ROSACEA

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Lucija Kračun, MD
Specialist of family practise
AAAMED diploma for aesthetic medicine

Rosacea is a common, chronic, inflammatory skin condition that causes redness and visible blood vessels in your face. It may also produce small, red, pus – filled bumps. These signs and symptoms may flare up for weeks to months and then go away for a while. Rosacea can be mistaken for acne, eczema and other skin problems or natural ruddiness.

CAN I GET ROSACEA?

Anyone can develop rosacea. But you may be more likely to develop it if you:

  • are female
  • have light skin, particularly if it has been damaged by the sun
  • are over age 30
  • smoke
  • have a family history of rosacea.

WHAT ARE COMPLICATIONS OF ROSACEA?

Over time, the oil glands (sebaceous glands) in your nose and sometimes your cheeks become enlarged, resulting in a buildup of tissue on and around your nose — a condition called rhinophyma. This complication is much more common in men and develops slowly over a period of years.

SIGNS AND SYMPTOMS OF ROSACEA

Facial redness

Rosacea usually causes a persistent redness in the central part of your face. Small blood vessels on your nose and cheeks often swell and become visible.

Swollen, red bumps 

Many people with rosacea also develop pimples on their face that resemble acne. These bumps sometimes contain pus. Your skin may feel hot and tender.

Eye problems

Many people with rosacea also experience dry, irritated, swollen eyes and red, swollen eyelids. This is known as ocular rosacea. In some people, the eye symptoms precede the skin symptoms.

Enlarged nose

Over time, rosacea can thicken the skin on the nose, causing the nose to appear bulbous (rhinophyma). This occurs more often in men than in women.

WHAT CAUSES ROSACEA?

Inflammatory triggers for rosacea include UV exposure, alcohol, and exposure to extreme temperatures. Family history, fair skin, abnormalities in facial blood vessels, and Helicobacter pylori in the gut are all contributors to this common condition. Clinical studies have found a link between disturbed gut flora and rosacea skin manifestations and it’s understood that skin conditions can be exacerbated by high stress levels, an inflammatory diet, alcohol, smoking and by taking antibiotics and steroid medications.

While there is no cure for rosacea, there are a number of ways to help relieve symptoms. Depending on the severity, a combination of medications, lifestyle changes and avoiding skincare products that irritate and add to the inflammation of the skin can all help.

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DIAGNOSIS AND TREATMENT

No specific test is used to diagnosis rosacea. Instead, your doctor relies on the history of your symptoms and an examination of your skin. You may have tests to rule out other conditions, such as psoriasis, eczema or lupus. 

Treatment for rosacea focuses on controlling signs and symptoms. Most often this requires a combination of good skin care and prescription drugs.The duration of your treatment depends on the type and severity of your signs and symptoms. Recurrence is common.

Lifestyle and skincare tricks for improving your condition

These self – care practices may help you control the signs and symptoms of rosacea and prevent flare – ups:

Identify and avoid triggers.

Pay attention to what tends to cause flare-ups for you and avoid those triggers.

Protect your face. 

Apply sunscreen daily. Use a broad-spectrum sunscreen — which blocks both ultraviolet A and ultraviolet B rays — with an SPF of 30 or higher.

Take other steps to protect your skin, such as wearing a hat and avoiding midday sun. In cold, windy weather, wear a scarf or ski mask.

Treat your skin gently

Don’t rub or touch your face too much. Use a nonsoap cleanser and moisturize frequently. Avoid products that contain alcohol or other skin irritants. Use dermatologically tested natural products. Rosacea sufferers should generally clean their skin once a day to remove dirt, pollution and other irritants. But the cleansing ingredients must be especially gentle – use a pH neutral soap for balance and follow with a hyaluronic – based serum to boost hydration and then a gentle moisturizer. Aggressive ingredients like glycolic acid, fragrance and harsh preservatives should be avoided as well as treatments including chemical acid peels and strong exfoliant treatments.

Facial massage

Gentle daily facial massage may help reduce swelling and inflammation. Use a circular motion with your fingers starting on the central part of the face and work toward the ears.

Coping and support

Rosacea can be distressing. You might feel embarrassed or anxious about your appearance and become withdrawn or self – conscious. You may be frustrated or upset by other people’s reactions. Talking to a counselor about these feelings can be helpful.

MEDICATIONS AND LASER THERAPY – what is better ?

You may need to try different options or a combination of drugs to find a treatment that works for you.

LASER THERAPY

Light therapy may be a better choice if you have tiny visible blood vessels (telangiectasia) on your face. Two options are laser therapy and intense pulsed light therapy. Studies show that light therapy may reduce the appearance of facial redness, flushing and telangiectasia. 

Light therapy involves repeat treatments to maintain improved skin appearance. Side effects are usually minimal and may include temporary redness, loss of skin color and bruising.

Before/after laser treatment

PRESCRIPTION DRUGS 

  • Topical drugs that reduce redness. For mild to moderate rosacea, your doctor may prescribe a cream or gel that you apply to the affected skin. Other topical products have less effect on the redness but help control the pimples of mild rosacea. These drugs include azelaic acid , metronidazole and ivermectin. 
  • Oral antibiotics. Your doctor may prescribe an oral antibiotic such as doxycycline for moderate to severe rosacea with bumps and pimples.
  • Oral acne drug. If you have severe rosacea that doesn’t respond to other therapies, your doctor may suggest isotretinoin. It’s a powerful oral acne drug that also helps clear up acnelike lesions of rosacea. Don’t use this drug during pregnancy as it can cause serious birth defects.