Rosacea and redness

Rosacea
Rosacea is a common chronic condition primarily of the facial skin. It is common in the third and fourth decade of life, peaking at the age of 40 and 50 years. The causes of rosacea are still not identified but there is a heriditary component. The early stage rosacea is characterized by persistent redness and teleangiectasia (spider veins) predominantly of the cheeks frequently followed by papules (bumps) and papulopustules (pus containing bumps). Later, there may occur diffuse overgrowth of connective tissue and sebaceous glands. This can cause a enlargement of the nose, a so called rhinophyma.
Rosacea occurs in stages and may effect the eyes, most commonly resulting in blepharitis (inflammation of the lids) and conjunctivitis (pink eye). Also other parts beside the face such as the neck, chest, back and the scalp may be affected. The clinical appearance can be similar to acne.
Rosacea can be treated and controlled if medical advice is sought in the early stages. When left untreated, rosacea often gets worse and then becomes more difficult to treat. We incorporate the use of three different laser procedures for Rosacea include Laser Genesis and IPL using Solar Genesis, and CoolGlide Excel a 1064 long-wave yag laser.

Clinical features
Rosacea used to be called 'acne rosacea' but it is quite different from acne. There are red spots (papules) and sometimes pustules in both conditions, but in rosacea they are dome-shaped rather than pointed and there are no blackheads, whiteheads, deep cysts, or lumps. Rosacea may also result in reddened skin, scaling and swelling of affected areas.
Characteristics of rosacea include:
· Red papules and sometimes pustules on the nose, forehead, cheeks and chin. Rarely it involves the trunk and upper limbs.
· Frequent blushing or flushing
· A red face due to persistent redness and/or telangiectasia ('broken capillaries')
· Dry and flaky facial skin
· Aggravation by sun exposure and hot and spicy food or drink (anything that reddens the face)
· Sensitive skin: burning and stinging, especially with make-up, sunscreens and other facial creams
· Red, sore or gritty eyelids including papules and styes (blepharitis and/or conjunctivitis)
· Enlarged unshapely nose with prominent pores (sebaceous hyperplasia) and fibrous thickening (rhinophyma)
· Firm swelling of other facial areas including the eyelids (blepharophyma)

Questions and Answers about Rosacea?
· What Is Rosacea?
· Who Gets Rosacea?
· What Does Rosacea Look Like?
· How Is the Eye Affected?
· What Causes Rosacea?
· How is Rosacea treated and can it be cured?

What Is Rosacea?
Rosacea is a chronic (long-term) disease that affects the skin and sometimes the eyes. The disorder is characterized by redness, pimples, and, in advanced stages, thickened skin. Rosacea usually affects the face; other parts of the upper body are only rarely involved.

Who Gets Rosacea?
Approximately 14 million people in the United States have rosacea. It most often affects adults between the ages of 30 and 60. Rosacea is more common in women (particularly during menopause) than men. Although rosa

ea can develop in people of any skin color, it tends to occur most frequently and is most apparent in people with fair skin.

What Does Rosacea Look Like?
There are several symptoms and conditions associated with rosacea. These include frequent flushing, vascular rosacea, inflammatory rosacea, and several other conditions involving the skin, eyes, and nose.
Frequent flushing of the center of the face--which may include the forehead, nose, cheeks, and chin--occurs in the earliest stage of rosacea. The flushing often is accompanied by a burning sensation, particularly when creams or cosmetics are applied to the face. Sometimes the face is swollen slightly.
A condition called vascular rosacea causes persistent flushing and redness. Blood vessels under the skin of the face may dilate (enlarge), showing through the skin as small red lines. This is called telangiectasia (tel-AN-je-ek-tay-ze-ah). The affected skin may be swollen slightly and feel warm.
A condition called inflammatory rosacea causes persistent redness and papules (pink bumps) and pustules (bumps containing pus) on the skin. Eye inflammation and sensitivity as well as telangiectasia also may occur.
In the most advanced stage of rosacea, the skin becomes a deep shade of red and inflammation of the eye is more apparent. Numerous telangiectases are often present, and nodules in the skin may become painful. A condition called rhinophyma also may develop in some men; it is rare in women.
Rhinophyma is characterized by an enlarged, bulbous, and red nose resulting from enlargement of the sebaceous (oil-producing) glands beneath the surface of the skin on the nose. People who have rosacea also may develop a thickening of the skin on the forehead, chin, cheeks, or other areas.

How Is the Eye Affected?
In addition to skin problems, up to 50 percent of people who have rosacea have eye problems caused by the condition. Typical symptoms include redness, dryness, itching, burning, tearing, and the sensation of having sand in the eye. The eyelids may become inflamed and swollen. Some people say their eyes are sensitive to light and their vision is blurred or otherwise impaired.

What Causes Rosacea?
Doctors do not know the exact cause of rosacea but believe that some people may inherit a tendency to develop the disorder. People who blush frequently may be more likely to develop rosacea. Some researchers believe that rosacea is a disorder where blood vessels dilate too easily, resulting in flushing and redness.
Factors that cause rosacea to flare up in one person may have no effect on another person. Although the following factors have not been well-researched, some people claim that one or more of them have aggravated their rosacea: heat (including hot baths), strenuous exercise, sunlight, wind, very cold temperatures, hot or spicy foods and drinks, alcohol consumption, menopause, emotional stress, and long-term use of topical steroids on the face.
Patients affected by pustules may assume they are caused by bacteria, but researchers have not established a link between rosacea and bacteria or other organisms on the skin, in the hair follicles, or elsewhere in the body.

How is Rosacea treated and can it be cured?
Although there is no cure for rosacea, it can be treated and controlled. The goals of treatment are to control the condition and improve the appearance of the patient's skin. It may take several weeks or months of treatment before a person notices an improvement of the skin.
Some doctors will prescribe a topical antibiotic, such as metronidazole, which is applied directly to the affected skin. For people with more severe cases, doctors often prescribe an oral (taken by mouth) antibiotic. Tetracycline, minocycline, erythromycin, and doxycycline are the most common antibiotics used to treat rosacea. The papules and pustules symptomatic of rosacea may respond quickly to treatment, but the redness and flushing are less likely to improve.
Some people who have rosacea become depressed by the changes in the appearance of their skin, They often experience low self-esteem, feel embarrassed by their appearance, and claim their social and professional interactions with others are adversely affected.
Doctors usually treat the eye problems of rosacea with oral antibiotics, particularly tetracycline or doxycycline. People who develop infections of the eyelids must practice frequent eyelid hygiene. The doctor may recommend scrubbing the eyelids gently with diluted baby shampoo or an over-the-counter eyelid cleaner and applying warm (but not hot) compresses several times a day. When eyes are severely affected, doctors may prescribe steroid eye drops.
Intense Pulsed Light (IPL) , Laser Genesis., and Excel 1064 Yag Lasers are state of the art techonologies used to treat rosacea. See the accompanying links to learn more.

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