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Diagnosed with rosacea, troubled by precautions and acne, very depressed. How can I get rid of it?

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Practicing since : 2004
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I am a 26 year old female. I was recently diagnosed with a condition called rosacea (a chronic disorder of the skin where certain triggers cause the facial blood vessels or capillaries to get inflammed, thereby giving a persistent redness to the face. There are several subtypes and stages of rosacea and I suffer from one where I have rosacea in my eyes as well as on my face. It is marked by persistent underlying redness across all across my face, acne like pustules and papules, XXXXXXX red- purple 'spots' arising because some of these capillaries have 'broken' underneath the skin and also visible blood vessels on parts of my face).
My skin has been a source of major distress for me for the past 10 years. I have been a sufferer of persistent acne for 10 years and hoped I would outgrow the condition like most other people. However, since it did not seem to go away, I finally decided to see a Dermatologist where I was told that not only do I have acne (though not as severe as I had it in the teenage) but I also have rosacea. Rosacea really has no cure and the symptoms can only be managed. Without taking adequate precations from the triggers and continual intake of the medication the symptoms can exaggerate, often irreversibly. Acne and now, Rosacea have taken a big toll on my personal and professional life. I have turned into an introvert and recluse. I shy away from social gatherings and I prefer not to go out whenever possible. Professionally, I have trouble interacting with colleagues, participating in group discussions and being proactive.

To put things in perspective, rosacea is put me in the biggest professional dilemma I've faced so far in life. In order to control my rosacea I must protect myself from the sun, limit outdoor activity especially during peak daytime and summers, not bathe with hot water, avoid alcohol, spicy food, coffee, chcocolate, tea, several nuts. I must also not stress myself out emotionally and not indulge in strenuous exercise. Basically I must stay away from anything that causes the body to warm up. The point of contention here is the line of my work. I am pursuing a PhD (now in the beginning of 3rd year) and supposed to start collecting data. And my data collection involves extensive field work. By which I mean living in a remote place close to the forests for about 10-11 months per year for 3 years. It involves travelling about 60-80 km on most days as well as walking several km in the forest. Not to mention, the environmental conditions are not forgiving and the weather is usually on the warmer end with plently of exposure to sunlight, dust and pollution. Despite taking precautions, my working lifestyle is stressing me out and it is becoming difficult to take the precautions while also working outdoors to collect data. And I can also not discount the emotional and psychological effect of such a condition where I , yet again, don't feel like meeting too many people.
Now I am contemplating either switching my topic of research to something more lab or desk based or discontuing the PhD altogether. Such a situation has put me in a conundrum. On one hand I would like to get a doctoral degree but on the other the topic I have chosen and the means of data collection are now daunting me. Increasinly I feel that I want to live in an environment where conditions are a little more controlled. In fact, I am bending towards a lifestyle which is completely opposite to that what my research requires. Instead of roughing in out in the forests I want to stay back indoors in the city. Giving up the PhD may also be hard considering future professional prospects and lack of other alternate career options at the moment. If I decided to discontinue at this point, I will leave with an extra master's degree instead of a phd.
I don't want to 'quit' or run away, but I don't know what I should opt for - a career despite health risks and emotional stress or settling for a less lucrative professional option but living in an environment where I can take precautions and look after rosacea. It's absolutely paramount for me to take this decision soon because I have to tell my PhD supervisor about it soon and take a decision before multiple stakehoders are involved. I'd really appreciate any counselling/advice in this matter.
Thank you
Posted Wed, 25 Apr 2012 in Mental Health
Answered by Dr. Ashish Mittal 11 hours later
Thanks for your query.

I appreciate your efforts for medical consultation in so much distress.

Important aspects of your query are:
•     26 year old female
•     Known case of rosacea
•     Difficulty in doing thesis work in final year
•     Complaints of: loss of confidence, avoidance of social situations and decrease proactive behaviour
•     Current concern related to long term plan for future.

First it was really nice to see such a elaborate and scientific description of problem.
Rosacea is chronic skin condition with exacerbation related to stressors. It also frequently associated with psychological symptoms most commonly anxiety and depression. Loss of confidence, avoidance of social situations and decrease proactive behaviour are the symptoms of depression.

Regarding PHD you discussed about following three options:
•     Change topic of thesis so that you can work comfortably: It will lead to stress to prepare for new topic and will take further 3 year to complete thesis. Rosacea lesions also increase due to stress.
•     Do current thesis and same time suffer from rosacea: It appears very disabling and unsuitable option.
•     Stop thesis and settle to some lower job: It will lead to lifelong dissatisfaction in career.
•     One more option I want to add: do current thesis- take your time- rest whenever there is exacerbation of lesions- work whenever lesions subside. In that way you can complete your thesis, although it may take 1 or 2 more years.

Apart from this you may need in person counselling and assessment by psychiatrist to help you in treatment and problem solving.

I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups.

Wish you good health.
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