SPOTLIGHT:ROSACEA What is Rosacea?

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Kristian Jennings
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1 AUGUST NEWSLETTER 2018 SPOTLIGHT:ROSACEA What is Rosacea? Rosacea is a common, chronic skin disease that often first manifests with a tendency to blush or flush easier than other individuals. This flushing and redness can

2 spread across the entire face or can be localized to the T-zone (forehead, nose, and or chin). According to the American Academy of Dermatology, 16 million Americans have rosacea and most of these patients do not know how to manage their symptoms and may go their entire lives untreated. Without treatment, the symptoms and changes in skin can be progressive, causing significant deformity over time. Rosacea is more than just redness and flushing. Flushing can appear on the ears, chest and the back. Rosacea can result in the appearance of visible blood vessels, acne breakouts, increased skin thickness and a bumpy texture to the affected area. This skin texture change commonly affects the nose and is known as rhinophyma in this location. Rosacea can also affect the eyes causing the sty formation combined with red, irritated eyelids that may or may not manifest swelling. These are the visible dermatological side effects of rosacea, however there are also significant psychological and social effects on a person that may significantly reduce selfconfidence and self-esteem. Do we know what causes rosacea? Unfortunately, the cause is unknown. Most individuals develop symptoms between their 30 s and 50s and are of Irish, Celtic or Scandinavian ancestry. Research to delineate the underlying cause is ongoing but scientists speculate there is a genetic contribution, in addition to the immune system playing a role. Cathelicidin-related antimicrobial polypeptides are a family of polypeptides contained in macrophages and specific white blood cells called polymorphonuclear leukocytes (PMN s) that play a critical role

3 in protecting the body against invasive bacterial infection. Scientist are researching how the body processes cathelicidin or if a defect in the peptide may have a causative role or an effect on the symptoms associated with rosacea. While the exact cause of rosacea remains unknown, there are definite lifestyle and environmental factors that can aggravate rosacea. These triggers can include sun exposure, emotional stress, hot or cold water, wind, alcohol, spicy foods, strenuous exercise, hot baths, hot drinks and even select skin care products. It is crucial for patients to identify the most troublesome triggers and control for their exposure, as best as possible. An example: 24/7 sun protection is essential so don a hat and wear sunscreen daily. There is no cure for rosacea, however there are several medical treatments available that can control and manage the symptoms. The first step in symptom management is to identify any triggers thus allowing patients to avoid these triggers. Medical treatments will vary based on the patient s exam and symptoms and may change over time. Many patients will benefit from low dose oral medications such as antibiotics. Various topical medications can also be prescribed alone or in combination with oral medications to augment their effects with good reported success at reducing symptoms. An additional option are light-based treatments, such as Broad Band Light. Various types or wavelengths of light can be applied for different concerns such as reduction of facial redness, eliminating visible blood vessels, reduction of bumpy, thickened skin in the nasal area, or

4 treatment of acne-like breakouts. It is important for patients to understand that insurance typically does not cover the cost of these light-based treatments. Most patients will need a series of treatments to achieve best results and because rosacea is a chronic condition, maintenance treatments are usually necessary. As always, the results from any light-based treatment depend on the provider performing the treatment. We recommend working with a board-certified physician who has experience with rosacea and understands the disease process. It is essential to achieve a successful outcome. Working with a less experienced or qualified provider can not only waste money, it could lead to exacerbation of the condition or complications, such as scarring. In addition to controlling environmental/lifestyle factors, oral and/or topical medications, and light-based treatments, all patients with rosacea need a regimen of gentle skin care products and cosmetics. Many skin care products and cleansing routine habits, such as scrubbing the skin, can be highly irritating and cause flare ups. Using mild skin care products and being gentle with our skin can help prevent flare-ups. Working with an aesthetician to create a plan for rosacea prone skin is essential. We want you to know there are options for patients with rosacea. Patients must understand they are managing a chronic condition and have a role in reducing their triggers and following gentle skin care routines. Patients should find a physician and aesthetician (working directly with the physician) who is experienced in working

5 with rosacea and create a customized treatment plan to successfully manage rosacea, prevent flares, and improve their quality of life.

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