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Rosacea Management 2016: Real Progress

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Rosacea may sound like a benign skin condition to those who do not have it, but anyone who does will tell them differently. Affecting over 5% of the world’s population, not only can Rosacea be painful, but it can also cause acute embarrassment, poor self esteem and adversely affect patients’ social lives. As many as 50% of rosacea patients admit to missing work and canceling social plans when they’re having an outbreak.

First the bad news: Rosacea is a chronic inflammatory skin condition. What this means is that once you develop it, you will unfortunately have it, to some degree, for the rest of your life. There is no cure currently available.

Now the good news: We currently have more options than ever to control the many symptoms of acne rosacea. In the past 2 years alone, 2 new very effective topical creams (Onreltea and Rosiver) and one new oral prescription medication (Apprilon) have become available to Canadian patients. These new treatments have quite literally, and figuratively, changed the face of acne rosacea.

Four subtypes of rosacea exist, each presenting with different clusters of symptoms:

Subtype I: Vascular erythemato-telangiectatic rosacea

This represents the most common type of rosacea patient that I see in my office. These patients experience remitting and relapsing courses of facial redness and flushing. Many have permanent small broken facial veins on their nose, cheeks and chin as well as occasional acne-like bumps. In more severe cases, they will also complain of facial burning and stinging.

Subtype II: Inflammatory papulopustular rosacea

Patients with this subtype of rosacea will have all of the above, but will also have more significant red bumps and acne like lesions.

Subtype III: Phymatous Rosacea

Least common type and mainly seen in men. Characterized by all of the above plus a bulbous deformity of the nose.

Subtype IV: Ocular Rosacea

As the name implies, these patients experience ocular symptoms such as burning or stinging in the eyes, itchy eyes, dry eyes, grittiness or a feeling of having something in the eye, tearing or eye redness. Ocular rosacea occurs in at least 50 % of all rosacea patients. It can precede the skin symptoms, develop at the same time, develop later or occur on its own.

Rosacea affects both women and men of all ages and ethnicities, but is most common in women, over the age of 30 and in individuals of fair complexion. There are any number of known triggers for rosacea flare ups. One of the biggest being cold weather and wind exposure (making this time of year an ideal time to take control over your rosacea). Other major triggers include:

  • Cold / Hot weather
  • Wind exposure
  • Hot bathes
  • Sun exposure
  • Stress
  • Hormonal changes
  • Alcohol
  • Spicy food
  • Hot beverages such as tea and coffee
  • Skin care products with AHA’s and/or retinoids

Given the many presentations of rosacea, most patients require a combination of 2 or more different therapies to achieve the best outcome. Since rosacea is one of the most common, non anti-aging skin conditions for which new clients seek my help at my Ottawa Cosmetic Clinic, I have acquired, over the years, a number of technologies capable of treating all of the above rosacea symptoms.

Here are the treatments that I usually recommend and am able to offer:

  1. Prevention.
    This is accomplished through avoidance of triggers, gentle skin care and broad spectrum sun protection. Physical sunscreens tend to be better tolerated by acne rosacea patients because they contain less irritating chemicals. One of our client favorites is a powder mineral sunblock from Colorscience. It’s SPF 50, very effective yet extremely gentle.
  2. Topical prescription creams such as Rosiver, Metrogel or Noritate, and Onrealtea. Rosiver is the “newest kid on the block” and definitively a more effective topical option for rosacea treatment and maintenance than prior options.
  3. Oral antibiotic (Apprilon).
  4. A series of 6 Laser Genesis Treatments.
    Laser Genesis is excellent at reducing diffuse redness as well as the acne like pimples that accompany rosacea flares.
  5. A series of 3-5 Intense Pulse Light (IPL) / Photorejuvenation
    IPL treatments will do wonders for patients with small broken facial capillaries and confluent redness.
  6. My vascular laser (Excel V) eliminates more significant broken vessels typically found on and around the nose, cheeks and the chin of certain patients.

So even if rosacea is not a curable skin condition, there are now plenty of excellent available treatment options to address and manage it before it gets out of control. If you suffer from acne rosacea, come talk with me to find out what options would be best for you.

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