What is Rosacea? 

Rosacea (pronounced rose-ay-shah)  is a common disorder of the facial skin, estimated to occur in one in 20 Americans, approximately 13 million people afflicting mostly fair-skinned individuals. The target areas for symptoms include the cheeks, nose, chin and forehead. Unusual and persisting redness, bumps and pimples, tiny, spider like veins called telengiectasia and potential hyperplasia characterizes rosacea. Hyperplasia is excess tissue accumulation, usually on the nose.

Rosacea often affects members of the same family because of similar complexions and genetic heritage or lifestyle patterns. It appears to occur most often in fair-skinned individuals of northern and eastern European descent, and may be especially prevalent in those of Celtic, English, Scottish and Scandinavian heritage.

In the late stages of the disorder, Rosacea brings the excess growth of tissue as inflamed bumps bridge across progressively larger areas of the face. An early sign of this progressed stage is fibroplasia, or enlarged pores. In rare cases, fibroplasia can result in an "orange-peel" appearance on a complexion that may initially have been exceptionally fine. Particularly in men, severe fibroplasia may cause enlargement of the nose from excess tissue - known as rhinophyma - and a lion-like facial appearance.

The eyes are also involved in up to 58 percent of patients. Eye findings in Rosacea range from minor to severe, though the minor manifestations occur more often. Findings included inflammation of the eye, swollen blood vessels, and small, hard bumps on the eyelids. The eye may appear bloodshot. Nearly half feel as though there is a foreign body or something gritty in their eye. They may also have a dry, burning or stinging sensation they may attribute to a contact lens problem.

What Causes Rosacea?

Its cause is unknown, though there are several theories. It has been postulated that the bacterium Helicobacter pylori, which has also been implicated in duodenal ulcers, may play some role. Study results are inconsistent, but it has been suggested that H. pylon synthesizes the hormone gastrin, which may stimulate flushing.

The presence of a mite called Demodex folliculorum, a normal inhabitant of human skin, has also been examined as a potential contributing factor to Rosacea, but study results have been inconclusive.

Managing Rosacea

If you suspect you may have Rosacea, it is essential to see a skin care specialist for further evaluation. Rosacea is a chronic and often progressive condition subject to remissions and flare-ups. Without treatment, the symptoms tend to become increasingly more severe.

The first challenge for patients is to realize that their skin condition is a recognized skin disorder that responds to therapy - not just a complexion problem that will simply go away, or an untreatable individual skin reaction. Therefore it is important to understand that Rosacea is a controllable although not curable skin condition. If left untreated, it will worsen. Early acceptance of the possible necessity for a continuing therapy program is important, as the stress that accompanies denial and disappointment can make the symptoms worse.

Medical/Topical Therapy

The key to managing Rosacea is to consult a skin care specialist. While it is not curable, Rosacea’s symptoms may be controlled and often reversed with oral and/or topical antibiotic treatment in addition to a well defined cleansing and moisturizing routine. Oral antibiotics are used in the clinic's treatment routine only to bring the inflammation of Rosacea under immediate control, and only in the most severe cases.  Otherwise, topical antibiotic therapy is recommended. Topical antibiotics, such as Metrogel and Benzoyl Peroxide are used most commonly for Acne Rosacea conditions. With continued use and in combination with other specific topical solutions, these antibiotics reduce the symptoms and serves to keep the condition in remission without the systemic side effects often found with long-term oral antibiotic therapy: gastrointestinal upset, nausea and vomiting, as well as photosensitivity and yeast infections.

Monthly clinical treatments are recommended to manage and monitor progress in Rosacea conditions. Treatments are crucial to reducing redness, controlling breakouts, balancing skin type, reducing pore size, re-texturizing skin surface and most importantly, evaluating progress and skin response to home care routines. Monthly treatments will generally include but are not limited to, enzyme and/or glycolic therapy to address textural, pigmentation, congestion and exfoliation needs. Deep pore cleansing for congested skin types, Hydration and Vitamin/Oxygen therapy. Oxygen therapy uniquely combines 87 vitamins, minerals and antioxidants to calm, sooth, and hydrate. 

Oxygen is responsible for the health and maintenance of every cell in the human body and can assist ultimately in improving the strength of the skins supporting structure. Collagen and elastin fibers and the delicate vascular network of the skin are nourished with high concentrations of moisturized, nutrient based additives.

The Copper Vapor, and DioLite lasers can be used to erase any traceable blood vessels effectively. The short pulses ensure that only the blood vessels are targeted, thus reducing or eliminating the chance of damage to surrounding facial tissue. DioLite Laser sessions are available at the clinic on a monthly basis. The pulse dye laser is more effective for solid redness in the skin. Pulse dye lasers disperse blood vessels over a larger surface area and will cause some bruising around the treatment sight.

Consult with your clinical aesthetician on what laser therapy would be right for you. Likewise, early treatment of rhinophyma with the ultra pulse dye laser can help shrink the nose tissue, and often prevents further development of the condition. A different type of laser, the CO2 laser, which requires a local anesthetic, can be used as a bloodless scalpel to effectively remove excess tissue and re-contour the nose. See your clinical aesthetician for recommendation and referral. Oxygen therapy should be considered following any laser treatment. Post Laser treatment will accelerates healing, reduce down time and significantly aid in associated discomforts.

Nutrition is important to maintenance of skin health. Internal vitamin therapy provides benefits that diet may be lacking and can also focus extra nutrients to address specific skin concerns such as inflammation, broken capillaries, excess oiliness, dryness, etc.  At a minimum, daily vitamin intake should include a multi-vitamin, up to 2,000 mg of Vitamin C and 80 mg of Zinc. Vitamin formulas should not contain any added algae, kelp or seaweed extracts, iodide or sea salts. Consult with your clinical aesthetician for other nutritional supplements that will benefit your skin needs.

What Triggers Rosacea?

After seeking and beginning a daily treatment program, the patient's next challenge in controlling Rosacea is to discover and avoid the environmental, emotional, or lifestyle factors that act as that patient’s personal Rosacea tripwires. While a vast variety of factors that can precipitate an outbreak have been observed, identifying these factors is an individual process, as what may cause a flare-up in one patient may not in another. Possible triggers are:

Foods

• Liver, Yogurt, Sour Cream, Cheese (except cottage cheese)
• Chocolate, Vanilla, Soy Sauce, Yeast extract (bread is OK)
• Vinegar, Eggplant, Avocados, Spinach
• Broad-leaf beans and pods, including Lima, Navy or pea.
• Citrus fruits, including tomatoes, bananas, red plums, raisins or figs.
• Spicy and thermally hot foods
• Foods causing histamine reactions

Beverages

• Alcohol, especially red wine, beer, bourbon, gin, vodka or champagne
• Hot drinks, including hot cider, hot chocolate, coffee or tea.

Stress

• Anxiety
• Physical
     + Exercise
     + "Lift and Load" Jobs

Environment

• Cold
• Heat, Humidity
  • Saunas
  • Hot baths or showers
  • Simple Overheating
  • Excessively warm environments
• Sun
• Strong Winds

Drugs

• Vasodilators
• Topical Steroids

Medical Conditions

• Frequent Flushing
• Menopause
• Chronic Cough
• Caffeine withdrawal syndrome

Home Care Products

• Some cosmetics and hair sprays, especially those containing alcohol, witch hazel, or fragrances.
  See comedogenic listing.
• Alcohol or acetone substances.
• Any substance that causes excessive redness or burning.
• Fragrances & Dyes

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