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"Skin Deep" - Rosacea

Tuesday, 22 January 2008

This is the third in a series of "Skin Deep" items, taking an in-depth look at the most common skin conditions that affect many of our viewers. For people who suffer with any type of skin condition, it's always relevant

Rosacea is a common skin condition which mostly affects people aged between 30 and 50. Today we take a closer look at what this condition actually is and how best to treat it.

What is Rosacea?
Rosacea is a progressive disease involving chronic inflammation of the skin on the face. It most commonly affects men and women between the ages of 30 and 50.  It is more prevalent in women (3:1), but more severe in men. Its exact cause is unknown, but many patients who present with it often have a history of reddened skin and acne or pimples. It is more common among fair-skinned people of Northern European ethnic backgrounds than among Asians and Africans. It is also known to affect people who blush easily & often. (1 S/S of severe Rosacea)

What are the symptoms?
1. Redness, usually in a central position on the face, covering the cheeks, nose, forehead and chin. (2 Still stores)

2. Dryness - facial skin may get very dry and scaly
3. Pimples on the face; either inflamed, hard and red, or even filled with pus. In the past Rosacea was sometimes called 'adult acne'. But Rosacea and acne are not the same. Rosacea does not normally cause blackheads, a typical sign of acne. (1 S/S)

4. Red lines, which physicians call telangiectasia, may appear when small blood vessels in the face get larger and eventually show through the skin. The lines may be hidden by general redness at first, but they eventually become visible.

5. Nasal bumps - when Rosacea is not treated some people, especially men, may eventually get knobby bumps on the nose. As more bumps appear the nose looks swollen. Rosacea may also be associated with enlargement of the nose from excess tissue, a condition known as rhinophyma. This may include thickening of the skin and irregular surface nodules, which in rare cases may also develop in areas other than the nose. (1 S/S)
6. Eye inflammation may accompany Rosacea (ocular rosacea). This may result in a watery or bloodshot appearance, irritation and burning or stinging. The eyelids may also become swollen, and styes are common. Let your physician know if your eyes often become red or irritated.

How is Rosacea treated?
Unfortunately there is no cure as yet for Rosacea but it can be managed.
The treatment your physician prescribes will depend on what stage the disease has reached. Early treatment is vital, particularly in men so as to avoid or minimize rhinophyma If your only symptom is redness your physician will probably prescribe:-
. Some patients may benefit from sulphur-based creams, which can be applied directly to the skin. A topical cream containing Metronidazole, a highly effective medication for treating Rosacea, to reduce redness. Steroid creams are not used for Rosacea and actually cause a disorder called 'steroid rosacea' which mimics the condition. In Ireland, these are prescription only creams.
. If you have bad pimples and inflammation you may have to take oral antibiotics for a while, either with or without a topical metronidazole cream, until those symptoms are under control. A medication which is similar to Vitamin A called  Isotretinoin (sold under the brand names of Accutane or Roaccutane) is sometimes effective against severe papopustular rosacea.
Intense pulsed light IPL is very helpful both at reducing the inflammation and also the damage to the blood vessels - telangiectasia

How You Can Help Control Rosacea Symptoms?
There are known to be certain trigger factors, which may make the condition worse. These should be avoided as much as possible.
Anything that causes flushing - hard exercise, red wine, weather extremes, stress, etc. - can trigger a flare-up of symptoms. You can do a lot to prevent flare-ups of your symptoms by avoiding the triggers that seem to affect you most. Common triggers include:-

. spicy foods
. alcohol, especially red wine
. hot drinks
. anger/stress
. excessive exercise
. very hot or cold weather
. wind
. sun exposure

For people with Rosacea even day-to-day sun exposure can trigger a flare-up of extremely unpleasant symptoms as their skin is photosensitive.
Sunscreens Make sure to choose a sunscreen that will not irritate your skin. Ask your physician or pharmacist to recommend a non-irritating brand and check product labels before use. The physical blockers eg containing titanium oxide are less irritating.
Cleansers Use only very mild cleansers. Avoid products that contain alcohol or irritants.
Cosmetics Choose facial products that will not clog pores