ROSACEA

Rosacea is a common skin condition that mainly affects the face. It is most common in those who are 30 years or older, fair-skinned, blonde and with blue eyes. Some families have a tendency toward rosacea.

What Causes Rosacea?

Researchers are still trying to figure that out. Overgrowth of surface bacteria and/or a mite called Demodex seem to play a role, but genetics is also important.

What are the Clinical Features of Rosacea

• Acne-like bumps: So called papulopustular rosacea consists of inflammatory papules and pustules on the face.
• Redness, blood vessels and flushing: Telangiectasias which are superficial blood vessels that make red lines on the skin are very common. A diffuse redness and flushing are also seen. The flushing may be triggered by hot foods or liquids.
• Eye symptoms: Burning, stinging, itching, dryness, and/or a foreign body sensation may indicate you have ocular rosacea. Make sure to tell your doctor if you have this. An oral antibiotic like doxycycline or minocycline can help with ocular rosacea.
• Sensitive Skin: Many patients with rosacea have sensitive skin and should avoid harsh or abrasive cleansers, etc.
• Enlarged nose: Thickening, and a bumpy texture of the skin, often on the nose may rarely occur.

What Can I Do?

• Protect yourself from the sun with hats and sunscreen.
• Protect your face from the wind and cold as these may trigger rosacea.
• Use a gentle skin care routine with unscented cleansers and moisturizers.
• Allow the skin to dry before applying any medication (or moisturizer).
• Always apply any prescription medication first, before any moisturizer or makeup.
• A green-tinted makeup can help reduce the appearance of redness.
• If flushing is a problem, triggers (e.g. hot foods or liquids) should be avoided as much as possible.

What Treatments Might My Dermatologist Recommend?

• Doxycycline is a great oral antibiotic to fight rosacea. Once the rosacea is clear, you can try to taper the doxycycline and just stay on the topical products for maintenance. Doxycycline can make you sensitive to the sun so be very careful especially in the summer. It can upset the stomach so take it with food, but no dairy. Take with plenty of water and don't take just before going to bed. (Rarely, it can stay in the esophagus and cause severe chest pain.)
• Rosacea Triple Cream contains three great ingredients for rosacea--ivermectin, metronidazole and azelaic acid. Apply it once or twice a day to rosacea-prone skin. Even when your face is clear, keep using it to prevent flares. Many patients stay on the Rosacea Triple Cream long term.
• Minocycline is an antibiotic pill that is also excellent for rosacea. It is less likely to upset your stomach and causes less sun sensitivity than doxycycline. However, it can cause dizziness with the first few doses, especially in women, and rarely joint pains. Very rarely it can cause blue spots in the skin, or bruises that don't go away, and if used for years, it can give a bluish color to the teeth and nails.
• Soolantra is topical ivermectin, a medication that kills demodex and can improve rosacea. Unfortunately, it is relatively expensive and insurance companies usually don't cover it. It is applied once daily.
• Laser can be excellent for the telangiectasias and may help with general redness of the face.