Rosacea: the Basics

28 Jul

I have been seeing an increasing number of patients who have been diagnosed with a skin disorder called rosacea. These patients state they have very sensative skin, and are often nervous about treatments.

What is Rosacea?

Rosacea is a chronic skin disorder of unknown origin that begins in the 30’s and is characterized by redness on the cheeks, nose, chin or forehead (most commonly, it can occur on the body as well). There are no specific tests that can be run to determine if you have rosacea. Rosacea occurs in periods of flare-ups and remissions. While there is no cure, treatments aimed a reversing signs and symptoms are necessary. Rosacea will worsen over time if left untreated, becoming ruddier and more persistant.

Who does it effect?

Patient Profile
30-60 year old females
Family history
Fair skin and blush easily

(Ihave found it very common in patients of Irish decent, which is a large population in Boston.)

If you think you may have rosacea, schedule and appointment with a dermatologist.

Signs of Rosacea
Primary Signs
flushing
persistant redness
bumps and pimples
visable blood vessels

Sub-Types of Rosacea

Four Types of Rosacea
facial redness (erythematololantagic)
bumps and pimples (papulopustular)
skin thickening (phymatous)
eye irritation

Many patients experience more than one subtype and symptoms occur in varying degrees of severity. Treatment is based of type and severity of symptoms a patient presents with. Flare-ups are most likely to be associated with certain stressors. Remember, even with this disorder, different patients need to follow different treatment plans based of their symptoms. Many dermatologists suggest you keep a diary of flare-ups and remissions to help track your stressors.

Important Facts
Skin Care
Treatments
Have a gentle skincare routine with minimal products.
Moisturizer is key for preventing burning, stinging and irratation. A strong moisture barrier will keep out impurities and irritants that may aggrevate the skin.
Wear SPF.
Test products on the neck before using them.
Make-up can dry and irritate the skin. Use water-based make-up products. Avoid waterproof and heavy foundations. Avoid make-up removers. Look for a light foundation that contains silicone (for skin barrier protection). If it contains a broad spectrum SPF, even better!
A dermatologist may perscribe you a product called Metrogel. It can be drying, so again, use a good moisturizer.
Products with Vitamin C: Vitamin C is known to decrease free radicals, which play a major role in inflamming rosacea when patients are exposed to the sun. The formulation of the product matters! Make sure it doesn’t containt alcohol as an ingrediant, specificall propylene glycol!

Stressors
Avoid anting that causes redness or stinging like salicylic acid, AHA’s, or retinol (even if you have rosacea with pimples as your subtype!)
Avoid products containing alcohol, witch hazel, or fragrances. Avoid peppermint, eucalyptus oil, clove oil.
Avoid acetone.
Check your products for an ingrediant “propylene glycol,” which is a perservative that causes stinging.
Do not use a toner, astringent, or anything that exfoliates. These products will dry and irritate your rosacea.
Be careful with over the counter products for redness. Altough they may claim they can help, you really should talk to a dermatologist.

**Interesting note: One article suggested patients with rosacea avoid so-called “natural” skin care products. If you look at the list of ingrediants in these products, it is usually very long, and is likely to contain something that will irritate rosacea.

Lifestyle
Treatments

Avoid triggers.
Stressors
Food (here’s a few)
avocados
spinach
citrus fruits
tomatoes
bananas
spicy
cheese, yogurt, sour cream
vineagar
Temperature
hot baths
saunas
Weather
sun
wind
humidity

Medications
Treatments

Antibiotics are typically perscribed for their anti-inflammatory properties (not their bacteria fighting capabilities). They come in creams, lotions, or oral forms.
Medications containing sulfer or azelaic acid may be prescribed as an alternative to, or in conjunction with, antibiotic treatments.
Acne drugs are sometimes prescribed. Avoid these if you are pregnant or plan on becoming pregnant.
Stressors
topical steroids (speficially mentioned is prednisone).
drugs that dialate blood vessels, such as certain heart medications (NEVER discontinue a heart medication without a doctor’s approval!).

Emotional
Stressors

stress
anxiety

Laser Treatments
Lasers emit light energy that targets red blood vessels. Heat for the laser’s energy causes the red blood vessels to disintegrate.
Expect to have 3 treatments
removes visable blood vessels
decreases extensive redness

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One Response to “Rosacea: the Basics”

  1. Johnc91 July 29, 2014 at 9:50 am #

    Very efficiently written information. It will be beneficial to everyone who employess it, including myself. Keep up the good work for sure i will check out more posts. geekeecdkeee

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