Dermatologist Joshua Fox, MD Offers Tips for Understanding Rosacea Symptoms and Treatment Alternatives
Red splotches, facial flushing, unsightly bumps and pimples, bloodshot, watery eyes and even swelling of the nose are all symptoms which often fall under a general diagnosis of rosacea. But how is it possible to know for sure if these symptoms are truly caused by rosacea, or if it’s simply a case of allergies or sensitive skin? According to Dr. Joshua Fox, founder and director of New York and New Jersey-based Advanced Dermatology P.C., “Estimates for the total number of rosacea sufferers in the United States vary from 14 to 16 million, and the reason for this broad range is that many people who suffer from the disease don’t understand that there are treatment options available for them. They don’t seek help and therefore are never diagnosed. Also most patients don’t seek help because they don’t realize that it often involves the eyes”
Tips for understanding Rosacea
Rosacea is a little-understood condition that afflicts people of all ethnicities, but seems particularly prevalent in people with a Northern European background. Some well-known rosacea sufferers include Princess Diana and former president Bill Clinton. It typically presents in women over 30 and men over 40, and symptoms can come out of nowhere, sometimes seemingly popping up overnight. It causes not just physical but emotional damage to its sufferers as they battle unpredictable flare-ups of unsightly break-outs on their faces which can sometimes get even worse as a result of the products used to cover them up. “Even the stress of contending with a flare-up before an important event, such as a wedding or a job interview, can worsen the condition and extend the duration of it. Left untreated, it’s a vicious cycle and it can go into the eyes,” says Dr. Fox.
Research has shown that varying strains of rosacea may be caused by immune or nervous system irregularities, excess production of cathelicidin (a protein found in the skin,) excessive systemic levels of Vitamin D, and demodex mites on the surface of the skin. If a dermatologist is able to isolate the probable cause of the rosacea symptoms, it is then possible to determine the most effective method of treatment.
Rosacea Treatment Alternatives
So what’s the best course of action for someone who thinks they may have rosacea? “The first step is to see your dermatologist for a diagnosis,” Dr. Fox continues. “We believe there are several types of rosacea which are promoted by various factors, and it’s helpful to determine the underlying triggers before deciding on a course of treatment.” The following are treatment options for consideration. Each case is unique and a skilled dermatologist will advise patients on the alternatives for their particular situation.
- Oral antibiotics, including doxycycline (effective for immune system and cathelicidin-based rosacea)
- Non-Ablative Laser therapy (which can seal off dilated blood vessels, reducing the severity and duration of a flare-up and lessen background redness and swelling)
- Topical treatments such as azelaic acid and metronidazole (which kill the bacteria that infect the pores)
- Specialized skin care programs with sulfacetamide, precipitated sulfur and other agents which are formulated specifically for rosacea sufferers.
- Demodectic Powder such as Moo Goo (a mineral blend treatment creates an environment on the skin where the demodex mites can no longer survive)
- Appropriate Vitamin D levels (which may tie into the fact that rosacea is aggravated by sun exposure)
- Ablative laser therapy can shrink and smooth out the bumps on the nose (Rhynuphema)
- Surgery (in extreme cases, surgery may be needed to remove excess blood vessels and/or repair nose disfigurement caused by untreated rosacea)
Once a path of treatment has been determined, rosacea sufferers can also take steps to control the severity and frequency of flare-ups simply by being observant of the stimuli that seem to trigger them. Common triggers include: sun exposure, hot and cold temperature extremes, emotional stress, hormonal changes, cigarette smoking, alcohol, and spicy foods. Patients should also take great care not to use any soaps or cosmetics that might contain irritating ingredients, and they should never use loofahs or other harsh cleansing products.
While there is currently no cure for rosacea, there are many options to lessen its severity. “Sufferers should do everything they can to pinpoint and track the triggers which lead to flare-ups, concludes Dr. Fox. “This information can help their doctor determine the best plan of action to mitigate symptoms and keep flare-ups to a minimum.”
Joshua L. Fox, M.D., F.A.A.D., is the founder and medical director at Advanced Dermatology P.C. He is a leading authority in the field of dermatology with expertise in skin cancer, cosmetic surgery and laser procedures and is program director of a fellowship in laser and cosmetic surgery.