Rosacea and facial redness management

Is a frustrating skin disorder that is frequently misdiagnosed by dermatologist and physicians
Develops over a long period of time, can come and go
Thought to be caused by a microbe called Demodex Follicularis under the skin, other theory as to cause point to it being a generalised vascular inflammatory disorder

Symptoms

Tendency to blush easily, exacerbated by alcohol, hot showers, saunas, after exercise
Extreme sensitivity to cosmetics

Early Signs

Characteristic butterfly redness over nose and cheeks
Bumps and pimples over nose and cheeks resembling acne
Oily patches of skin interspersed with dry flaky skin

Late signs (if left untreated)

Rhinopyma – bulbous nose, rarely occur in women
Telangiectasia – broken, enlarged blood vessels. Treatment is with vascular laser KTP 532 or Nd Yag 1064 laser
Ocular rosacea – persistently red, irritated eyes, sties – rarely, the cornea is affected

Skin care plan for rosacea

Avoid potentially irritant – including alcohol, witch hazel, fragrance, menthol, peppermint, eucalyptus – Go to www.rosacea.org for complete list
Lifestyle factors to avoid – sun exposure, spicy foods, alcohol, hot tubs
Other irritants to avoid – physical exfoliating scrubs, facials with steam or masks, use of washcloth

AM

Cleanser

Use gentle, water based cleanser – eg Cetaphil Gentle Cleanser or Neutrogena Cream Cleanser

Exfoliate

Use 2%BHA (beta hydroxy acid) as exfoliant in a base of pH 3-4 – this helps remove the built up dead layer of the epidermis (stratum corneum) and can help with flakiness.
BHA is also related to salicylic acid and acts as an anti inflammatory which reduces the redness so often seen in rosacea
Can be used long term, especially during periods when you are off the topical antibiotics

Antibiotics

Use Metronidazole topical cream. (Source: Journal of Dermatology June 1999, pp 961-965)
This works by dampening down the inflammatory response caused by the microbe as opposed to directly killing it
Recommendation is to use it for 4 months then stop for 1 month then recommence for 4 months (Note: there is no consensus as to what the ideal time period is )

Sunscreen

Use physical (or non chemical) sunscreen – Look for sunscreen with the ingredients like Titanium Dioxide or Zinc Oxide

PM

Cleanser, Exfoliate, Antibiotics
Moisturise

Use lightweight moisturiser which contains anti-oxidants
Avoid formulation with “actives” like Vitamin A (although prescription Adapalene is sometimes used as treatment for “breakouts”), vitamin C

About Dr May Marr

Dr May Marr is a graduate of Flinders University Medical School and a Fellow of the Royal Australasian College of Physicians. She has a lifelong interest in aesthetic medical procedures and evidence based skin care and believes passionately that people should have access to medical aesthetic procedures and products that are based on the best available evidence and provided by highly trained professionals. Dr Marr provides best practice, advice and treatment in the areas of injectable rejuvenation. Treatments for localised fat and cellulite reduction, skin tightening and rejuvenation using mesotherapy techniques are also offered. Dr Marr has studied with Dr Jacque Le Coz, one of the pioneers of Mesotherapy at the Institute of Mesotherapy in Paris.