Rosacea is a condition usually highlighted by redness, pimples and pus-filled bumps or pustules on the nose, cheeks, chin, and forehead. The National Rosacea Foundation reports that more than 16 million Americans suffer from this condition, but only a fraction are being treated. Rosacea is a progressive disease, which means that if left untreated, the condition will worsen over time. Rosacea is often mistakenly self diagnosed as a skin allergy or eczema. For this reason, it is imperative to have a knowledgeable dermatologist diagnose your condition. Although there is currently no cure for rosacea, there are treatment options available to control and reduce the signs and symptoms.
Doctors and researchers are unsure what exactly causes rosacea. Many, however, believe that rosacea stems from a combination of hereditary and environmental factors. Links to certain foods and activities that increase blood flow to the surface of the skin have been found to act as triggers of rosacea. Hot foods or beverages, spicy foods, alcohol, extreme temperatures, sunlight, stress, anger or embarrassment, and drugs that dilate blood vessels, such as certain blood pressure medications are all triggers of rosacea.
Rosacea symptoms can vary substantially from one individual to another. As mentioned above, one can easily suspect their rosacea to be eczema or a food allergy and a knowledgeable dermatologist should be consulted. The most common and earliest symptom of rosacea is flushing of the skin, ultimately leading to more persistent redness of the skin. Small red solid bumps or pus-filled pimples often develop and are commonly confused with acne. A large population of those with rosacea develop visible blood vessels. Several other possible symptoms of rosacea include: Burning or stinging, dry appearance, swelling, and skin thickening.
As mentioned above, there is no cure for rosacea, meaning, there is no medication that can permanently obliterate all rosacea symptoms. The current treatments that are available are intended to manage and control symptoms of the condition such as minimizing facial redness and acne-like bumps. Several treatment options are: Oral and Topical antibiotics, laser treatments, and topical moisturizers and oils.
Antibiotics used to treat rosacea act by killing bacteria and thus, reduce inflammation and reduce the number of pimples and the amount of redness around pimples. Two methods of introducing antibiotics to the body are: 1.Oral antibiotics (taken by mouth) and 2.Topical antibiotics (applied directly on the skin). The severity of ones rosacea will determine what type of antibiotic they are prescribed. Those presenting a mild form of rosacea may only require a topical antibiotic while those with a more severe case may require oral antibiotics. Generally, people can expect to see a change in their condition after being on antibiotics for 3 to 4 weeks. It is important to remember that an antibiotic that works for one person with rosacea may not work for another.
There are many products on the market to treat rosacea. Some common topical antibiotics that may be prescribed include: Erythromycin (sold under numerous brand names such as Erygel®, A/T/S®, Staticin®, Erycette®, Ery-Sol®, and Erythra-Derm®.) Metronidazole is a topical antibiotic that is intended to treat skin redness and pimples (sold under the brand names Metrogel®, Metrocream(Tm), and Noritate®). Clindamycin is an antibiotic that treats acne and skin infections (sold under the brand name Cleocin-T as a solution, gel, or lotion).
As an oral antibiotic, Erythromycin is sold under names such as Robimycin®, Eryc®, E.E.S.®, E-Mycin®, and Ilosone®. Other oral medications that our doctors may prescribe can include Tetracycline that treats infections. It is sold under the brand names Panmycin®, Tetracyn®, and Robitet®. This particular antibiotic increases ones risk of sunburn and developing melanoma. One should wear a high grade sunscreen and avoid direct sun when taking this medication. Doxycycline and Minocycline are other oral antibiotics that may be prescribed for one with rosacea. As with any antibiotic, you should contact a medical professional immediately if a skin rash or hives develop or if you experience difficulty breathing or swelling of the face, throat, or lips. Speak to one of our doctors to get a clear understanding of what side effects are normal and what symptoms to look out for.
Antibiotics are known to cause side effects. Some normal side effects include nausea or vomiting, diarrhea, and vaginal yeast infection. Diarrhea and vaginal yeast infections occur when antibiotics destroy “good” bacteria that lives in the body. One should seek medical attention immediately if they experience trouble breathing or if a rash develops.
At our offices, laser technology is utilized in many different ways. For rosacea patients, laser technology can be highly effective in removing red lines, visible blood vessels, and reducing extensive redness. The laser works by emitting predetermined wavelengths of light that target tiny blood vessels just under the skin. The heat from the direct laser light causes the vessels to disintegrate. Generally, at least three treatments are required, depending on the severity of redness or visible blood vessels.
Various lasers are used to treat rosacea, including the ND:YAG laser, the pulsed-dye laser, and the KTP laser. Thickening of the skin on the nose and cheeks (rhinophyma) associated with rosacea can be treated with the erbium:YAG laser and the CO2.
Laser treatments have been described by patients as “a rubber band snapping on ones wrist.” For your comfort, a topical numbing cream can usually be applied prior to treatment. Laser treatments have no down time. One can return to work or their daily routine immediately following treatment. After laser treatment some swelling and redness is expected. This typically lasts for two to six hours, but can last up to a day.
As mentioned earlier, the best form of treatment for rosacea is prevention. One should try to avoid activities and items that may trigger an outbreak. If you suffer from rosacea, you should know that you are not alone and millions of others suffer from the same condition. There are numerous research projects underway to advance treatment options for those with rosacea. If you suffer from rosacea, please call our office to make an appointment at one of our convenient locations. Our team of specialists will provide you with all the information you need to know about your condition and will draw up a treatment plan that suits your personal needs. Our doctors’ extensive experience with lasers and our continuous effort to bring you, the patient, the latest and best forms of treatment is what we pride ourselves in.
Advanced Dermatology’s Valerie Goldburt, M.D. speaks on Rosacea
Advanced Dermatology’s Medical Director, Joshua Fox, M.D., Speaks with NASRF’s fellow on Rosacea