September 2004
Dear Paula,
I am sure you've received a few notes about this already, but I'd thought I'd chime in with my support. In your January/February 2004 newsletter "Dear Paula" column, someone asserted that, "...in the Yahoo! Rosacea email list, which has over 3,000 members, the consensus seems to be that anyone who has tried BHA (salicylic acid) has had bad experiences with it."

Well, I'm on that list and I use your 1% and 2% BHA formulations (as spot treatments) without any problem. I have posted my positive experiences with Paula's Choice BHA products to the list, as have others. Certainly, more people on the list have had problems with BHA products than not, but there's also the very good chance that some of these individuals may have overused a product, or combined it with other irritating topicals. I'm writing to apologize for the incorrect implication that the aforementioned statement makes, as I don't want to see you have to defend yourself against something that is not true.

Erika, via email

Dear Erika,
I am glad to hear you found success using my products. I completely understand how tricky and fickle rosacea can be and how hard it is to find a combination of products that is successful. While I feel BHA-based (salicylic acid) products can be helpful for some, they clearly don't work for everyone. It takes experimentation to find what is best for your skin. Actually, when it comes to rosacea, nothing works for everyone, whether it is laser, topical agents, or general skincare products.

While I'm on the subject of rosacea, another reader asked me what my specific differences were with Dr. Geoffrey Nase, who wrote the book Beating Rosacea: Vascular, Ocular and Acne Forms with regard to his skin care recommendations for rosacea. Interestingly enough, the primary area where Dr. Nase and I disagree is in the use of BHA (salicylic acid). While he agrees that it can help with pustules and papules that can accompany some rosacea conditions, he feels it causes other underlying irritation of the blood vessels and skin that is not good for rosacea. That doesn't coincide with the research I've seen, however. Salicylic acid is unique because it is an anti-inflammatory agent, exfoliant, and antimicrobial agent. Those factors can have an overall positive effect on rosacea (Sources: British Journal of Dermatology, May 2003, pages 906-912; Archives of Dermatology, November 2000, pages 1390-1395; and QJM: An International Journal of Medicine, August 2001, pages 445-448).