Did you know that April is Rosacea Awareness Month, as deemed by the National Rosacea Society? For those who have it, rosacea can often be much more than an unsightly nuisance on the faces of both women and men. Let’s shed some light on this very common skin condition called rosacea.
Rosacea is a chronic skin condition that can be cosmetically annoying and shows up on the face, including the cheeks, chin, and the area between the brows. Signs include redness, acne-like bumps and nodules, and in more extreme cases, soft-tissue swelling. The hallmark early skin finding is the appearance of blood vessels and increased redness that can start insidiously during adulthood, as early as the late 20’s to early 30’s. However, it is most common during middle age. Epidemiologic factors of rosacea include: genetics, a Celtic or Scandinavian ancestry, middle age, and being a woman. Although women do more readily get rosacea, if men get it, it is more likely to be more severe and more inflammatory. The more severe cases involve inflamed, red bumps similar to breakouts of moderate to severe acne that can lead to chronic swelling and scarring.
As the inflammation of rosacea continues and becomes more chronic, the skin can thicken and change, resulting in a type of scarring tissue of the skin called phymas. For example, many have seen the end-stage condition on the noses of some rather famous people like W.C. Fields and former President Clinton. When it involves the nose, it is known as rhinophyma. According to the American Academy of Dermatology, nearly 14 million individuals are affected with rosacea. Naturally, it probably comes to no surprise that we see many rosacea patients every week and that we are more than happy to help.
There are several triggers and factors that can worsen rosacea. Many of these factors involve lifestyle and diet. Examples of some common triggers include foods like dairy products, red wine, and spicy foods, emotional triggers like stress or anxiety, and even physical triggers like strenuous exercise. Since rosacea is a chronic skin condition, it can have a noticeably negative impact on individuals, their self-esteem, and their personal lives. Many individuals affected with rosacea state that their faces’ appearing constantly red take a huge toll on them emotionally. However, there are so many treatments on the market that help tremendously, ranging from prescription oral and topical medications, cosmetic topical treatments, and various in-office procedures like lasers and chemical peels. These can effectively help mitigate against redness and the appearance of rosacea.
Did you know that many rosacea patients also have ocular rosacea, where their eyes can get extremely blood-shot, red, dry and irritated? These cause symptoms of stinging, grittiness, and scratchy dryness in their eye, which may bring them to the attention of their allergist or ophthalmologist. Ocular rosacea can get so bad that the vision can be affected as well. Often, these patients can be mistakenly told that their eye irritation is due to allergies, when in fact, they may have ocular rosacea.
Oftentimes, rosacea is hereditary along with other causes, which actually shape and direct the therapeutic approach for rosacea. According to the American Academy of Dermatology, besides the genetic component, there are several causative factors involved in rosacea, including a bacterium called Bacillus oleronius, a parasite called Heliobacter pylori, a mite called Demodex, and an immunologic protein called cathelicidin. Although it may be disconcerting and unnerving to think that there are creepy crawly creatures causing rosacea, remember that normal skin have these, too. Many studies have found that all people both with and without rosacea have large numbers of these microscopic organisms living on and in their skin. However, it is the genetically-predetermined, abnormal immunologic response to these bacteria, mites, and parasites that actually cause the disease of rosacea.
Of course, it’s important to talk to your dermatologist about beginning a new prescription treatment, but there are some new options on the market that improve rosacea over time for the long haul. There are even prescription topical medications that work to improve redness for short periods of time, which is ideal for the important social event or for even everyday use. Various prescription topical and oral medications can work specifically against the mites, bacteria, and parasites to help improve the symptoms and signs of rosacea.
Alongside medical treatments, Dr. Honet will often recommend that our rosacea patients also boost their course of prescription treatment with a topical cosmeceutical regimen, as well as cosmetic procedures. Topicals can include cleansers, moisturizers with sunscreen, antixoidants, and anti-inflammatories. One of the office treatment options we offer for rosacea in the office is mandelic acid chemical peels by Enerpeel for Glytone. These peels are specially formulated to reduce the appearance of occasional to permanent skin redness while improving skin texture and pore size. Another popular in-office option is treatment using our Ellipse Nordlys laser. This multiplatform hybrid laser machine uses light energy to target diffuse or focal redness. Our certified aesthetic technician Adelle has been treating our patients with the Nordlys for many different skin issues, but finds that treating rosacea patients with it has shown some incredible results.
Hope you have enjoyed this little lesson on rosacea. If you feel that you or a loved one may be suffering from rosacea, let Dr. Honet and her staff evaluate and determine an effective therapeutic plan, customized for the specific skin type and the severity.
Happy, Healthy Skin!
–Senada and Dr. H