Rosacea is a chronic skin condition of unknown cause and it cannot be cured but it can be controlled. Medical grade vascular lasers play an important role in controlling and treating the redness component of Rosacea.
Typically it begins after 30 years of age, is commoner in women but more severe in men, characterised by flare ups and remissions and is more common in fair skinned adults of Northern European heritage.
There are 4 types of Rosacea:
(1) Facial Redness (Erythematotelangiectatic Rosacea) which is the commonest type and presents as persistent redness often associated with visible blood vessels.
(2) Acne ( Papulopustular Rosacea ) which is the combination of facial redness and acne and is commonly termed Acne Rosacea.
(3) Thickened skin ( Phymatous Rosacea) which is where the skin becomes very thickened and enlarged usually around the nose.
(4) Eye Irritation ( Ocular Rosacea) which is fortunately less common as it can result in watery, bloodshot eyes with constant irritation and burning.
Rosacea is recognised as a condition that has intermittent flare ups and often particular trigger factors can be identified as causing these flare ups. Triggers can be difficult to identify and can be unique to each patient and the severity varies substantially from one patient to another.
Certain cosmetics and hairsprays can be aggravating especially those containing alcohol, witchhazel and fragrances. As a general rule any topical products that cause redness or stinging should be avoided.
Any situation that results in an increased body temperature will also result in increased facial redness because the body tries to dissipate heat through the facial skin. Common factors to raise the body temperature are extreme heat, hot showers, saunas, intense exertion, hot spicy foods and alcohol. These aggravating factors are not the primary cause of Rosacea but will make the facial redness that is present more obvious.
Some patients identify certain foods as aggravating their Rosacea but this seems to be very unpredictable and variable. Obviously if in a particular patient a certain food aggravates their facial redness then avoid that food. In patients with Rosacea the use of a special diary (Rosacea Diary) can help to identify environmental and lifestyle factors that may trigger flare ups in their particular case.
Whilst there is no cure for Rosacea there are effective treatment options to control the condition. Treatment of Rosacea focuses on reducing inflammation, controlling excessive sebum production, avoiding trigger factors and treating the blood vessel proliferation. If acne is a major component then this will need to be specifically targeted.
Advice and education on the best topical skincare program for a particular skintype is essential. Sunblock is important to reduce the inflammatory effect of UV light, moisturisers can be important in some patients but cause aggravation in others and avoidance of products that might trigger Rosacea is important.
Topical medications such as Vitamin A products can be important as can topical salicylic acid if acne is a component. Prescription topical antibiotics and Vitamin A as well as oral medications such as antibiotics and Roaccutane can be required for more severe cases.
The treatment of choice for removing blood vessels is with medical grade vascular lasers. When treating the redness of Rosacea it is important to have realistic expectations as Rosacea is a chronic condition that we are trying to control and can’t cure. It must be appreciated that not all lasers are the same and not all laser practitioners are the same. The best option for achieving a safe and effective result in treating the redness of Rosacea is to have laser treatment in a medical clinic setting using medical grade laser equipment and performed by experienced University trained laser practitioners.