Acne Rosacea - Fighting with rosacea
What is rosacea?
Rosacea is a chronic disease which usually first appears as subtle reddening on the face. It is usually focused on the center of the face. Rosacea commonly starts on the nose and spread outwards to include the cheeks, chin and forehead. Over time this may develop into some inflammation and may be accompanied by skin eruptions. If left untreated, rosacea can worsen over time and even affect the eyelids and mucous membranes. By some recent estimates Rosacea afflicts 13 million Americans.
If you believe that you may have Rosacea, the first thing to do is to see your dermatologist. Many of the symptoms of Rosacea could be the result of other ailments. As always when dealing with this sort of situation, professional advice should be your first course of action.
If you have been diagnosed with Rosacea you need to know that there is currently no cure. In fact, the cause of Rosacea is still somewhat of a mystery. Having said this however, the good news is that there are many things that can be done to bring the disease under control and minimize the symptoms and also to prevent the disease from progressing further. In general, the treatment is aimed at the control of redness, inflammation, and skin eruptions. Treatment is necessary to prevent permanent damage.
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Forms of Treatments
In most cases, once a diagnosis of Rosacea has been made a dermatologist will prescribed a combination of oral antibiotics and the use of antibiotic gel as initial treatment. The oral antibiotics will bring the condition under control (reducing redness and the formation of papules and pustules), then the topical treatments will be used to keep the symptoms under control. In all cases the dermatologist should help to determine the relevant lifestyle factors which may need modification to keep flushing/blushing from occurring.
Long term use of Oral Antibiotics is not recommended due to a number of side effects which may occur including sun sensitivity and upset stomach.
A couple of important notes:
- It may take several weeks or more to see any improvement in the condition
Controlling Flushing and Blushing
It is important to control the flushing & blushing aspects of Rosacea to help prevent the Rosacea from becoming worse. This can be accomplished through various forms of treatment described below as well through lifestyle adjustments.
Treatments Taken Orally
Oral antibiotics used in rosacea treatment are tetracycline; Minocin®/minocycline; erythromicin.
An alternative is a medication which is similar to Vitamin A called Isotretinoin (sold under the brand names of Accutane or Roaccutane) that is sometimes effective against severe papopustular rosacea. It works by inhibiting sebaceous gland function and physically shrinking the glands and, since it has potent anti-inflammatory properties, it is ideal to treat resistant rosacea. [Note that Isotretinoin is not to be taken by women who are, or may become pregnant due to the risk of birth defects.]
Metronidazole - In 1989 metronidazole was approved as the first topical treatment specifically for rosacea. It can help to reduce rosacea flare-ups once the rosacea is brought under control. In North America Metronidazole is sold under various brand names including Metrogel (and Metrolotion & Metrocream, all 3 contain .75% metronidazole and are manufacturered by Galderma Laboratories, Inc.) and Noritate (1% metronidazole cream). In Australia and New Zealand the equivalent of Metrogel is called Rozex. Metrocream, Metrolotion and Noritate are not available in Australia.
Azelaic Acid, a treatment sometimes used for acne, has been shown to be effective in treating papules & pustules.
Treating Red Lines
If Rosacea is left untreated, red lines (known as telangiectasis) may appear. These are as a result of blood vessels in the face becoming enlarged or damaged. Currently the only choices for treating these red lines is to cover them with makeup or correct them with surgery.
The damaged blood vessels may be treated in one of three main ways :
i) By injecting a concentrated saline (saltwater) solution into vessels to cause them to close up;
ii) By using a laser or cautery to seal the broken vessels and prevent blood flow to the surface. With traditional laser treatment of these lines they will typically disappear after two to four laser treatments. The cost to treat one view would be $150 for each of two treatments. If there are several veins, the cost could rise to several hundred dollars.
iii) Mixed light pulse (Photoderm) which, despite it's name is not a laser treatment, is emerging as an effective treatment for these Rosacea symptoms. Mixed light pulse therapy works by sending light energy through the outer skin, concentrating on the dermal layer just below. This attacks the problem from the inside; it stimulates growth of collagen. So there is no visible damage, no healing that has to occur.
You can also get yourself this anti redness cream for rosacea treatment to reduce the appearance of redness while at the same time calming and soothing the skin.
Treatments to Avoid
Topical steroids may help the symptoms initially but can severe problems over time and should be avoided. (Steroids may be sold under brand names such as DesOwen and Westcort.)
Acne Treatments - Although rosacea used to be called 'acne rosacea', rosacea is no longer considered a form of acne and the treatments are quite different. Benzoyl peroxide, a common ingredient of many acne treatments, may actually make rosacea symptoms worse.