REDNESS AND ROSACEA
Redness is a very common treatment indication that is experienced by many people at some time in their life, potentially causing psychological and self-confidence issues, which in turn, can affect social and professional interactions. A common skin condition causing redness, flushing and visible capillaries is known a Rosacea. It is an inflammatory skin disease affecting the face and the underlying cause is yet to be determined. There is a strong genetic link and association with skin bacteria and mites (demodex mite). Rosacea can also be triggered by diet (gluten and pro-inflammatory foods), alcohol, hot/spicy foods, emotional stress, smoking and heat.
Rosacea is a combination of a damaged capillary network, redness and inflammatory lesions occurring on the cheeks, nose and forehead. Often the small surface capillaries of the face enlarge and give the appearance of permanent flushing. The inflammatory lesions or pustules can often be misdiagnosed as acne.
Rosacea often occurs between the ages of 30 and 50 with frequent flushing or blushing being the first sign. The symptoms tend to worsen with advancing age.
It can be classified into 3 stages.
Stage 1: Persistent erythema and visible capillaries
Stage 2: Persistent erythema and visible capillaries (Stage 1), accompanied with papules and pustules
Stage 3: Persistent erythema and visible capillaries (Stage 1), accompanied with papules and pustules (Stage 2) and also accompanied with significant swelling. In men, severe rosacea can cause the nose to become reddened and enlarged (rhinophyma)
Symptoms of rosacea include:
- Telangiectasia and enlarged capillaries (link to telangiectasia)
- Flushing and blushing of the cheeks
- Pustules and pimple like lesions
- Lumps under the skin
- Swelling of the cheeks and nose leading to rhinophyma
- Burning and stinging sensations
The underlying cause of Rosacea is unknown, though it is thought to be genetically linked, and demodex mite is suspected to be involved.
Some of the triggers of Rosacea include:
- Hot/spicy foods
- Hot drinks
- Emotional stress
- Overheating, especially in bed at night
- Hot showers
Treatments are generally continuous in order to give an ongoing reduction of Rocasea.
The most important treatment of Rosacea is complete avoidance of known triggers. It is especially important to avoid overheating, hot showers and prolonged exposure to sunlight.
Other treatment options depend on the severity of the condition.
BBL - broadband light is used to treat the superficial capillaries, decrease cellular damage, encourage healthy new blood vessel formation and treat inflammation.
Oral and/or topical antibiotics - antibiotics such as Doxycycline and minocycline help to treat the inflammation and are thought to act against the mites/bacteria that are implicated in the condition. These will start to work in 4-6 weeks and need to be continued until resolution of the Rosacea. Topical antibiotics such as Metronidazole may be applied to the skin.
Use of cosmeceuticals which prevent redness and flushing, support the skin's protective barrier and decrease inflammation within the skin.
Laser - certain types of laser can be used to decrease the redness and treat the damaged capillaries, Laser can also be used to remove disfiguring rhinophyma.
Diathermy - a small device that generates heat is applied to the damaged blood vessels. This can be done by the same device used to remove skin lesions and moles.
Surgery - for rhinophyma.