DEAR DR. DONOHUE: I am 76 years old and first experienced rosacea about one month ago. My primary-care doctor started treatment, but I asked to see a dermatologist. He prescribed metronidazole gel and doxycycline pills, neither of which have yet helped. The doctor thinks laser treatments would help me. My finances don’t allow me to pay for them, and my insurance carrier won’t cover the expense because they say it’s cosmetic treatment. Am I to continue my remaining years looking like W.C. Fields? – Anon.

ANSWER: It was thought that rosacea (row-ZAY-she-uh) came on during the 30s and 40s, but the National Rosacea Society completed a survey that found 39 percent of rosacea patients developed it after 50, and 17 percent before 30. It’s a skin condition affecting mostly the face. It often begins as a blush on the cheeks, nose and chin. In time, the blush remains more or less permanent, and tiny webs of blood vessels sprout in those areas. In addition, small, pimplelike bumps emerge on the affected skin. In time, the skin may thicken and the nose may become quite bulbous – like the nose of W.C. Fields, one of America’s greatest comedians.

Rosacea also can affect the eyes and make them burn and feel scratchy.

Your medicines are standard treatment, and it might be that you haven’t taken them long enough. If they do fail you, there are others, like Differin cream and Finacea gel. You should avoid the sun, alcohol and spicy foods.

Your insurance company’s attitude strikes me as a bit odd. Rosacea doesn’t kill, but it can kill one’s social and functional life. Laser treatment often excels when drug treatment fails. It’s especially good for reducing severe skin redness and for getting rid of the tiny surface blood vessels.

The National Rosacea Society can provide you and all other rosacea patients with a wealth of information on treatment. You can contact the society at 888-NO-BLUSH and on the Web at www.rosacea.org.

DEAR DR. DONOHUE: I was recently discovered to have type 2 diabetes. One of my doctors suggested I have a Doppler sound study of blood flow in my legs. Is this worth doing? – B.J.

ANSWER: It is if you have symptoms of poor blood circulation. If your doctor can’t feel a pulse at the ankles or if blood pressure in the legs is lower than arm blood pressure, a Doppler study can confirm poor circulation. If that’s not the case, ask your doctor what his hurry is for such a study.

Peripheral vascular disease (also called peripheral artery disease) is common in older people and diabetics. The booklet on this topic explains it and its treatment. To obtain a copy, write: Dr. Donohue – No. 109, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: Recently I was told I have an autoimmune disorder called myasthenia gravis, which results in muscle weakness. I was put on pyridostigmine, but it didn’t agree with me. I do take prednisone. Both my mother and sister died of Huntington’s chorea. Is there a connection between it and myasthenia? What more can you tell me about it? – R.B.

ANSWER: Myasthenia is a disconnect between nerves and muscles. Nerves release the chemical acetylcholine, which lands on a muscle receptor and switches the muscle into action mode. The muscle receptor is like an electric outlet, and acetylcholine is the plug that inserts into it. Without this connection, muscles become weak. Eyelids droop. Double vision often occurs because eye muscles can’t keep the two eyes aligned. There is no connection between it and Huntington’s chorea.

There are medicines other than pyridostigmine (Mestinon). Azathioprine and mycophenolate are two such medicines. Surgical removal of the thymus gland, a mysterious gland in the upper chest, can be beneficial.

Let me direct you to the Myasthenia Gravis Foundation at 800-541-5454. It’s a source of information and can direct you to local chapters scattered throughout the country, all of which are active in helping myasthenia patients. The foundation’s Web site is www.myasthenia.org.

DEAR DR. DONOHUE: My husband has been diagnosed with chronic kidney disease. He also had prostate cancer and was eating lots of potassium-rich foods until his kidney doctor told him to stop. We both thought potassium lowered blood pressure. He suffered a TIA, and we wonder if dropping his potassium caused that. – A.W.

ANSWER: Potassium counters the effect of sodium and can lower blood pressure. The reduction is significant, but not stupendous. Not taking potassium didn’t cause your husband’s TIA (a mini-stroke). Your husband should follow the kidney doctor’s advice. The benefits of potassium for him are outweighed by the danger too much potassium could do to him.

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. Readers may also order health newsletters from www.rbmamall.com