Rosacea - Medical Esthetics

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Medical & Esthetic Association Medical Esthetics®_1987-2010

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ROSACEA
By A3 / Michelle Palmer, CTN, CMES

Rosacea affects as many as 13 million Americans, it occurs mostly in middle-aged men and women of Northern European descent. Rosacea results from persistent and excessive redness and flushing in the center of the face. If left untreated, it can lead to swelling, raised lesions, and certain types of acne. Advanced rosacea-not drinking alcohol-gave W.C. Fields his trademark bulbous nose. However, the good news is that knowing certain sensitivities can help in avoiding flare-ups, while treatment to lesson or get rid of symptoms is available.

What Are the Signs of Rosacea?
Rosacea includes a variety of skin disease symptoms:

red face
flushing
swelling
acne
burning sensation
inflammation
dryness
eye irritation

For most patients, rosacea starts with redness, or "blushy complexion," ranging in appearance from light pink to bright red. For some people, facial flushing is the only sign of rosacea. Most of us associate flushing with embarrassment, but there can be other causes, such as menopausal hot flashes or certain drugs. The flushing can also be aggravated by certain environmental factors, such as eating hot foods, drinking alcohol, exercise, and emotions such as rage and embarrassment.

Some patients suddenly develop acne in the center of their face, often in waves and occasionally in clusters. However, the blackheads and whiteheads associated with ordinary acne do not appear in rosacea. Inflammation ignites around the facial follicles and is related to redness, swelling, bacteria, which plays an unknown role. Inflammation leads to acne, soreness, and even more redness and swelling. Some patients also have mild skin dryness, particularly over the central face, called "rosacea dermatitis." Finally, quite a few patients with rosacea experience irritation in their eyes. This can include itching and burning, along with a pink tint in the white portion of the eyeball. "Ocular rosacea" commonly results in styes and many of these patients cannot tolerate contact lenses.

What Causes Rosacea?
We do not yet understand the exact causes of rosacea. Blood from the central part of the face flows through the skull and alongside arteries of the membranes in the spinal cord and neck to help cool the brain. Patients with rosacea may have an exaggerated blush response to help radiated heat for this purpose. In other patients, it may be inherited; a large number of people of Celtic descent seem predisposed. Whatever the cause, treatment is available.

What Are the treatment for Rosacea?
Some symptoms of rosacea are easily treated while others are more difficult. The more difficult components are redness, flushing, and swelling. No drugs are available that reliably constrict the facial blood vessels to eliminate some of the redness. However, you can cover the redness with cosmetics, including green-tinted gels and lotions. But the best treatment for the redness is to avoid what can trigger the flushing. (See, Steps for Treatment Success - MediEsthetics™ manual)

Sucking on ice chips may stop flushing caused by heat stimulation, such as hot flashes. You might notice tiny blood vessels after long periods of facial flushing. You can also cover these up with opaque makeup, or they can be destroyed by appropriate laser light. In contrast to the difficulty treating redness and flushing, the acne associated with rosacea can be very effectively treated with a number of different topical and internal medications. Most reliable and effective are the antibiotics, including tetracycline and erythromycin. They not only reduce the incidence of acne, but also may eventually reduce the redness. Topical treatments are also effective and are often used in combination with internal medications. Usually, these treatments also reduce the skin's hypersensitivity and the burning sensations associated with it.

Because rosacea is a chronic problem, it's best to maintain control by using only topical medications. However, many patients with rosacea have hyper-sensitive skin. As a result, topical medications in the form of gels and ointment, and even cosmetics, can cause burning or stinging. The good news is that may patients- perhaps up to one-third of those with mild or moderate rosacea- do well with no therapy at all over various periods of time. For these patients, occasional treatment with topical and internal medications may be the best plan.

Steps For Treatment Success
Learning particular sensitivities will help to adapt and keep rosacea symptoms at bay. Here are some suggestions:

Always be protected by sunlight by using sunscreen with an SPF of 15 or higher.
Avoid temperature extremes by staying inside on either very hot or very cold days.
Avoid eating spicy foods, drinking hot liquid and alcohol.
Exercise moderately, avoiding high-intensity or heavy exertion, and stay cool.
Avoid extreme emotions such as rage, embarrassment, and fright, if possible.
Cope with stress by practicing deep-breathing techniques

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