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rosacea

What is Rosacea?

Rosacea is a chronic skin disease that causes redness and swelling and is easily confused with other skin conditions, such as acne and sunburn. Rosacea can occur for a long period of time and often progresses to a persistent redness, pimples, and visible blood vessels in the center of the face that can eventually involve the cheeks, forehead, chin and nose.

Rosacea

Signs and symptoms of Rosacea include:

  • Red areas on your face
  • Small, red bumps or pustules on your nose, cheeks, forehead and chin (but not the same as whiteheads or blackheads)
  • Red, bulbous nose (rhinophyma)
  • Visible small blood vessels on your nose and cheeks
  • Burning or gritty sensation in your eyes (ocular rosacea)
  • Tendency to flush or blush easily

Rosacea usually appears in phases:

  • Pre-rosacea: Rosacea may begin as a simple tendency to flush or blush easily, then progress to a persistent redness in the central portion of your face, particularly your nose. This redness results from the dilation of blood vessels close to your skin's surface. This phase may sometimes be referred to as pre-rosacea.
  • Vascular rosacea: As signs and symptoms worsen, vascular rosacea may develop — small blood vessels on your nose and cheeks swell and become visible (telangiectasia). Your skin may become overly sensitive. Rosacea may also be accompanied by oily skin and dandruff.
  • Inflammatory rosacea: Small, red bumps or pustules may appear and persist, spreading across your nose, cheeks, forehead and chin. This is sometimes known as inflammatory rosacea

Rosacea Mild
Mild

Rosacea Moderate
Moderate

Rosacea Severe
Severe

Early Rhinophyma
Early Rhinophyma

Advanced Rhinophyma
Advanced Rhinophyma

Telangectasia
Telangectasia
Photo Source: DermNetZ

Psychological Effects of Rosacea

The social and emotional effects of Rosacea are worse than physical symptoms. A survey conducted by National Rosacea Society indicate that the condition lowered the self confidence and self esteem in 70% of rosacea patients and 41 % avoided public contact or cancelled social engagements.

“Rosacea awareness month unmasks symptoms of the “great pretender”.
Spring 2002 Rosacea Review.
National Rosacea Society. http://rosacea.org/rr/2002/spring/article_1.php

Current Rosacea Treatment Options

A Rosacea management program begins with topical agents such as Metrogel, Finacea and if appropriate, oral antibiotics or the new Rosacea medication Oracea. Proper skin care products are essential as Rosacea skin is sensitive and must be treated gently.

Special cleansers containing gluconolactone - an ingredient which improves skin texture, dryness, erythema (redness) and overall irritation in sensitive skin.

Moisturizers which contain green tea, the Kinerase moisturizers, and Quadrinone all help Rosacea specifically. Quadrinone is effective in relieving the redness, roughness, scaling and dryness commonly associated with Rosacea. Cutanix contains quadrinone and is often recommended as part of your Rosacea treatment regimen.

Sunblocks which contain zinc oxide (a physical sunblock) are especially effective for Rosacea as many chemical suncreens can irritate inflamed skin. T-Silc Sheer SPF 45, Skinceuticals Physical UV Defense  SPF 30 and Colorescience Sunforgettable Brush On SPF 30 (dry mineral sunscreen) are potentially non-irritating with excellent UV protection.

Metrogel (in gel, lotion or cream) is a form of topical antibiotic specifically developed and used for Rosacea sufferers.

Oracea is the new FDA approved oral medication for pimples and pustules of Rosacea.

Finacea contains azelaic acid. Azelaic acid is a naturally occurring acid. It helps the skin to renew itself more quickly and therefore reduces pimple and blackhead formation. It also helps to kill the bacteria that cause acne and Rosacea.

Oral antibiotics are added if required.

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About 30% of people with mild Rosacea will progress to more severe forms. Rhinophyma, the bumpy nose condition, occurs in about 5% of patients with Rosacea

Avoiding Rosacea 

Rosacea Avoidance requires that you understand your Rosacea triggers (link to Rosacea triggers below) and do what you can to avoid them. Also, making simple changes in your lifestyle habits can directly improve your skin's behavior.

Minimizing Rosacea-caused Appearance Problems involves the use of the non ablative Vbeam laser and/or IPL (Intense Pulsed Light) treatments to remove or reduce existing broken facial veins. In particularly resistant cases, Dr. Sikorski may alternate Vbeam for broken blood vessels and IPL for redness. For these treatments to be most effective, a series of 5-6 with maintenance treatments every 3 to 4 months is required.

An overall program can have your skin looking normal, be smooth and free of acne and will help prevent the progressive damage that Rosacea can cause if left untreated.

Common Rosacea Triggers and How to Manage Rosacea Symptoms

  • Sun. Avoid sun exposure, which adversely affects more than 80 percent of Rosacea sufferers. Minimize exposure from 10 a.m. to 2 p.m. When you do go out, use a UVA sunscreen with an SPF of 30 or higher. Physical sunscreens with zinc and/or titanium oxide are less irritating and work instantly.
  • Avoid Stress. Expect the unexpected. Also, don't try to do too much in a day.
  • Staying Cool. Retreat to air-conditioning when temperatures rise. Avoid steam rooms and saunas.
  • Dress "Cool." Keep it light, loose and topped with a broad-brimmed hat.
    Stay Hydrated. Drink plenty of cold liquids. You may also want to mist your face when you are outside in the heat.
  • The Spice Connection.  Steer clear of spices, hot drinks and foods that may cause you to flush. Peppermint may also cause flushing.
  • Choose your Workout Time. Early or late in the day is best, when it's cooler outside. Shorten workout times.
  • Umbrellas in the Sun. A must at the beach...anywhere without shade.
    Keep Your Routine. Don't sporadically start and stop your treatment. Successful management of Rosacea only happens when you follow your treatment program.
  • Avoid Harsh Products. Your skin care routine should consist of mild cleansing products and your prescribed topical medication. Don't add scrubs or glycolic acids which will only irritate already sensitive skin.

Because the signs and symptoms of Rosacea vary from one patient to another, treatment must be tailored by a physician for each individual case.

Resources

In addition to medical treatment, Rosacea sufferers can improve their chances of maintaining remission by identifying and avoiding lifestyle and environmental factors that trigger rosacea flare-ups or aggravate their individual conditions. The National Rosacea Society offers a free Rosacea Diary Booklet to assist patients in identifying factors that may affect their individual cases, as well as a booklet called "Coping with Rosacea" that provides tips on lifestyle management.

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