- 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