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Sunday
Jun122005

Rosacea

The Stages and Treatments

The original name of this disease was acne rosacea, an inappropriate term that may cause confusion with acne vulgaris (common acne). The disease evolves in stages. The early signs are recurrent episodes of blushing that finally become persistent in dark-red erythema (abnormal redness), particularly on the nose and cheeks, often in persons less than 20 years of age. Theses are so-called flushers and blushers. Rosacea is common in the 20's and 30's and peaks between the ages of 40 to 50 years. In the worst cases, disfiguring hypertrophy (swelling and redness), particularly of the nose (rhinophyma), may develop after many years.

The Contributing Factors

Rosacea is a fairly common disease, especially in fair-skinned people of Celtic or Northern European heritage, hence the term curse of the Celts. Although women are more affected than men in earlier stages (3:1 ratio), men develop the swelling tissue that lead to rhinophyma (an enlarged, bumpy nose) much more frequently.

The importance of sun-damaged skin in rosacea cannot be stressed enough. Rosacea is always associated with sun exposure, so protection of the skin with total sun blocks and cover ups is important.  However, an increase in sun sensitivity has not been shown in rosacea patients.

Some other contributing factors may be genetic disposition (heritage); gastrointestinal disturbances; and bacteria. The sun may also heat the skin and cause it to blush. None of them has been definitely confirmed, other than the contributing factors of sunlight and heat. It is certain, however, that rosacea patients have a tendency to flush and blush.

The Stages Of Rosacea

Rosacea patients often experience increased redness (erythema) on the central areas of the face, less often the neck and v-shaped areas of the chest. These individuals are constantly blushing, caused by numerous reasons: ultraviolet radiation, heat, cold, exercise, chemical irritation, strong emotions, alcoholic beverages, hot drinks, and spices. Eventually flushing and blushing lead to permanent erythema.

Stage1: The erythema persists for hours and days. Tiny, scattered, red blood vessels (telangectasia) become progressively more noticeable, forming sprays on the nose and cheeks. Most of these people complain of sensitive skin that stings and burns after application of a variety of cosmetics, fragrances, and certain sunscreens.

Stage 2: Inflammatory papules and postules, that resemble tiny pimples, crop up and persist for weeks. Comedones do not occur, facial pores become more prominent, and shallow scars from inflamed lesions are possible. The attacks of pimple-like papules become more and more frequent. Finally, rosacea may extend over the entire face and also the scalp.

Stage 3: A small proportion of people go on to develop the worst expression of the disease, namely, large inflammatory tissue hyperplasia. This causes swelling deformations on the cheeks and nose, less often on the chin. The facial contours become coarse, thickened, and irregular. People may not notice this gradual coarsening of appearance, and the change becomes evident when old photographs are viewed. Finally the person shows inflamed and thickened skin with large pores, resembling the surface of an orange. Late stage rosacea can be helped with laser treatment.

Skin Care and Topical Treatments for Rosacea

Rosacea sufferers have skin that is unusually vulnerable to chemical and physical insults. All sources of irritation, such as soaps, alcoholic cleansers, tinctures, astringents, abrasives, and peeling agents, must be avoided. Only very mild soaps or properly diluted detergents are advised. Protection against sunlight requires emphasis. For some it may be hard to find a sunscreen that is tolerated without burning or irritation.

Topical Antibiotics as used in acne, are sometimes effective. The mandelic acid in NuCelle's Mandelic Marine Complex has natural antibacterial properties. Prescription antibiotics can also be obtained from your dermatologist.

Retinoids are also worth a trial. This includes the tretinoin products such as Retin-a® and Renova®.

Azelaic Acid The anti-inflammatory properties of this compound may be the cause of its promising results.

Salicylic Acid or Mandelic Acid Exfoliation is a key for getting rid of the papules and postules associated with rosacea. The hard part is find an exfoliant that does not irritate sensitive rosacea skin. Salicylic Acid and Mandelic acid are the two least irritating.

Vitamin C L-Ascorbic acid has been shown to be particularly beneficial in reducing redness. Start off with a lower concentration. Make sure to test any vitamin C product in a small area as L-Ascorbic acid can be irritating to some.

Sunscreens Preferably of the broad spectrum UVA plus UVB and infrared type, with a sunprotecting factor (SPF) of 15 or higher. Sunscreens that consist of titanium dioxide or zinc oxide are least irritating.

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