Rosacea

Rosacea is a complex problem mainly involving the face causing redness and acne like appearances.

The cause of rosacea is poorly understood but can affect up to 5% of the population.  Because of it's effects on personal appearance rosacea can affect self esteem causing social and occupational problems.  The before and after photo of rosacea below demonstrates the huge improvement that can be achieved with treatment.

Rosacea

Symptoms of rosacea:

  • redness on the cheeks, nose, chin and central forehead.
  • visible facial veins on the face.
  • small pimple like bumps on the same areas as the redness.
  • watery or irritated eyes if you have ocular rosacea.
  • sensitive skin causing burning or stinging.
  • flushing or blushing of the face and neck.
  • dry thickened appearance to the central facial skin.
Rosacea typically starts from around age 30 and can come and go over time.  The redness tends to deteriorate over time and can extend to involve the neck, chest and scalp.  In severe cases the skin on the nose may become swollen and bumpy in a condition called rhinophyma.
 
Although more women than men have rosacea, men can often have more severe symptoms, particularly the rhinophyma component. People with fair skin seem more predisposed to rosacea. 
 

Subtypes of Rosacea

A consensus committee of 17 medical experts internationally identified 4 types of rosacea:
 
  • Subtype 1 (erythematelangiectatic rosacea) which is characterised by flushing and persistent redness and may include visible facial veins.
  • Subtype 2 (papulopustular rosacea) characterised by persistent redness with pimples and bumps that come and go.
  • Subtype 3 (phymatous rosacea) characterised by skin thickening often resulting in a large bulbous nose (rhinophyma).

  • Subtype 4 (ocular rosacea) causing dry eye, tearing and burning, swollen eyelids, recurrent styes or blepharitis and possible vision loss from corneal damage if the cornea dries out. 

 

 Treatment of Rosacea

There are various treatments available and the best treatment for your rosacea is best determined at an initial consultation at Palm Clinic. If pimples are a prominent part of the rosacea these are often treated short term with oral or topical antibiotics.  The main topical antibiotic used is metronidazole known as Rosex cream and this can be used for maintenance treatment.  Tetracyclines such as minocycline or doxycycline are generally used orally.

If the predominant symptom is facial redness treatments with vascular lasers or IPL (intense pulsed light) devices are used.  It is important to have the correct settings used for rosacea as too much energy can create additional inflammation which can make rosacea worse.  Your Palm Clinic doctor or laser nurse is experienced at determining the right settings for rosacea with IPL (Photoderm or Aurora) or vascular laser (Coolglide 1064 NDYag).  This will generally involve 3-5 treatments spaced 4-6 weeks apart for best results.  Because rosacea is controlled rather than cured you will need top up treatments from time to time.

Rhinophyma can be treated by using lasers or radiofrequency (Surgitron) techniques to trim the excess skin off enabling the nose to be reshaped.