DEAR DR. DONOHUE: I am a 43-year-old woman and am bothered by a nose whose tip is red and looks like it has pimples on it. I put makeup on it and can hide it pretty well. Is this just plain old acne? I had a little bit of it when I was a teen. – R.O.

ANSWER: I am pretty confident that you have rosacea (row-ZAY-shuh). More than 14 million Americans and Canadians have it. It most often begins as a redness of the nose and cheeks. The redness comes and goes, but eventually a time comes when it persists. Often, small bumps and pimples break out on the red skin. Spider-web tangles of tiny blood vessels can also be seen on the affected skin.

The list of famous rosacea sufferers is long. Former President Clinton is one.

The cause is somewhat up in the air. Fair-skinned people and those who blush easily are susceptible to it. About 10 percent of Finns have it. That’s partial evidence that genes are involved.

In addition, a skin mite called demodex and an associated bacterium contribute to its emergence. Alcohol, which is often mistakenly blamed for it, does not cause it but can make it worse, as can spicy foods and hot beverages. Beans, citrus fruits, chocolate, yogurt and sour cream are other foods that aggravate it for some people. Food and drink, however, are an individual thing, and you have to keep track of any possibly offending food or drink for yourself. Sunlight definitely intensifies it.

MetroCream or MetroGel, both containing the antibiotic metronidazole, can sometimes keep matters in check and even clear the skin. Finacea Gel is a newer treatment. Oral antibiotics like tetracycline are sometimes needed to achieve control.

Have your doctor give you an up-close and personal exam. If you do have rosacea, contact the National Rosacea Society at 1-888-NO-BLUSH or online at www.rosacea.org for a wealth of information on this illness and its treatment.

DEAR DR. DONOHUE: My daughter has been diagnosed with tuberculoid leprosy. She had bad side effects from her medicine. It was killing her red blood cells. Two doctors are testing different meds to find one she can take. If there is anything you know about this, please tell me. I am 87. – D.C.

ANSWER: Say “leprosy” and people immediately think of the tropics, but currently there are around 4,000 people with leprosy under treatment in the United States. People also immediately think of a terribly deforming illness, but such is usually not the case these days with the effective medicines now available.

Tuberculoid leprosy is the form of leprosy where the infection is limited to a few skin patches and some nerves. The skin patches lose their color, and often those areas lose some feeling. The number of leprosy bacteria in the body is relatively small, and this kind of leprosy lends itself to successful treatment.

Dapsone must have been your daughter’s medicine. It is the one that is often chosen first for leprosy treatment. In a few people it causes red blood cell hemolysis – breakup of the cells. When dapsone is too great a risk, then other drugs are waiting in the wings. Two examples are rifampin and clofazimine.

I can understand your concern. Leprosy is a misunderstood illness. I am not trying to minimize her condition or her predicament, but you should know that her chances for a full recovery are great. Some cases of tuberculoid leprosy resolve on their own.

DEAR DR. DONOHUE: I had a scan of my liver and gallbladder for presumed gallstones. It turns out I don’t have gallstones, but I do have a liver cyst. The doctor says it doesn’t require any treatment. I would like your opinion on this. – K.P.

ANSWER: About 5 percent of the population have a liver cyst, and most need do nothing about it. If the cyst is larger than 2 inches (5 cm) in diameter, if it causes symptoms like pain or if it interferes with liver function, then something must be done.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.