Rosacea
What is Rosacea?

Rosacea is a skin condition that affects the face, nose, cheeks, forehead and chin. There are small and superficial dilated blood vessels, pimples which cause redness and swelling. Patient can have increased sensitivity to sunlight and the skin can become red on sun exposure.

What causes rosacea?

Rosacea can run in families and it has been seen more commonly in some ethnic groups. The exact cause of rosacea is still unknown, but some associations have been found with a mite demodex and a bacteria found in stomach called H pylori. A protein called cathelicidin can also be one of the aggravating factors which is found in the skin.

What are different procedural treatments which can help in rosacea?

Laser or light therapy: Intense pulse light therapy helps in reducing the redness in the skin and it also can help in reducing the size of capillaries in the skin. It can also help by controlling the acne flare ups. Blue LED light therapy can also help in this condition. Few sessions (4-5)are required for effective control. These treatments should always be done under the supervision of a dermatologist and people who get it done from parlours or chain clinics put their skin to the risk of scarring or pigmentation or other side effects.

Lasers: rosacea can also lead to submarine, comedones formation in some patients on the nose and near the chin area, so in such cases Rosacea once subsided completely by fractional laser, derma roller, MNRF and sometimes CO2 laser. Thats why it requires a lot of experience and skills and should be done by an experienced dermatologist only.

Things to Know

The condition of Rosacea can worsen if exposed to

  • Heat
  • Exercise
  • Sunlight
  • Psychological stress
  • Steroid creams
  • Alcohol
  • Cold
  • Cosmetics
  • Smoking
  • Spicy food
  • Caffeine
  • Wool or synthetic fabric
  • Menopause
  • High glycemic index foods
  • Drugs like some blood pressure medicines & opiate painkillers.
Rosacea can effect any gender at the age of 30-50 yrs depending upon the condition and severity which can differ from person to person. Although it can be seen in younger patients also.

A person affected by rosacea can have symptoms involving face & eyes. Major symptoms are:-

A. Redness of face: The skin of face especially the central part of face becomes red & reddish capillaries are also visible. Most commonly it affects nose, cheeks & chin area.

B. Swelling & pimples: Many a times the condition is confused with acne & being treated for acne only. Although some treatments are similar so they also help to relieve the symptoms. One can have swelling and bumps on the skin. These are usually painful and can also resemble pustular or nodular acne.

C. Ocular or Eye involvement: It is characterised by red, dry or swollen eyelids. The skin of eyelids is highly irritable. Sometimes only ocular lesions are seen before it becomes visible on facial skin.

D. Rhinophyma or big nose: This is one of the most embarrassing or troublesome part of rosacea where the nose becomes thick & swollen and appears bigger in size. This hardness or increased thickness of skin is also seen over the chin in some patients.

Females are more commonly affected than males.
Besides affecting the skin & causing eye problems, rosacea has a lot of psychological effects on the life of a patient. It can badly affect the confidence of a person & even can lead to depression. It can lead to low self esteem, less social outings, bad personal relationships, low performance at the work place & reduced quality of life index. In fact this is one of the major reasons to treat rosacea and it has been seen that the quality of life improves significantly after treatment of rosacea as it induces more self acceptance.

The treatment of rosacea is basically to treat the symptom and avoiding the things which cause flare up of the condition.

1. Topical creams or gels: Retinoid gels or creams like tretinoin or adapalene are the commonest prescribed medicines for it. Benzoyl peroxide preparations have also been found to be effective in treating rosacea. One has to take care of the irritation part caused especially by the retinoids. Other topical medicines include clindamycin, dapsone, azelaic acid, metronidazole and clarithormycin etc.

2. Oral antibiotics: Like Doxycycline, Minocycline, Clarithromycin & Lemecycline are commonly used medicines when the lesions get flared up. Usually the condition responds pretty well to 2-3 weeks of medication.

3. Isotretinoin: This is the most common medicine prescribed for rosacea and gives lasting relief to the patient. This medicine has got serious side effects so should be used only under the supervision of a dermatologist.

1. Sun protection: This is essential 365 days a year. Sunlight is the leading cause of rosacea flare-ups, which leads to redness. Even when you treat the redness, you still have to protect your skin from the sun. To protect your skin, dermatologist recommend the following every day:

  • Apply a broad-spectrum sunscreen with SPF 30 or higher every day. If the sunscreen irritates your skin, try one that contains only titanium dioxide, zinc oxide, or both.
  • Wear a wide-brimmed hat when outdoors during the day.
  • Seek shade.
  • Avoid the midday sun.

1. Brimonidine (Erythego) gel is found to be helpful in reducing the erythema on the skin. But it should be used under the supervision of a dermatologist only.

One must try to figure out the trigging factors of rosacea in his/her case and avoid those.

Skin care: As we know the skin in rosacea is very sensitive so everything from the skin care products and the way you handle your skin matters a lot. Rosacea friendly skin care involves:

  • Finding a mild cleanser to wash your face.
  • Using only your fingertips to gently apply the cleanser to your face.
  • Rinsing with lukewarm or cool water.
  • Gently patting your face dry with a soft, clean towel
  • Use a broad spectrum sunscreen or silicon/ dimethicone based sunscreen.
  • Avoid using cosmetics.
  • Avoid using oil even on hair.

One must avoid using toners, astringents, fragrances, harsh soaps and shampoos. One should stay away from wool clothes or at least they should not come in direct contact with the skin. The different options to treat rosacea can vary from person to person depending upon the condition of the skin, But doing yoga, meditation, living a healthy lifestyle, drinking a good amount of water, cutting down on high glycemic index foods help. Use of sun protection and moisturisers will also helps. In same patients there is a direct relationship with increase in dairy product foods also so one can avoid them or reduce it.

One should avoid use of cosmetic, sun protection is necessary, good intake of water, diet rich in fibrous also helps.
Dr Shail Gupta, MD (renowned dermatologist) with almost 2 decades of experience in the field of dermatology says that this treatment (rosacea) is a very stubborn condition & it can be treated to relieve the symptoms but we cannot cure it completely. In case of rosacea patients have an associated low self esteem problem. Meditation, self hypnosis techniques definitely help a lot in this condition.

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