ArcaMax

DEAR DR. ROACH: I am 82 years old and in very good health. I have no major medical issues so far, but I work on my health as I believe in prevention. During the past eight months, I've had three colds, plus COVID-19 for the first time this past November. I remember the old days when we used to wear camphor necklaces every winter in order to "scare away" viruses. Before I order one, I want your advice on it. -- N.G.

ANSWER: Camphor is a waxy substance that is derived from the camphor laurel tree. It is often used topically to relieve pain, but some people use it as a skin rub to relieve congestion. (It's in Vicks VapoRub and many other products.) Many people believe in its use as a topical agent, although the evidence supporting its effectiveness is modest.

Wearing bags of camphor to prevent viruses was done during the influenza pandemic of 1918. It wasn't effective then and isn't effective now. I'm surprised that these are still available for sale since they have a significant potential for harm. Highly concentrated camphor can be poisonous if inhaled and if absorbed through the skin; it can cause vomiting, confusion and seizures. Some necklaces that are sold as camphor actually contain chlorine dioxide, which is a respiratory irritant that can cause eye irritation.

I am glad that you believe in prevention. You can prevent yourself from getting sick by not buying these products. Getting vaccinated every year for the flu, once for respiratory syncytial virus, and as recommended for COVID-19 will actually help to protect you from respiratory viruses. Viruses may be scary, but they don't get scared away.

DEAR DR. ROACH: I am 78 years old and have recently developed rosacea on my face, which has worsened over the past four months. I have seen a dermatologist and was prescribed metronidazole 1% gel and pimecrolimus cream, but they haven't had any effect.

The dermatologist has now prescribed 100 mg of doxcycline daily for six weeks. I'm very leery of taking an antibiotic for this long for fear that it will do damage to my bowels. Do you know of any other treatment that would be as effective? What is your opinion on taking doxycycline at this dosage for six weeks? -- B.L.

ANSWER: Rosacea is a common, chronic, relapsing skin disorder that causes inflammation of the skin, especially the central face. Rosacea isn't curable, so long-term treatment is necessary. The specific treatment depends on a person's rosacea. People with more redness are treated differently than people with more pustules (pus-filled bumps).

Metronidazole is a common first-line treatment, and pimecrolimus is used in people with prominent redness -- but less often. Your dermatologist may have tried it because you didn't respond well to metronidazole.

Doxycycline is also used in people with rosacea, especially when they have papules and pustules. The primary goal is its anti-inflammatory effect, not its antibacterial effect. In fact, a trial comparing 100 mg (an antibacterial dose) to 40 mg (an anti-inflammatory dose) showed them to be at about the same effectiveness, but 40 mg had fewer side effects on the stomach and intestines. It's reasonable to ask your dermatologist about this lower dose, especially given your concern for side effects.

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Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu.

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