Rosacea

Concern:

Redness, broken vessels, red bumps

Solution:

Homecare and clinic management (see below)

What is Rosacea?

Rosacea is a common chronic incurable skin condition that is controllable and medically manageable. Untreated, it will worsen over time. Over 45 million people worldwide have it. Most people with it have fair skin, from English, Scottish and Irish backgrounds, but it can occur in other skin types. Most often it affects the middle of the face. There is a spectrum of rosacea symptoms. These symptoms can come and go over time.

 

The range from:

  •  Redness of the face, with easy flushing and sometimes a burning sensation
  •  Tiny red pimples and pustules, or acne- like spots. Because of this it is sometimes called acne-rosacea. Blackheads don’t generally occur with this though
  •  Scattered visible vessels (telangiectasia) on the skin
  •  Rhinophyma – an enlarged bulbous red nose
  •  Eye problems such as swollen, red eyelids (blepharitis), conjunctivitis and keratitis.

 

Rosacea can be mistaken for just rosy cheeks, sunburn or acne. It can of course occur with other conditions that can confuse the picture (for example over 25% of people with Rosacea have Seborrhoeic Dermatitis also). The diagnosis is usually clear from the clinical picture, but occasionally a biopsy or blood tests may be recommended to exclude other things.

Triggers for this problem include sun exposure, alcohol, hot or spicy foods, stress, smoking, and heat. A skin mite called Demodex can also be a trigger. However there needs to be that genetic underlying condition where the skin cannot control its inflammatory response to these things – especially to the sun. Some medications can trigger rosacea also, for example, some blood pressure and heart medications.

 

Treatment Plan

There are many different treatments for rosacea depending on the severity and the type of symptoms. It is always important to remember rosacea skin is sensitive. Rule number one is not to use irritating skin products. Sometimes if the condition is confused with acne, strong irritating ‘home-care’ might be used which will actually worsen the situation. Doctor Holmes will guide you in the right direction what is best for your skin.

 

Laser and Broadband Light: These devices can certainly make a visual improvement to the skin by reducing visual redness and vessels. They also seem to cause an improvement to the skin quality itself and reduce the number and severity of episodic flares.

 

LED Light: This is a gentle but effective treatment often used in combination with other treatments. There are strong LED light machines now in use compared to the weaker less effective devices originally available.

 

Script Products: There are times when prescription medicines can help rosacea. Antibiotics like Doryx actually act as anti-inflammatory agents on the skin. Rosex, Soolantra and even Roacutane can help some cases. Topical antibiotics like Erthromycin, Clindomycin or Metrogel. An acid like Finacea gel can help reduce bumps and redness. Sometimes these may be prescribed together.

 

Home care: A very gentle cleanser, moisturiser and effective sunscreen daily is good place to start. After calming the skin, some active topical products like Niacinamide, Growth Factor, and even acids like AHAs can start to rebuild the skin. Products to help protect the outer skin layer will also promote healing deeper in the skin. Avoid alcohol, witch-hazel, peppermint, eucalytpus oil, clove oil, menthol and fragrance in your topical products.

 

Healthy eating: Many foods can cause inflammation in our body. Saturated fats and foods that make our blood sugars spike (like simple sugars and white flour etc) will have this effect. Dairy is thought to contribute. Alcohol makes facial redness worse by dilating blood vessels and dehydrating skin. Eating a lot of curries and similar hot foods that make you red in the face, can exacerbate rosacea symptoms.

 

Probiotics: Gut health is fundamental to the function of all our body systems. Probiotics can help keep our gut happy. This in turn will reduce inflammation generally. Remember stress, anxiety, low fibre foods and highly processed food messes with our gut microbes.

 

Sun protection: UV will make rosacea worse and can be a trigger for an initial episode. Being Sun Smart is an important part of rosacea management.