A further look at Rosacea

Rosacea (roe-ZAY-she-uh) is a common skin condition that causes blushing or flushing and visible blood vessels in your face. It may also produce small, 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, other skin problems, or natural ruddiness. It can affect anyone but it is most common in middle-aged white women. Treatment can control and reduce the signs and symptoms.

Causes

The cause of rosacea is unknown, but it is thought to be due to an overactive immune system, infection of the skin’s oil glands, or a combination of these. Rosacea is not caused by poor hygiene, and it is not contagious.

Flare-ups are a common sign of rosacea, often triggered by hot drinks and spicy foods, red wine and other alcoholic beverages, temperature extremes, emotion, and even by some cosmetics.

Anyone can develop rosacea, but you are more likely to suffer from it if you are female, have skin that burns easily in the sun, are over the age of 30, and are a smoker.

Diagnosis

No specific test is used to diagnose rosacea. Instead, your doctor will look at the history of your symptoms and perform an examination of your skin. You may have tests to rule out other conditions, such as psoriasis or lupus. Studies show that in people of colour, rosacea is often missed entirely, or misdiagnosed as an allergic reaction or seborrheic dermatitis.

Signs and symptoms of rosacea include:

1. Facial blushing or flushing - rosacea can cause persistent blushing or flushing in the central part of your face. This sign of the condition may be difficult to see on brown and black skin.
2. Visible veins - small blood vessels in your nose and cheeks break and become visible (spider veins).
3. Swollen bumps - many people with rosacea also develop pimples on their faces that resemble acne. These bumps sometimes contain pus.
4. Burning sensation - the skin of the affected area may feel hot and tender.
5. Eye problems - many people with rosacea also experience dry, irritated, swollen eyes and eyelids. This is known as ocular rosacea. In some people, the eye symptoms precede the skin symptoms.
6. 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. This is why we recommend treating the condition as soon as possible.

Treatment

Treatment for rosacea focuses on controlling inflammation and infection. Most often this requires a combination of good skincare and prescription drugs.

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

1. Identify and avoid triggers. Pay attention to what tends to cause flare-ups for you and avoid those triggers. These may be dietary or extremes in temperature (a very warm room for example).
2. Protect your face. Be sunwise and avoid excessive sun exposure. Protect your skin by wearing a hat and avoiding midday sun. In cold climates or windy weather, wear a scarf or ski mask to protect the face.
3. Treat your skin gently. Don't rub your face or touch the skin too much. Use a slightly acidic liquid cleanser (with a pH of around 5) twice a day. Choose fragrance-free products, and avoid those that contain other skin irritants, such as alcohol, camphor, urea, SLS, and menthol. Do not use products that contain paraben preservatives.
4. Spray Thoclor Labs GF2 twice daily onto your facial skin, after cleansing. Allow GF2 to dry naturally before applying other products. If you feel you need moisture on the skin use a serum that contains hyaluronic acid. If the redness has not subsided after a month, consider using Ivermectin 1% cream once daily for a week in place of the serum. Ivermectin is an anti-parasitic that treats a Demodex infestation.

Demodex infestation

Demodex is a genus of microscopic mites that live in human hair follicles. The tiny creatures are cousins of spiders and ticks.

Almost everyone has Demodex mites living on their skin and in their pores, particularly their cheeks, eyelashes, forehead, and sides of the nose. Usually, they cause no harm, but too many can cause a skin condition that is very much like rosacea.

Treatment for a mite infestation usually involves Ivermectin 1% cream (brand name Soolantra) that is available without a prescription from your pharmacy. The recommended treatment course is 3 months.

Laser therapy

Chronic rosacea inflammation can lead to enlarged veins in the facial skin. Intense pulsed light (IPL) laser therapy can make enlarged blood vessels less visible and reduce the experience of flushing. Because the laser targets visible veining, it's most effective on skin that isn't tanned, brown, or black.

The full effect of the treatment might not be noticeable for weeks. Repeat treatments may be needed periodically to maintain the improved appearance of your skin.

Laser treatment for rosacea is usually considered a cosmetic procedure, which medical insurance typically doesn't cover.