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Cambridge Medical
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202020 Jul

A Doctor's Guide to Rosacea

Often mistaken for acne, Rosacea (roh-say-sha) is no doubt the scarier and angrier sister. It is a skin condition that leads to widespread inflammation across areas such as the cheeks, nose, chin and forehead. Usually, this is accompanied by pus-filled bumps that look like pimples and the appearance of blood vessels beneath the skin. In some cases, the blood vessels may break and thicken causing pain and swelling of the affected area resulting in a bulbous nose and even eye problems. Much like acne, rosacea can come and go within a few weeks but if left untreated, it may become a permanent affliction.

The painfully complex roots to the problem

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There are many causes of rosacea ranging from one’s genetics to the mites living on their face. A study[1] conducted by Standford medical school identified hereditary factors that contribute to the condition suggesting that rosacea does tend to run in families.

Another cause of the characteristic flushed appearance is sun damage[2] to the small capillaries beneath the skin. It UVB rays are found to be able to increase the formation of blood vessels leading to a red and irritated appearance of the skin.

Mites and bacteria may also play a role in the development of the condition. Mites called Demodex folliculorum[3] are harmless microscopic creatures that are found on everyone. However, some people may have heightened sensitivities to these tiny creatures leading to skin inflammation. Another possible reason would be there are too many mites living on your face. A study had found that people with rosacea tend to have 10 times the normal amount of mites living in their skin. This means that there are increased production of mite faeces that can lead to irritation. A review[4] published in the Journal of Medical Microbiology found a link between the bacterium Bacillus oleronius that triggered this condition.

Other environmental factors such as smoking habits, age, complexion and diet can all be likely triggers for rosacea.

There are four types of Rosacea which can be categorised as follows:

Subtype 1: Erythematotelangiectatic rosacea (ETR). This type of rosacea sees redness being concentrated in the centre of the face with the prevalence of broken blood vessels that are close to the surface of dried, swollen skin.

Subtype 2: Papulopustular Rosacea is also known as acne rosacea. As the name suggests, this type of rosacea combines acne-like breakouts with broken blood vessels and raised skin patch leading to an oftentimes painful and stinging sensation in the affected area.

Subtype 3: Phymatous Rosacea which leads to the thickening of the skin around the nose, enlarged pores and broken blood vessels. However, this is a more uncommon form of Rosacea that occurs more often in men. 

Subtype 4: Ocular Rosacea. This affects the area around the eyes and can lead to bloodshot, watery eyes with a burning sensation. This makes the person very sensitive to light. Other symptoms may include cysts on the eyes and in some worse case scenarios, may lead to a diminished field of view. 

Avoiding the triggers

Dealing with Rosacea is essentially dealing with sensitive skin. The hot and humid weather we live in can cause increase secretions of the sebaceous glands in the face. This can serve to further irritate the skin and encourage the mite population growth thus worsening the condition. However, a combination of proper diet, skincare and medication should do the trick.

Changing your diet would help you avoid triggers of rosacea. That means reducing the intake of alcohol, chocolate and spices. Experts[5] in Brown University department of Dermatology believe that alcohol can weaken the immune system and cause the dilation of blood vessels that lead to flushing associated with the condition. Another study[6] published by the rosacea review had found that spicy foods ranging from mild hot sauces to our beloved Mala dishes significantly increases instances of rosacea flare-ups. Other trigger foods can be chocolate, citrus fruits and shellfishes.

On top of the diet, a gentler approach to skincare would be ideal. This can be done by diligent use of sunscreen to protect the highly sensitive skin from sun damage. Experts suggest the use of SPF 30 and stronger sunscreens when going outside. When it comes to cleaning off the skin after a long day, stay away from harsh cleansers and exfoliators. They may make your skin feel squeaky clean but in reality, you are just setting yourself up for another flare-up. Give gentle, soap-free cleansers a go along with fragrance-free moisturisers to take care of your face.

A visit to your doctor may also allow you access to medication[7] that can help with the symptoms of rosacea. Your doctor may prescribe drugs such as Brimonidine to tighten the blood vessels in the skin reducing the flushed appearance, Azelaic acid which can help clear up the bumps in the skin and Flagyl, an antibiotic that helps to bring down the redness and swelling.

Treating Rosacea with Pro Yellow Laser

Rosacea is not a life-threatening condition. However, it can do a number to your self-confidence.

Introducing laser treatments. At Cambridge Medical, we employ the use of the Quadrostar Pro Yellow Laser that has clinically proven its efficiency with dealing with pigmentation problems. The laser operates at a wavelength of 577nm and uses a dual yellow light combination. What this means is that the laser is specifically designed to tackle problems related to vascular treatment as it is this colour that is best absorbed by the blood. This allows the laser to shrink vessels of almost any size from small to large capillaries and leaving them completely unharmed.

What you can expect during the treatment is just a mild prickling sensation. This is because the treatment is designed to maximise patient comfort and doctors would administer topical anaesthetics if patients would like to be more comfortable. Here’s the kicker, it takes only 45 mins of your time. Other than a slight pinkness in the treatment area, there is virtually no downtime and you can go right back to your daily activities. The condition should completely clear up after 4 to 6 treatments with 3 to 4 weeks between treatments.

[1]https://blog.23andme.com/23andme-research/the-genetics-of-rosacea/
[2]https://www.riversol.com/pages/what-causes-rosacea#Sun%20exposure
[3]https://www.newscientist.com/article/dn22227-rosacea-may-be-caused-by-mite-faeces-in-your-pores/
[4]https://microbiologysociety.org/news/press-releases/bacterial-cause-found-for-skin-condition-rosacea.html
[5]https://www.sciencedaily.com/releases/2017/04/170420114020.htm
[6]https://www.rosacea.org/press/2003/july/new-survey-pinpoints-spicy-foods-that-may-often-trigger-rosacea/
[7]https://www.medicinenet.com/rosacea/article.htm

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