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Q: As I’ve gotten older, eyewear has become necessary — welcome to the world of readers — and the glasses have affected the skin on the bridge of my nose. I now have irritated, callused patches. Is there anything I can do about this? It’s really unattractive when my glasses are off.
A: Sometimes, I wonder if you readers are reading … my mind. I just noticed the same problem myself, which seems to have sprung up overnight. Fortunately, dermatologist Heidi Waldorf, M.D., has a few helpful suggestions.
“This is an interesting question for me, too, because after a lifetime of eagle-eyed vision, I’ve needed eyeglasses to function since my early 50s. My optometrist told me that contacts wouldn’t provide the visual acuity I needed for my work, so I became a collector of frames. Given my low nasal bridge (a so-called ‘Asian bridge’), I’ve needed the nasal pads built up on every one,” says Waldorf.
“The problem is that anything that chronically presses on or rubs against the skin — including the nose pads of eyeglasses frames — can make changes to that area. Eyeglasses aren’t heavy enough to cause pressure ulcers, but after wearing them for years, you can see discoloration (redness or bruising) and tissue thinning under the nose pads,” she adds. The area is particularly vulnerable, because as we age, we lose facial subcutaneous volume everywhere, including the nasal bridge and sides of the nose, so it becomes more susceptible to any kind of pressure.
What you describe, dear reader, is hyperkeratosis (thickening or callused skin). That’s commonly seen on areas of long-term pressure like the elbows and knees (people who lean on elbows or kneel at work), buttocks (under the “sit bones” in people with limited fat or muscle), or with trauma to the skin (like from picking, for example), says Waldorf.
Here are Waldorf’s recommendations, starting with the least invasive options:
Choose lightweight frames
Titanium frames are both lightweight and extremely durable.
Don’t wear the same frames every day.
If it’s possible, choose styles with differently shaped nose pads that hit your nose at different points.
Try adding adhesive cushions
When you first begin to notice changes or discomfort, try adding adhesive cushions to the pad area or replace plastic pads with silicone, which is less potentially irritating.
Moisturize the irritated area before putting on glasses and when removing them
When the skin is already showing changes (as both yours and mine is, dear reader), choose a barrier-type moisturizer containing dimethicone. If the irritation is severe, you can even use a soothing diaper cream like Desitin Daily Defense or Triple Paste (which also includes zinc).
Try injections of hyaluronidase gel filler
This can add a supportive layer between your nose and the frames to improve appearance and comfort. However, it is not a “spa” procedure! The nose is particularly vulnerable to vascular occlusion (a blocked blood vessel that can lead to necrosis), so choose a physician with experience injecting this area who is able to take care of complications should they arise.
Don’t assume that the irritation is from your eyeglasses
Early in my career, I saw several people whose complaint was actually an actinic keratosis (pre-cancer) or basal cell carcinoma (skin cancer). See your dermatologist if you have any spot that’s new and doesn’t heal in a normal period of time, especially if it’s on just one side of the nose. And always remove your eyeglasses when having your regular skin-cancer check!
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