from the Fall 1999 issue
Rosacea is a facial skin condition characterized by persistent redness, flushing, mild swelling and red, pimple-like bumps, on the cheeks and nose. It is most common in fair-skinned individuals. Prominent public figures afflicted by the disease include President Clinton and the late Princess Diana, but they are not alone. Today, 13 million Americans suffer from rosacea and millions of others are at risk of developing it.
The persistent red color of the face comes from a network of small blood vessels (called telangiectasia) that have enlarged and become more visible in the skin. Certain foods and drugs, alcohol, heat, stress and exercise can trigger rosacea. Because it is so visible, this disease can affect quality of life by making affected individuals self-conscious about their appearance.
Despite major advances in our understanding of rosacea, we still cannot cure this emotionally-distressing condition. However, with early diagnosis and medical intervention, we can usually achieve remission of signs and symptoms, minimizing rosacea's impact on a person's quality of life.
The mainstay of therapy for rosacea is antibiotic treatment. Initially, we frequently treat clients with both internal and topical antibiotics. When the condition is in remission, the oral antibiotic is tapered off and the topical antibiotic is continued for long-term control. Some clients may need periodic retreatment with oral antibiotics for flare-ups of their disease. The oral antibiotics we most often use are tetracycline, doxycycline, minocycline and erythromycin. Metronidazole (such as MetroGel® or NoritateTM cream) is our most frequently prescribed topical antibiotic. Another crucial part of rosacea treatment is strict sun protection. Sun exposure can cause the formation of new telangiectasia. Rosacea patients should apply a moisturizer with sun screen that blocks UVA and UVB daily. Zinc oxide and titanium dioxide are good UVA and UVB blockers that are also less irritating than some other chemical sun screens.
Although antibiotic treatment will control the outbreaks and decrease the redness of rosacea, antibiotics will not eradicate the network of tiny red blood vessels on the face. For that, we recommend PhotoDerm® intense pulsed light therapy to destroy the facial blood vessels. Most clients require a series of two to four treatments, performed at four-week intervals. Side effects can include temporary redness, swelling or bruising. Since we began using PhotoDerm in December 1997, we have achieved excellent results.
For more information, see:
Rosacea: Remedies
Winter 2002
Rosacea trigger factors include the following:
Foods
cheese, spicy foods, chocolate, soy sauce, vanilla, thermally hot foods
Beverages
hot drinks, alcohol (especially red wine)
Temperature-related
saunas, hot baths, radiant heat, excessively warm environments
Drugs
vasodilators, topical steroids
Skin-care products
alcoholic or acetone substances, any substance that causes redness or stinging, some cosmetics
Emotional stress
Physical exertion
Menopausal hot flashes
Caffeine withdrawal
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