Rosacea
Rosacea is a progressive inflammatory disorder of the skin and facial blood vessels. In the beginning, rosacea produces symptoms of frequent, lasting facial flushing and skin irritations. Left untreated, the symptoms worsen to include coarse skin texture, acne papules and pustules, and sometimes even permanent damage such as broken capillaries, scarring, tissue hyperplasia and rhinophyma.

Anyone who suspects that he or she might have rosacea should to see a dermatologist as soon as possible. Although believed to be incurable, early diagnosis and treatment not only control the signs and symptoms of rosacea, but also might actually reverse progression. Early treatment can prevent blood vessels from enlarging and from developing. When left untreated, rosacea often becomes worse and more difficult to treat—especially if it progresses to rhinophyma.

Who gets rosacea?
Rosacea generally affects adults between the ages of 30 and 60, occasionally also affecting children. Men and women are equally likely to be affected although men have the tendency to get more severe symptoms than women. Rosacea affects people of all ethnic backgrounds; although it is most apparent in people with fair skin.

There also appears to be a genetic connection to the disease – 40% of rosacea suffers can identify a relative with symptoms of rosacea.

What are symptoms of rosacea?

Symptoms can include:

* Facial redness
* Facial telangiectasia (spider veins)
* Skin hyper-reactivity
* Lumpy-bumpy facial skin
* Facial papules
* Facial pustules
* Facial burning sensations
* Facial swelling
* Rhinophyma


What are causes for rosacea flare-ups?

Causes include:

* Nerve activity
* Skin irritation - topical irritants
* Sun
* Environment - heat, cold and wind
* Topical steroids
* Immune system
* Free radicals
* Stress - neural and hormonal
* Menopause
* Oral dilators - food, beverage, medications and supplements
* Exercise
* Other disease
* Collagen breakdown in facial skin
* Gastrointestinal tract disorder
* H. Pylori of the stomach


Is rosacea contagious?
Rosacea is NOT contagious. There is no evidence that it can be spread by contact through the skin. In fact, evidence shows that rosacea may be passed to family member through the genes.

Can rosacea go away by itself ?
Rosacea will not go away by itself. Symptoms may go into remission but no matter what the stage or symptom severity, the underlying disorder is still present.

Rosacea sufferers have noted that changing seasons and environmental factors aggrevate their condition. Flare ups can be triggered by sudden colder temperatures and windy days or an increase in sun, heat and outdoor activity. The skin generally adapts to the environmental changes within 4 to 6 weeks, and symptoms improve.

Treatments for Rosacea

1) Oral and topical medications
One of the most common treatments prescribed by a doctor are oral anti-inflammatories such as antibiotics or accutane and topical anti-inflammatories such as metronidazole based products. This treatment is usually followed for 4 to 6 months until the rosacea is under control, and then only topical treatment is prescribed to maintain clear skin. Topical medications usually takes about two months to for dramatic results. Oral antibiotics tend to work faster than topical antibiotics.

It is important for the patient to note that over-the-counter hydrocortisone cream should never be used. It will worsen rosacea symptoms over time. It causes rebound dilation, thinning of the epidermis, thinning of the blood vessel walls, and holes in the architecture of the dermis.

Topical medications that are used to control the acne like papules and pustules include:

* Azelaic acid
* Benzoyl peroxide
* Clindamycin
* Erythromycin
* Metronidazole
* Sulfacetamide
* Sulfur lotions

Oral medications that are often prescribed include:

* Doxycycline
* Erythromycin
* Minocycline
* Tetracycline


2) Glycolic Acid
Glycolic acid peels – These peels are applied to the face for up to five minutes. Following treatment, the skin is red for a few hours, and patients should avoid sun exposure until their skin returns to its normal color. Recommended every two to four weeks.

Glycolic acid washes and creams – Dermatologists prescribe these in low concentrations to further enhance the peel’s effect.

3) Isotretinoin – Also known as accutaine, it is prescribed only in very severe cases, as Isotretinoin is not FDA-approved for Rosacea. Isotretinoin may help shrink thickened facial skin. Isotretinoin is a powerful medication, and due to potentially serious side effects, only some patients are candidates for its use.

4) Electrosurgery – An electrical device emitting a high-frequency electric current is used to destroy the visible blood vessels.

5) Intense light and laser therapy – Light and laser therapy is used to treat the redness caused by rosacea and eliminate the dilated blood vessels.

6) Vascular lasers - Vascular lasers emit wavelengths of light to heat up the visible blood vessels and collapse them. The collapsed vessels are then absorbed back into the body without bruising or scarring.

Treatment of Rhinophyma
Very advanced stages of Rosacea can result in thickening of the skin and swelling and disfiguring growth of the nose and central facial areas. At times the ears may be involved as well. This condition is called rhinophyma, and can become permanent. Generally, surgery is necessary to remove thickened tissue that can occur around the nose. The following procedures are used to treat rhinophyma by sculpting the affected areas to a more normal appearance:

* Dermabrasion
* Electrosurgery
* Laser surgery



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