Management of Rosacea

Management of Rosacea

Rosacea is a common chronic skin condition that affects the face causing redness, tiny blood vessels to become prominent, acne like pimples, and more rarely, red eyes or enlarged nose. It is thought to affect 10% of the population and is more common in women than men, more common in fair-skinned people, and is more likely to occur if you have a relative with rosacea, if you have had sun-damage on the face, or if you flush easily. Rosacea is most commonly diagnosed between 30 – 50 years of age.

What causes rosacea?

Well that is the million-dollar question. Nobody is certain. Research tells us that genetics plays a role (e.g., you inherit it from a parent). There are several triggers that make rosacea more prominent. Common triggers are: sunlight, heat, wind, cold air, alcohol, spicy food, and stress.

Types of rosacea.

There are 4 sub-types of rosacea. You may have one of the sub-types or more than one sub-type at the same time.

Erythemotelangiectatic (red) rosacea. This is a mouthful that means your rosacea is marked by redness and flushing on the forehead, cheeks, and chin and you also see many small tiny blood vessels that can appear pink, red, or purple. These tiny vessels are called telangiectasia. Usually this type of rosacea has very sensitive skin and reacts to triggers.

Papulopustular (acne) rosacea. This is the classically described rosacea where there is redness on the face in the forehead, cheeks and chin region, accompanied by pimples that look like acne pimples. The redness typically is always there but the pimples often come and go in breakouts. This is one of the causes of adult acne. One way to tell if it is acne rosacea is that there are no blackheads or whiteheads.

Phymatous rosacea. This is uncommon and appears as a thickened uneven skin on the nose, causing it to look red and swollen. This is more common in men. It is best treated with BBL (Photofacial) and Nd:YAG 1064 laser treatments followed by laser resurfacing to smooth down the skin.

Ocular rosacea. This is another uncommon rosacea and appears as recurrent red eyes that may sting, itch or water. Often people with ocular rosacea are misdiagnosed with allergies for years.

Rosacea treatment

The main goal in treating rosacea is to protect the skin from further damage by using rosacea-designed skin-care products, avoiding excess sunlight exposure, wearing sunblock SPF 30 or higher with UVA and UVB protection, and to avoid other triggers such as alcohol or spicy foods.

Acne rosacea can also be treated with topical creams and oral antibiotics which can work some of the time. One of the most common topical creams used is topical metronidazole (an antibiotic).

The most dramatic treatment for rosacea is to use laser or light therapy to reduce or get rid of the redness. The BBL (Photofacial) laser can be used to get significant redness reduction. The BBL is usually sold in a package of 3 treatments which are each done about 1 month apart. This gets you the most significant reduction in redness and can last more a long time. Some people will repeat this treatment once per year to keep the redness well controlled.

We can combine the BBL treatment with Nd:YAG 1064nm laser treatment for the telangiectasia (prominent or red vessels). Larger or more prominent vessels often need stronger and more direct energy than the BBL can provide and this is when we use the Nd:YAG laser to get excellent results.

Available Treatments

Click the links below for more details about the available treatments.