What is Rosacea and how do you treat it?

Rosacea is a very common, often acne-like, benign disease of the skin usually involving the central part of the face, primarily the nose and cheeks. It is more common in fair skinned people, usually of Irish, English, or Scottish descent. It affects a large number of people worldwide. As of 2010, it is estimated that rosacea affected 16 million people in the United States and 45 million people worldwide. In the mildest cases, the primary symptoms are dilated capillaries around the nose and cheeks with frequent flushing, such as blushing. This causes red or pink patches to occur. Rosacea can also involve the forehead and chin areas. In more advanced cases, there will be small red bumps or cysts. Patients may also have irritated pink eyes. As with most fair skinned people, they are very sun sensitive, and should thus avoid sun as much as possible.

Rosacea is a chronic disease and considered non-curable, however, most people who have rosacea may not know that they have the disease or that it is treatable, but as stated, non-curable. Characteristically, like acne, the patients have flare-ups, but unlike acne patients do not out-grow rosacea. Rosacea is not contagious. Interestingly, President Clinton, Winston Churchill and W.C. Fields are people that we know who had rosacea.

The treatment required for rosacea is dependant on the severity of the symptoms and the success of the various treatments used.

Treatments are:

  • Sulfa based washes aimed toward reducing the bacteria
  • Facials using glycolic acid which sterilizes the skin and helps absorption of nutrients
  • Acne treatments, containing benzyl peroxide and salicylic acid
  • Medications:
    • Topical – Metrogel, Finacea. These two can be alternated every two weeks if necessary. Tretinoin such as Retin-A or retinol.
    • Tetracycline – an oral medication, a lower dose tetracycline is Oracea 40 mg once a day
    • Accutane – for the most difficult cases with cysts
  • IPL (Intense pulse light) or BBL (Broad band light) which are intense lights that coagulate and eliminate the dilated capillaries, which cause the flushing and red patches. We have found that these are very effective when used with proper topical creams/ gels and sun protection.
  • Non-ablative Lasers, which also coagulate the dilated capillaries, are also very effective, and there is no down time, as with the IPL and BBL.

While rosacea is not curable, treatments used in proper combinations have been satisfying to both patients and health care provider.

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