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Rosacea


What is Rosacea?

Rosacea (pronounced "roh-ZAY-sha") is a chronic and potentially life-disruptive disorder primarily of the facial skin, often characterized by flare-ups and remissions. Rosacea affects mostly adults, usually people with fair skin, between the ages of 30 and 60. Many have observed that it typically begins any time after age 30 as a redness or acne on the cheeks, nose, chin or forehead. It typically first appears as a flushing or redness that comes and goes. In some cases, rosacea may also occur on the neck, chest, scalp or ears. Sometimes referred to Acne Rosacea or misdiagnosed as adult acne, Rosacea has no specifically known cause.  

Over time, the redness becomes ruddier and more persistent, and visible blood vessels (telangiectasia) may appear. Bumps (papules) and pimples (pustules) often develop, and in some people the eyes feel irritated and appear bloodshot. In other cases, the nose may become swollen and enlarged from excess tissue. Without treatment, each of these potential signs and symptoms may progress from mild to moderate to severe. Dr. Groysman and staff at Cahaba Dermatology are highly experienced at treating rosacea and getting it under control.

Who gets Rosacea?

  • Between 30 and 50 years of age
  • Fair-skinned, and often have blonde hair and blue eyes
  • From Celtic or Scandinavian ancestry
  • Likely to have someone in their family tree with rosacea or severe acne
  • Likely to have had lots of acne - or acne cysts and/or nodules

What are the signs of Rosacea?

  • Flushing Many people with rosacea have a history of frequent blushing or flushing. This facial redness may come and go, and is often the earliest sign of the disorder.
  • Persistent Redness Persistent facial redness is the most common individual sign of rosacea, and may resemble a blush or sunburn that does not go away.
  • Bumps and Pimples Small red solid bumps or pus-filled pimples often develop. While these may resemble acne, blackheads are absent and burning or stinging may occur.
  • Visible Blood Vessels In many people with rosacea, small blood vessels become visible on the skin.
To remove these blood vessels, Dr. Groysman will use the Vbeam laser. Vbeam affects the vessels within the skin and does not affect the surface skin. 

What are the different types of Rosacea?

Erythematotelangiectatic rosacea: redness on cheeks and nose with redness, flushing, visible blood vessels Papulopustular rosacea: Redness, swelling, and acne-like breakouts on the face Phymatous rosacea: Skin thickens and has a bumpy texture on nose Ocular rosacea: Eyes red and irritated, eyelids can be swollen, and person may have what looks like a sty  

What are other Potential Signs and Symptoms?

  • Eye Irritation In many people with rosacea, the eyes may be irritated and appear watery or bloodshot, a condition known as ocular rosacea. The eyelids also may become red and swollen. Severe cases can result in corneal damage and vision loss without medical help.
  • Burning or Stinging Burning or stinging sensations may often occur on the face. Itching or a feeling of tightness may also develop.
  • Dry Appearance The central facial skin may be rough, and thus appear to be very dry. 
  • Skin Thickening The skin may thicken and enlarge from excess tissue, most commonly on the nose. This condition, known as rhinophyma, affects more men than women.
  • Swelling Facial swelling, known as edema, may accompany other signs of rosacea or occur independently.
  • Signs Beyond the Face Rosacea signs and symptoms may also develop beyond the face, most commonly on the neck, chest, scalp or ears.

What are the Common Rosacea Triggers and How to Manage Rosacea Symptoms?

  • Avoid sun exposure, which adversely affects more than 80 percent of Rosacea sufferers. Minimize exposure from 10 a.m. to 2 p.m. Use sunscreen with at least SPF 30. Physical sunscreens with zinc and/or titanium oxide are less irritating and work instantly.
  • Avoid Stress. Expect the unexpected. Also, don’t try to do too much in a day.
  • Staying Cool. Retreat to air-conditioning when temperatures rise.
  • Dress "Cool." Keep it light, loose and topped with a broad-brimmed hat.
  • Stay Hydrated. Drink plenty of cold liquids. You may also want to mist your face when you are outside in the heat.
  • Avoid Spicy Foods.  Steer clear of spices, hot drinks and foods that may cause you to flush.
  • Umbrellas in the Sun. A must at the beach...anywhere without shade.
  • Don’t stop your medicines even when skin gets better. Don’t sporadically start and stop your treatment. Successful management of Rosacea only happens when you follow your treatment program.
  • Avoid Harsh Products. Your skin care routine should consist of mild cleansing products and your prescribed topical medication. Don’t add scrubs or glycolic acids which will only irritate already sensitive skin.

What are Rosacea Treatments?

Many people with rosacea do not recognize it in its early stages. Identifying the disease is the first step to controlling it. Self diagnosis and treatment are not recommended since some over-the-counter skin products may make the problem worse.

Dermatologists often recommend a combination of treatments tailored to the individual patient. These treatments can stop the progress of rosacea and sometimes reverse it. Creams, lotions, foams, washes, gels, and pads that contain various topical antibiotics, metronidazole, benzoyl peroxide, and retinoids may be prescribed. A slight improvement can be seen in the first three to four weeks of use. Greater improvement is usually noticed in two to three months.

Oral antibiotics tend to produce faster results than topical medications. Cortisone creams may reduce the redness of rosacea; however, they should NOT be used for longer than two weeks since they can cause thinning of the skin and flare-ups upon discontinuation. It is best to use these creams only under the direction of a dermatologist.

The persistent redness is treated with laser surgery, called V-Beam laser, to close off the dilated blood vessels. Cosmetics also may be helpful. Green-tinted makeup may mask the redness. When rosacea affects the eyes, a dermatologist may give you instructions for washing the eyelids several times a day and a prescription for eye medicine. 

The key to successful management of rosacea is early diagnosis and treatment. It is important to follow all of the dermatologist’s instructions. When left untreated, rosacea will get worse and may be more difficult to treat.

Outcome

There is no cure for rosacea. People often have rosacea for years.  

Rosacea is a progressive disease that must be treated.

Some people have rosacea flare-ups for life. Treatment can prevent the rosacea from getting worse. Treatment also can reduce the acne-like breakouts, redness, and the number of flare-ups.

To get the best results, people with rosacea also should learn what triggers their rosacea, try to avoid these triggers, and follow a rosacea skin-care plan. Please make an appointment with Dr. Groysman to help control your rosacea now.

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Claims of results, patient testimonials, treatment recovery time, and before/after images may not be representative for every situation or be applicable to every patient. Individual results may vary. Always seek the advice of a physician or other qualified health care provider with any questions you may have regarding a medical condition, treatment, or elective procedure.
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