Mitzi Perdue

Diagnosing, Preventing, And Treating Rosacea

WHAT IS ROSACEA?

Rosacea is a chronic and potentially life-disrupting disorder that occurs primarily on the facial skin. It an also occur, however, on other parts of the body such as the scalp or in the eye. Rosacea is usually characterized by flushing or redness on the cheeks, nose, chin, or forehead. The redness initially comes and goes but can also be persistent and begin at any age. As it progresses, there can be a matting of the little blood vessels that appear as spider-like veins called telangiectasia.
 
By manipulating the optics of the skin during an examination – such as using perpendicular polarized light – one can observe that the blood vessels become disorganized, and in places, they may look almost like a bird’s nest. The blood vessels dilate, and may lose the ability to contract – thus the flushing and blushing or persistent redness. The lymphatic system also no longer functions well, the circulatory system becomes overloaded, and you get a mechanical and chemical breakdown of the system. There may also be an acute or chronic inflammatory response as well as edema.

There are several categories of rosacea. Subtype 1 is “flushing and blushing.” Subtype 2 has bumps and pustules. In Subtype 3, the skin feels hard, and the nose may become large and bulbous. We don’t know if W.C. Fields’ large red nose was due to rosacea, but that’s what a Subtype 3 enlarged and reddened nose can look like. Subtype 4 is ocular (eye) rosacea, which if untreated can lead to impaired vision or even blindness.

ROSACEA IS UNDERDIAGNOSED

Sixteen million people in this country have rosacea. We find from billing records that women seek treatment at a significantly greater rate than men. However, the sixteen million figure is likely to be an underestimate; over 60% of the population may have some degree of rosacea. Many people may be unaware that they have the disorder. Only one in four individuals knows that rosacea even exists. They may dismiss their symptoms by thinking: “I have a red face because I’ve been in the sun too much.”; “I’m flushed because I’ve exercised too much,” or “My face always turns red when I drink wine.”

ROSACEA IS AN IMPORTANT QUALITY OF LIFE ISSUE

Rosacea can have a major psychosocial impact on a woman’s life. It can mean decreased self-esteem and can adversely affect both her social and work life. In addition, in severe cases, untreated ocular rosacea can result in loss of vision. Those with the condition should seek treatment early on. There’s a lot that can be done to decrease the number and severity of flare-ups. Progression of the disorder can also be prevented when treatment is sought after early. . Further ocular rosacea can occur in the absence of associated skin findings, and individuals may think they just have an irritated eye or eyelid, so it is important to seek help from a qualified physician.

STOP THE PROGRESSION BY AVOIDING THE TRIGGERS

It’s important to find the triggers of rosacea for each individual. The number one factor likely to aggravate rosacea is sun exposure. For patients whose rosacea is triggered by sun exposure, prevention will mean wearing sunscreens, broad-brimmed hats, and if at the beach, staying under an umbrella.

Other common triggers include: cold or hot weather, wind, heavy exercise, alcohol consumption, and hot foods whether the “heat” comes from the temperature of the food or its spiciness. Keeping a trigger diary for two weeks can help patients identify their individual triggers, and this in turn can help patients avoid or mitigate the triggers. For example, if an episode of flushing or persistent redness occurs following exercise, then try exercising in a cool area or with a fan. For a free downloadable copy of a trigger diary, go to:

http://www.rosacea.org/patients/materials/diary/instructions.php .

The goal of the Rosacea Diary Booklet is to help the patient avoid those factors that trigger or aggravate symptoms.

STOP THE PROGRESSION BY SEEING A DERMATOLOGIST WHO IS FAMILIAR WITH ROSACEA

It’s important to differentiate rosacea from conditions that mimic it. When diagnosed, consult a dermatologist with training in Rosacea. For example, a dermatologist may also examine for Dermodex mites, which can aggravate the problem. They will also work with the patient to find and eliminate the triggers, and in addition will provide customized treatment for each individual patient. There are topical and systemic medications that are used to treat rosacea, and these can be used individually and in combination. Further, if rosacea has progressed to a red, bulbous nose, laser surgery can provide impressive results by re-sculpting the nose. The patient may need a referral to an eye specialist if the eye is involved. The most important message is that rosacea is a treatable disease, and no one should have to suffer.