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July 20, 2020

A Doctor's Guide to Rosacea

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Rosacea is a chronic skin condition often confused with acne, but it presents in different ways—commonly with redness across the cheeks, chin, forehead, and nose, accompanied by bumps, visible blood vessels, and occasionally eye irritation. If left untreated, rosacea can worsen over time and may lead to persistent swelling and discomfort.

Understanding the Causes

Rosacea can stem from a mix of genetic, environmental, and microbial factors. Research suggests that:

  • Genetics may play a role, with familial clustering observed.
  • Sun damage can affect blood vessels under the skin, contributing to persistent redness.
  • Microscopic mites (Demodex folliculorum) may exist in higher concentrations in those with rosacea.
  • Bacteria such as Bacillus oleronius may trigger inflammation.
  • Lifestyle factors like smoking, age, and diet can worsen symptoms.

Four Subtypes of Rosacea

  1. Erythematotelangiectatic Rosacea (ETR): Redness, visible vessels, and dry, sensitive skin.
  2. Papulopustular Rosacea: Acne-like breakouts with stinging and burning sensations.
  3. Phymatous Rosacea: Skin thickening, typically around the nose, more common in men.
  4. Ocular Rosacea: Affects the eyes with redness, irritation, and sensitivity to light.

Managing Triggers

Diet

Limiting alcohol, spicy foods, chocolate, and certain shellfish may help manage flare-ups. These foods have been associated with triggering inflammation in sensitive individuals.

Skincare

  • Use broad-spectrum sunscreen (SPF 30 or higher).
  • Choose gentle, soap-free cleansers and fragrance-free moisturisers.
  • Avoid harsh exfoliators and alcohol-based toners.

Medical Approaches

Doctors may prescribe topical or oral treatments such as:

  • Brimonidine to reduce redness by constricting blood vessels
  • Azelaic acid for bump and redness management
  • Oral antibiotics (e.g., metronidazole) for anti-inflammatory effects

Always consult a licensed medical practitioner for diagnosis and personalised treatment recommendations.

Laser Therapy for Rosacea

For patients with visible capillaries or persistent redness, vascular lasers may be recommended. These treatments deliver targeted energy to reduce the appearance of blood vessels under the skin, helping to improve overall tone and redness.

Types of laser-based therapy include:

  • Pulsed dye lasers (PDL)
  • Intense pulsed light (IPL)
  • Dual-wavelength yellow light lasers

These lasers are typically selected based on their ability to target vascular conditions. Yellow light lasers, in particular, may be considered as they emit wavelengths that can be absorbed by blood vessels without harming surrounding tissue.

Outcomes vary based on individual skin types and severity of rosacea. Patients typically undergo several sessions spaced a few weeks apart. Any aesthetic-based treatment should be discussed with a licensed practitioner to determine suitability and expected results.

In Summary

Rosacea is manageable with the right combination of trigger avoidance, gentle skincare, and professional treatment. While there is no cure, many patients can achieve significant improvements with consistent care. If symptoms persist or worsen, consult your doctor for a comprehensive treatment plan tailored to your skin’s needs.


Disclaimer: All medical treatments should be reviewed and approved by a licensed medical professional. Individual outcomes vary. This article is for informational purposes only and does not substitute medical advice.

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