While a subtle, rosy glow to the cheeks lights up a face and reflects good health and inner radiance, the persistent ruddiness experienced by over 2 million Canadians with chronic rosacea is not the glow they’re looking for. The good news is that while there is no cure, there are new developments in treatment for this chronic skin condition. Typically affecting fair-skinned individuals over the age of 30 and found in women more often than men, rosacea affects the central face with redness and sometimes an acne-like outbreak. It can also affect the eyes.
The cause of rosacea is still unknown; however, immune dysfunction, ultraviolet damage, inflammatory reactions to microorganisms in the skin and gut, and vascular dysfunction are thought to play a role in flare ups.
There are four subtypes of rosacea, with the two most common types including Erythematotelangiectatic Rosacea (redness) and Papluopustular Rosacea, which involves acne-like lesions.
Skin affected by rosacea is very sensitive, so gentle skincare is essential. The skin should be cleansed with a gentle non-soap cleanser and moisturized frequently, avoiding skin-irritating toners and exfoliating agents. For redness concealment, choose a green-tinted foundation for the affected areas and layer a skin tone matching product on top. Hypoallergenic make-up is recommended.
Smoking, sun exposure, certain foods and other environmental factors can cause rosacea to flare up. The following are defense strategies you can use:
- Avoid flushing as much as possible. Individuals with rosacea flush and blush easily due to vascular dysfunction. Usual triggers include hot or cold environments, sunlight, spicy food, alcohol, exercise, emotion, some medications and menopausal hot flashes. It’s important to know your own triggers.
- Quit smoking. Smoking ages the skin and may aggravate rosacea, so smoking cessation is advised.
- Protect your skin from the elements. Use a sunscreen with an SPF of at least 30, cover up and stay out of the mid-day sun. Avoid alcohol-based sunscreens which may irritate the skin.
Pharmaceutical treatments for rosacea have been minimally effective for simple facial redness – until now. The new once-a-day topical treatment, Brimonidine (Onreltea) became available in Canada this April. It is a potent vasoconstrictor and temporarily reverses the redness caused by dilated blood vessels. The conventional topical therapies, metronidazole and azelaic acid, do reduce redness to a degree, although their main role is in reducing the acne-like skin lesions.
Oral tetracyclines have been another cornerstone of treatment, primarily used to treat the acne-like lesions. They are antibiotics, but are thought to work via an anti-inflammatory mechanism. To avoid disruption of the gut flora or contribution to global antibiotic resistance, they can be given at sub-antimicrobial doses (for example, Doxycyline is used at the sub-antimicrobial dose of 40 mg instead of the usual antibiotic dose of 100 mg).
While the new Bimonidine is expected to be an important weapon in the arsenal against rosacea, energy based treatments such as vascular laser and Intense Pulsed Light (IPL) are the most powerful methods for common forms of rosacea. This method treats the telangiectasia (tiny spider veins), that the conventional methods cannot, and also reduces background redness. Repeated treatments are required for optimal improvement.
If you are affected by rosacea, talk to your Copeman Healthcare provider about new approaches to treatment that could help.