Rosacea

Rosacea is a condition that affects the facial skin and sometimes the eyes. It typically starts as flushing and blushing on the cheeks in response to triggers such as stress, heat, spicy food or alcohol. Over time the flush and blushing transitions from episodic to permanent and if untreated, progresses into pink papules or nodules. To prevent worsening of your rosacea it’s important to get treated early. Do you think you have rosacea? Submit your photos for an online consultation with a board-certified dermatologist at Skin & Scripts today and get your answer within 24hours.

While people of all ages and races can develop rosacea, it’s most common in the following groups:
-People between the ages of 30 and 60,
-Individuals with fair skin, blonde hair and blue eyes
-Women, especially during menopause
-People with a family history of rosacea

The exact cause of rosacea remains unknown. We do know that there is a combination of genetic factors and environmental triggers that both play a role in rosacea. Many patients with rosacea have an abnormal vasomotor response of their facial blood vessel to thermal and other stimuli. This means that their blood vessels react and dilate very easily to certain triggers. This flushing reaction first only occurs in response to triggers such as emotional stress, hot drinks, alcohol, spicy food, exercise, and cold or hot weather. Eventually the flushing and facial redness remains permanent and patients can even progress to form small acne-like red bumps.

Some studies have shown that people with rosacea are also more sensitive to the demodex mites that live on our skin. It’s believed that while all people have demodex mites (they are part of our Normal Flora) , only people with rosacea have a negative reaction to them. Because of this, some rosacea treatments specifically target the demodex mite.

Since there are different stages to grading the severity of rosacea, it has varying clinical morphologies. A patient’s clinical appearance will depend on what stage they are in.

• Stage 1: persistent erythema (redness) with telangiectasias (superficial blood vessels)
• Stage 2: persistent erythema (redness) with telangiectasias (superficial blood vessels), papules (small red bumps)
• Stage 3: Persistent deep erythema(redness), dense telangiectasis (thick superficial blood vessels in greater number), papules) small red bumps) and nodules (bumps under the skin).

*It’s important to note that progression from one stage to another does not always occur and some patients may start with stage 2 or 3.

Although there’s no cure for rosacea, proper treatment can control the condition. Patients with mild to moderate rosacea usually respond well to topical therapies alone. These include metronidazole cream, azelaic acid, sulfacetamide/sulfur or topical ivermectin. For more advanced cases oral antibiotics such as doxycycline or minocycline are helpful. Sunscreen is a must for all patients with rosacea as UVR from the sun is a common trigger. The underlying redness of the skin can often be treated with lasers. It’s best to consult with a board-certified dermatologist to determine which is the best therapeutic option for you.

Identify and avoid triggers. Several factors including spicy foods, alcohol and hot beverages may trigger rosacea flare ups. A great way to identify triggers to keep a journal documenting your rosacea flare ups in your exposure to common triggers. Once you identify triggers, try to avoid them if you can.

Protect your skin from the sun: seek shade especially between the hours of 10 AM and 2 PM. Wearing protective clothing such as light weight long sleeve shirts and pants and a wide brim hat with sunglasses. Using broad-spectrum, water resistant sunscreen with an SPF of 30 or higher. Look for sunscreen that contains zinc oxide or titanium dioxide, which are the least irritating to skin with rosacea. When you’re outside make sure you reapply sunscreen every two hours

Keep your skin care routine simple: avoid cosmetic and personal care products that contain alcohol and avoid using too many products. Avoid rubbing and scrubbing or massaging your face to aggressively. Shield your face when using hairspray. Using very gentle cleanser such as Cetaphil or Sarah VA is recommended. There are other specialty facial cleansers that specifically help to calm down the skin and improve the redness. These include Avene’s Antirougeurs Cleansing Milk, Cetaphil Anti-redness and Eucerin Redness Relief.

There aren’t any foods that directly cause rosacea but there are some dietary items such as alcohol, caffeine, and spicy food that can trigger or worsen it. If you have rosacea, then it is wise to avoid any food that triggers it in order to prevent your rosacea from progressing to a more advanced stage.