After the hormone storms of adolescence, most adults consider complexion problems a thing of the past. Then along comes the flush and sting of rosacea. But with the right drugs and lifestyle changes, your skin can regain its normal, healthy glow.
Your rosacea probably started innocently enough as a simple tendency to blush easily. Then came the harder-to-ignore signs: persistent facial flushing, visible spidery blood vessels, an uncomfortable stinging in your face--all typical early symptoms. If your rosacea has progressed, you've probably also noticed small red bumps (papules) and pus-filled blemishes (pustules) on your face as well. A few people go on to develop severe rosacea with its overall facial inflammation growth of excess skin tissue or enlarged nose (called rhinophyma, mostly found in men.) Half of those with rosacea also develop a burning or gritty feeling in their eyes.
While experts agree that rosacea is caused by dilated blood vessels in the face, they've been unable to pinpoint the prescise reason why the dilation endures. What triggers rosacea varies from person to person, but certain situations in daily life, alcohol, spicy foods, caffeine, stress, bright sunlight, extreme heat or cold, wind or vigorous exercise. Medications, especially niacin and blood pressure drugs, are common culprits as well. And some cases are associated with the hormonal changes of menopause.
Rosacea is a chronic condition that tends to progress gradually, with flare-ups and periods of remission. Most common in women between ages 30 and 60, it tends to run in families and favours the fair-skinned--the 'curse of the Celts', it's been called.
LIKELY FIRST STEPS
For now, there is no cure for rosacea but faithfully using the right treatments can help clear up your skin and keep your symptoms from recurring. In most cases, the best results come from a topical antibacterial drug, often when combined with an oral antibiotic. It's also important to detect and avoid what sets off your flushing. In advanced cases, laser surgery, dermabrasion and other surgical techniques have a good track record for repairing damaged skin.
Medications
For mild cases, rosacea treatment usually starts with a cream, gel or lotion, most likely the
antibacterial drug metronidazole (Rozex) or the topical antibiotic erythromycin, which in this case appears to work by reducing inflammation rather than by killing germs. An antibacterial cream containing 2 percent sulphur in aqueous cream can often benefit those who are not allergic to sulphur drugs. With topical drugs, it can take three to nine weeks to see improvements so have patience and stay with it.
Treating more advanced rosacea is an inside job: oral antibiotics such as tetracycline and erythromycin or, alternatively, the acne drug isotretinoin (Roaccutane) work more quickly than topical prepartations and some antibiotics can prevent eye damage. Once oral medications get rosacea under control, most people can manage it successfully with just a topical drug.
Treatment Options
MEDICATIONS
------------------------------------------------------------------------------------------------------------------------------------------
Topical drugs Benefits seen in three to nine weeks.
------------------------------------------------------------------------------------------------------------------------------------------
Oral antibiotics Best for moderate to advanced rosacea.
A plastic surgeion or dermatalogist can remove unslightly dilated blood vessels with cosmetic surgery techniques, using a laser or an electric needle. And if you have excess skin tissue, you can have it removed via surgical debulking, dermabasion, electrosurgery or laser treatement. (For more information on these techniques, see Acne, and Wrinkles).
What is happening
Your rosacea probably started innocently enough as a simple tendency to blush easily. Then came the harder-to-ignore signs: persistent facial flushing, visible spidery blood vessels, an uncomfortable stinging in your face--all typical early symptoms. If your rosacea has progressed, you've probably also noticed small red bumps (papules) and pus-filled blemishes (pustules) on your face as well. A few people go on to develop severe rosacea with its overall facial inflammation growth of excess skin tissue or enlarged nose (called rhinophyma, mostly found in men.) Half of those with rosacea also develop a burning or gritty feeling in their eyes.
While experts agree that rosacea is caused by dilated blood vessels in the face, they've been unable to pinpoint the prescise reason why the dilation endures. What triggers rosacea varies from person to person, but certain situations in daily life, alcohol, spicy foods, caffeine, stress, bright sunlight, extreme heat or cold, wind or vigorous exercise. Medications, especially niacin and blood pressure drugs, are common culprits as well. And some cases are associated with the hormonal changes of menopause.
Rosacea is a chronic condition that tends to progress gradually, with flare-ups and periods of remission. Most common in women between ages 30 and 60, it tends to run in families and favours the fair-skinned--the 'curse of the Celts', it's been called.
- Topical drugs to reduce redness and blemishes.
- Identifying triggers and making lifestyle changes to avoid them.
- Oral antibiotics or anti-acne medicine for more advanced cases.
- Laser surgery or other procedures if needed.
QUESTIONS TO ASK
- If I have to be an oral antibiotics long term, what can I do about handling their side effects?
- Do I have to give up my tropical holiday and other under-the-sun activities?
- Will I develop acne scars or bumps and a big nose?
Treatments
For now, there is no cure for rosacea but faithfully using the right treatments can help clear up your skin and keep your symptoms from recurring. In most cases, the best results come from a topical antibacterial drug, often when combined with an oral antibiotic. It's also important to detect and avoid what sets off your flushing. In advanced cases, laser surgery, dermabrasion and other surgical techniques have a good track record for repairing damaged skin.
Medications
For mild cases, rosacea treatment usually starts with a cream, gel or lotion, most likely the
antibacterial drug metronidazole (Rozex) or the topical antibiotic erythromycin, which in this case appears to work by reducing inflammation rather than by killing germs. An antibacterial cream containing 2 percent sulphur in aqueous cream can often benefit those who are not allergic to sulphur drugs. With topical drugs, it can take three to nine weeks to see improvements so have patience and stay with it.
Treating more advanced rosacea is an inside job: oral antibiotics such as tetracycline and erythromycin or, alternatively, the acne drug isotretinoin (Roaccutane) work more quickly than topical prepartations and some antibiotics can prevent eye damage. Once oral medications get rosacea under control, most people can manage it successfully with just a topical drug.
Treatment Options
MEDICATIONS
------------------------------------------------------------------------------------------------------------------------------------------
Topical drugs Benefits seen in three to nine weeks.
------------------------------------------------------------------------------------------------------------------------------------------
Oral antibiotics Best for moderate to advanced rosacea.
LIFESTYLE CHANGES---------------------------------------------------------------------------------------------------------------------------------------------
Avoid triggers The key to preventing flare-ups.
----------------------------------------------------------------------------------------------------------------------------------------------
Cleaning regimen Gentle routine; mild soaps without fragrance. -----------------------------------------------------------------------------------------------------------------------------------------------
Eye care Wash eyelids; use artificial tears.
PROCEDURES
---------------------------------------------------------------------------------------------------------------------------------------------
Cosmetic surgery Laser, debulking, dermabrasion, electrosurgery.
TAKING CONTROL
Lifestyle changes
The right lifestyle choices are the key to helping your skin.
Avoid what makes you red. This might mean shunning spicy foods or alcohol, staying out of the midday sun, letting hot drinks cool or covering your face with a scarf when it's cold or windy.
Reduce your stress. Anxiety can trigger rosacea so consider ways to keep yours to a minimum. Often a daily walk can help.
Use mild soaps. Wash your face gently (no scrubbing) with a mild, fragrance-free cleanser and pat--rather than rub--it dry.
Choose cosmetics carefully. Anything you apply to your face should be alcohol-free, nonoily and noncomedogenic (not pore clogging). You can conceal redness with green-based make-up.
Wash your eyelids daily if your eyes are affected. You can use a commercial eye scrub or a drop of baby shampoo diluted in water and rinse thoroughly. If your eyes are very dry, you can get relief with artificial tears.
ProceduresAvoid triggers The key to preventing flare-ups.
----------------------------------------------------------------------------------------------------------------------------------------------
Cleaning regimen Gentle routine; mild soaps without fragrance. -----------------------------------------------------------------------------------------------------------------------------------------------
Eye care Wash eyelids; use artificial tears.
PROCEDURES
---------------------------------------------------------------------------------------------------------------------------------------------
Cosmetic surgery Laser, debulking, dermabrasion, electrosurgery.
TAKING CONTROL
- Become a sleuth. People react differently to common rosacea triggers. To identify your personal flushers, keep a diary of episodes and what preceded them.
- Chill out. If heat is a rosacea trip wire for you, keep the temperature on the cool side at home and dress lightly. Take warm (not hot) showers, have frequent sips of ice water as you exercise and keep your (fragance-free) facial mositurer in the refrigerator so it cools your face when you apply it.
- Avoid topical acne drugs. Most topical medicines for teen-style acne (acne vulgaris) don't work for rosacea and may make it worse. (Acne is caused by hormones and bacteria while rosacea is a vascular disorder).
- Try cold-water soaks. During flare-ups, press a cloth soaked in cold water against your face for 10 minutes. This will constrict blood vessels.
Lifestyle changes
The right lifestyle choices are the key to helping your skin.
Avoid what makes you red. This might mean shunning spicy foods or alcohol, staying out of the midday sun, letting hot drinks cool or covering your face with a scarf when it's cold or windy.
Reduce your stress. Anxiety can trigger rosacea so consider ways to keep yours to a minimum. Often a daily walk can help.
Use mild soaps. Wash your face gently (no scrubbing) with a mild, fragrance-free cleanser and pat--rather than rub--it dry.
Choose cosmetics carefully. Anything you apply to your face should be alcohol-free, nonoily and noncomedogenic (not pore clogging). You can conceal redness with green-based make-up.
Wash your eyelids daily if your eyes are affected. You can use a commercial eye scrub or a drop of baby shampoo diluted in water and rinse thoroughly. If your eyes are very dry, you can get relief with artificial tears.
A plastic surgeion or dermatalogist can remove unslightly dilated blood vessels with cosmetic surgery techniques, using a laser or an electric needle. And if you have excess skin tissue, you can have it removed via surgical debulking, dermabasion, electrosurgery or laser treatement. (For more information on these techniques, see Acne, and Wrinkles).
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