, if your vessels dilate and skin comes to the surface, that’s basically inflammation. That’s what inflammation is. Inflammation is blood flow increasing to a certain area. That’s what it is. And, it’s usually in response to something. So, to me, reading this, there’s some sort of trigger, though. I mean, just because your blood vessels are dilating and bringing blood to the surface, that’s still not answering the question for me. There still must be some trigger causing that. To me, it’s an inflammatory process. Could it be infectious? Could it be allergens? I don’t know.

Numerous factors can cause rosacea to flare up in one person, but have no effect in another individual. Some people claim that one or more of the following have aggravated their rosacea:

Heat, hot baths, strenuous exercise, sunlight, wind, very cold temperatures, hot or spicy food. I haven’t heard that one. Alcohol consumption, menopause, emotional stress and steroid use on the face.

So, bottom line is, we don’t really know what rosacea is. To me, it’s some sort of inflammatory process. There’s some sort of trigger. Whether some of those aggravators that I just read can be the trigger for the inflammatory process, maybe so. I’m not sure. I, personally, would like to see some rosacea research into infectious origins. You know why? Because if you use an antibiotic cream, in most cases, that works the best. Most doctors simply just give an antibiotic cream. Why? Well, they’ll tell you that they’re trying to prevent a secondary infection because of the inflamed skin and when skin’s inflamed, it allows more bacteria to come in. All that’s true, but could they be treating some sort of, you know, previously unidentified bacteria that’s linked to rosacea? That might be something worth researching. There’s also some evidence that Diosmin will work. I’ve mentioned that before. Diosmin is from the rind of citrus fruit. It helps the vasculature, specifically the veins, to maintain tonicity so that will decrease that inflammatory response a little bit, decrease the dilation. It will get rid of some of that fluid faster. So, Diosmin might be helpful. And then, I wrote down here “white peony”. White peony is an herb that has some immune modulating effects, meaning that it tends to turn on certain parts of the immune system by kind of deactivating other parts. Kind of rebalancing the immune response. White peony has had some benefit in autoimmune issues, even some big ones like lupus. So, could there be some sort of overactive immune response here? Maybe the trigger is some bacteria, but we overreact. We get that inflammation in the skin. You get the flare up of the rosacea. That’s all possible. So, maybe the antibiotic cream, the Diosmin to control the vascular aspect of it and the white peony to control maybe that overactive immune response. I would try those three things. But, I’m not a dermatologist. Talk to your dermatologist.

Let’s go on to the next question that I promised about bruising easily. We’ll see how far I get with this.

“I frequently get black and blue marks and bruise very easily. Can you explain why this happens and what can be done about it?”

Well, okay. The first thing is, if it’s chronic--if this has been going on a long time--you might have some blood clotting problems. So maybe right there, you just need to have a good hematological workup. You know, there are doctors who study the blood. Hematologists. I have a good friend of mine back in Texas where we went to school—in Dallas. He’s a hematologist. So, maybe you need a good blood clotting workup. I mean, that’s just a thought. You also might have to consider poor diet. Malnourishment has been associated with easy bruising. For instance, if you’re not getting enough Vitamin C. You know, if you have absolute Vitamin C deficiency, that’s called scurvy. That’s not what I’m talking about, but even just, you know, slight drops in Vitamin C. You know, maybe I’ll just call it a “Vitamin C inefficiency”. It’s not really a deficient level, but maybe just not enough. That’s been associated with weakening of vessel walls and maybe some bruising there. So, maybe some Vitamin C rich foods that are called bioflavonoids from citrus plants.

So, I guess my focus would be diet, first. Vitamin C, anti-oxidants from bright-colored fruits. That’s going to give you these things called bioflavonoids. All that could help, but if this is really an ongoing problem, I would see a hematologist.

This is Healthy Talk on RadioMD. I’m Dr. Mike. Stay well.