The Rosacea Enigma

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Rosacea is a very common skin condition with prevalence for persons of fair skin type (Fitzpatrick 1 or 2), Celtic or Northern European heredity. However, the condition can be found in dark skinned patients as well. Rosacea has many variations ranging from a simple tendency to Flush or Blush in one's early 20’s to 30’s to a severe form of disfiguring conglobate inflammatory Acne, resulting in a leonine (lion-like) face similar to that found in leprosy. The condition peaks between ages 40 to 50. Women are affected more often than men in a 3:1 ratio.

Rosacea tends to run a much milder course in women, however, with men developing the more disfiguring aspects such as rhinophyma (the red bulbous nose) and disfiguring, difficult to treat Acne. The condition can arise suddenly after an environmental or chemical impact in one prone to having Rosacea or slowly, developing over years and never becoming fulminant. The one thing that is common to all cases of Rosacea are that solar irradiation makes it flare and worsens its clinical course and prognosis.

Other environmental factors such as heat, humidity, cold, and dryness have been cited as possible irritating factors as well. The skin may be exquisitely sensitive to fragrance, detergents, emollients and many skin care product ingredients. Drinking hot liquids, eating spicy foods and development of emotional reactions will also stimulate the flushing response, as will alcoholic beverages. The best treatment is to abstain from the initiating factors, which exacerbate the condition.

There is no known cause for Rosacea, although there seems to be a problem with abnormal blood vessel dilation and constriction in the arteries of the face. Rosacea is a disease of the central aspect of the face, localized to the nose, forehead, cheeks, chin and glabella (the area between the eyebrows). A bright red central face, capillary prominence and Acneiform eruptions mark full-blown Rosacea. The Acne associated with Rosacea differs somewhat from the pustular comedomes of adolescent Acne. Many times there are inflammatory eruptions without sebaceous material, although there can be full-blown sebaceous cysts, which will require incision and drainage. Rhinophyma (Greek for “bulbous nose”) results from excessive sebaceous activity of the nose with enlarged, scarred sebaceous glands.

Once Rosacea is under control with medical measures, rhinophyma responds well to CO2 laser reduction. Treatment of Rosacea is controversial since there is no single known cause. However, absolute avoidance and block of UVA and UVB with broad brim hats and sunblock is imperative. The best blocks are mechanical with a combination of Titanium Dioxide and Zinc Oxide with otherwise non-irritating ingredients (GreatSkin® Sunblocks, Coats Aloe Sunscreen SPF30, M.D. Forte Environmental Protection).

Topical Metronidzole Gel and Cream, topical Erythromycin, topical Cleocin and oral antibiotics like Tetracycline, Doxycylcline and Minocycline are commonly use antibiotic treatments. In more severe cases, tretinoin and accutane may be used. (Note: These unique prescription products can only be obtained from your skin care physician.)

Our favorite recommendations for Rosacea:

GREATSKIN
Ultra Sensitive Cleanser
Ultra Sensitive Toner
Matrix Booster
Restorative Marine Moisturizer
SPF 30 w/ Green Tea

JOEY
Gentle Soothing Cleanser
Gentle Soothing Toner
Calm and Correct Serum
Gentle Soothing Moisturizer


LA ROCHE POSAY
Toleraine Gentle Dermo Cleanser
Thermal Spring Water
Toleraine Facial Fluid
Toleraine Facial Skin Care Creme
(need username and password to purchase La Roche Posay products, call 1-800-700-4414 for more information)

In-clinic professional treatments and a good home-care regimen can make a world of difference. GreatSkin®.com carries many products that can address Rosacea in an effective way. Need help on deciding on products? Get a free personalized analysis and recommendation – Fill out our GreatSkin Analysis Questionnaire.