Rosacea is a common skin condition with characteristic symptoms and signs, including symmetric flushing, stinging sensation, inflammatory lesions (papules and pustules), and telangiectasias (flattened veins on the skin) on the face. It may also cause inflammation of the eyes and eyelids. In most patients, the central area of the face is affected, such as the areas around the nose, forehead, chin, and mouth. Swelling can occur with thickened skin and large pores. Clinical findings represent a spectrum of disease with one or several predominating characteristics, including a pattern of exacerbation and relative inactivity.
Patient with Subtype 2 (papulopustular) rosacea, treated with topical therapy in a split-face study.
What skincare products are appropriate to use with rosacea?
Topical regimens are first-line therapies for mild papulopustular rosacea because there is less risk of adverse events, drug interactions, and antibiotic resistance. The severity of the patient’s presentation helps guide the decision to initiate topical therapy alone or in combination with systemic therapy. Systemic therapy should be withdrawn when adequate response occurs.
The skin of many rosacea sufferers may be sensitive and easily irritated. Patients should avoid using any products that burn, sting, or irritate their skin. In a National Rosacea Society survey, many individuals with rosacea identified alcohol, witch hazel, fragrance, menthol, peppermint, eucalyptus oil, clove oil and salicylic acid as ingredients that irritated their individual cases, and many also avoided astringents and exfoliating agents. A useful rule of thumb may be to select products that contain no irritating or unnecessary ingredients.
Sunscreens or sunblocks effective against the full spectrum of ultraviolet A and B radiation can be especially important for rosacea patients, whose facial skin may be particularly susceptible to sun damage and consequent rosacea flare-ups. An SPF of 15 or higher is recommended, and physical blocks utilizing zinc or titanium dioxide may be effective if chemical sunscreens cause irritation.
Patient with Subtype 1 (erythematotelangiectatic) rosacea, before and after pulsed-dye laser treatment. (Photos by Thomas E. Rohrer, M.D., courtesy of Candela Laboratories.).
How does laser therapy work?
To remove visible blood vessels or reduce extensive redness, vascular lasers emit wavelengths of light that target tiny blood vessels just under the skin. Heat from the laser’s energy builds in the vessels, causing them to disintegrate. Generally, at least three treatments are required, depending on the severity of redness or visible blood vessels.
Vascular lasers may also be used to help retard the buildup of excess tissue, and in severe cases a CO2 laser may be used to remove unwanted tissue and reshape the nose. New laser technology has been developed to minimize bruising, and recently developed devices called intense pulsed light sources mimic lasers but generate multiple wavelengths to treat a broader spectrum of tissue. As with any surgical technique, the safety and effectiveness of laser therapy may depend on the skill of the physician.
Patient with Subtype 1 (erythematotelangiectatic) rosacea, before and after treatment with a pulsed-dye laser. (Photos by Elizabeth Rostan, M.D., courtesy of Candela Laboratories.).