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Answering Your Burning Questions about Rosacea

By Anne Marie Tremaine, MD

Rosacea is a common skin condition that presents with redness, broken blood vessels, swelling, flushing, and acne-like lesions on the face. Much less commonly, rosacea can cause the nose to enlarge and become more bulbous, a variant known as rhinophyma (W. C. Fields is a famous example). Rosacea can also affect the eyes causing a myriad of symptoms including redness, irritation, conjunctivitis, blepharitis, and frequent styes. Rosacea tends to wax and wane overtime, but it is most often a chronic condition.

Who gets rosacea?
Really anyone can be affected by rosacea, but it is most common in adults over the age of 30 and those with fair skin. Individuals with Celtic or Scandinavian ancestry have an increased risk of getting rosacea. This disease is more common in women, but men with rosacea tend to have more severe skin findings.

What causes rosacea?
There is not a clear cause for rosacea, but we know it tends to run in families, so there is likely a genetic component. Other factors that may play a role are an overactive immune system, as well as, Demodex, which is a mite that lives on the skin.

Does rosacea have triggers?
Yes, there are many triggers that can flare rosacea, including exposure to sunlight, heat, stress, cold temps with wind, alcohol (especially red wine), spicy foods, and hot beverages.

What are the treatment options?
There are several treatment options and your dermatologist will determine which is best for you. Often it is necessary to try different treatments or use several of the treatments in combination to see improvement.

The most important treatment is daily use of broad-spectrum SPF 30 or higher, in addition to sun avoidance using a combination of factors (seeking shade when outside, wearing wide-brimmed hats and sunglasses) because sunlight is a major trigger for rosacea. Use of the appropriate skin care products is crucial because people with rosacea tend to have sensitive, dry skin that can be easily irritated by common products for our hair and skin. It is extremely important for those with rosacea to use gentle cleansers and moisturizers. If you are having trouble finding skin care products or sunscreens that your skin can tolerate, ask your dermatologist for recommendations.

There are several prescription strength topical products that your doctor may recommend. Medication creams containing metronidazole, azelaic acid, sulfur, and ivermectin can address the redness and acne-like lesions of rosacea.

Topical brimonidine and oxymetazoline can be applied daily to reduce the severity of skin flushing. Oral antibiotics can be used when topical creams fail or if there is any ocular involvement.

Laser and light-based devices such as the Pulsed Dye Laser and Intense Pulsed Light are also fantastic treatment options. These procedures are quick, have little downtime, and are highly effective at reducing redness and the appearance of broken blood vessels. Most patients need a series of three to four treatments to achieve a clearer complexion, followed by intermittent touch ups to maintain the results. Unfortunately, these treatments are generally considered cosmetic in nature and are not covered by insurance.

Although we cannot yet cure rosacea, thankfully, we have many treatment options to help control this disease.

Anne Marie Tremaine, MD
Board Certified Dermatolgist
Harvard Cosmetic and Laser Medicine Fellowship

Dr. Tremaine is a board-certified dermatologist with fellowship training at Harvard Medical School in laser and cosmetic surgery. She has contributed as a dermatology expert for online and print magazines including Family Fun, msn.com, menshealth.com, and ccn.com. In addition, she frequently lectures to professional societies on her diverse research.

For more information about skin care visit the Skin Wellness Physicians website at: www.skinwellnessflorida.com 

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