From
Rosacea is an extremely common,
but often overlooked, disease affecting over 14 million Americans
today. Unfortunately, the National Rosacea Society says that about
78 percent of Americans neither know how to recognize this disease,
or how to treat it.
Extremely common in fair-skinned people, Rosacea is most often
characterized by “erythema,” or flushing of the forehead, cheeks,
nose and chin. In less prevalent cases, this flushing can also
affect the shoulders and back of the individual. Although rosacea
affects women about three times more often than men, rosacea does
not discriminate.
The ultimate cause of rosacea is unknown, but some scientists
believe that there is a hereditary component. Those of European
and Scandinavian descent seem to be predisposed to the disease.
Scientists have also learned that factors such as elevated levels
of the peptide Cathelicidin, Stratum Corneum Tryptic Enzymes (SCTEs),
and steroids can induce, or lead to rosacea. Trigger factors include
prolonged sun exposure, increased stress, excessive exercise,
severe temperature fluctuations, and certain skin care products.
There are four subtypes of rosacea. Erythematotelangiectatic rosacea
often exhibits a persistent flushing, or redness, with the possibility
of visible blood vessels in the face. Papulopustular rosacea also
manifests as distinct redness, but includes a bumpy uneven texture
that often leads it to being confused as acne vulgaris. Phymatous
rosacea leads to a thickening of the skin because of an excess
of tissue and an irregular epidermal texture. Finally, ocular
rosacea affects the eyes, making eyelids irritated, red, swollen,
and uncomfortable.
Although there is no cure for rosacea, the disease can be controlled.
Treatments include a personalized and gentle skin-cleansing regime,
daily sun protection with products containing zinc oxide and/or
titanium dioxide, Tetracycline antibiotics, and even laser and
Intense Pulsed Light therapy.
Often rosacea patients simply learn to identify their trigger
factors and avoid those situations. Treatment is long-term, as
rosacea is characterized by periods of flare-ups and remissions,
but most patients see an outlook of about one to two years before
their rosacea is more adequately controlled.
From
Understanding Treatments For Rosacea
By Mark B. Taylor, M.D.
The causes of
acne rosacea are still somewhat of a mystery. Some of the causes
are thought to be related to immune, inflammatory, infectious
and circulatory factors. However, there are several ways to treat
and manage this skin condition.
Acne rosacea has been,
and continues to be, treated with topical and systemic antibiotics
both in antibacterial and anti-inflammatory doses. Long-term high-dose
antibiotics such as Tetracycline, Minocycline, Amoxicillin, and
Doxycycline have become less favorable treatments because of potential
side effects and bacterial resistance issues.
In recent years, treatments
with light-based technologies including lasers, intense pulsed
light, and photodynamic therapy (light or laser and 5 aminolevulinic
acid) have been shown to be effective in the treatment of many
difficult cases of acne rosacea. I have personally had great success
with these modalities at the Gateway Aesthetic Institute and Laser
Center in Salt Lake City.
There are also new
handheld high-intensity light sources, such as Omnilux New-U,
that have recently become available for use at home with excellent
improvement in the inflammatory lesions of acne rosacea.
Topical Metronidazole,
Sulfacetamide, Sulfur, and Clindamycin are still prescribed with
moderate to good improvement in many patients.
At SkinCareRx, we
have pioneered some great non-prescription innovations for the
treatment of acne rosacea. I developed the NuCelle product line
containing Mandelic Acid and Algae Extract. The 10% Mandelic Serum
has shown excellent long-term improvement in acne and rosacea
for many of my patients.
I believe that this is due to two factors. One: Mandelic Acid
acidifies the skin without irritation making it more difficult
for bacteria to live in the skin and pores. Two: Mandelic Acid
appears to have significant anti-inflammatory properties similar
to mild steroid products without the rebound flare and dependence
that we often see with chronic steroid product use.
For most of my patients,
an individualized combination of the treatments mentioned above
gives the greatest long-term relief from acne rosacea.
