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Center of Dermatology and Laser Surgery of Philadelphia

Rosacea

Rosacea - before and after treatment
Rosacea – Before and after treatment

Rosacea is a chronic inflammatory condition that causes redness and bumps on the face, neck, and chest. We understand that rosacea can be embarrassing because it affects areas of the skin that are visible to others. We also realize that rosacea can cause discomfort. Therefore, we utilize medication, pulsed dye laser treatments, chemical peels, and lifestyle modifications to reduce symptoms and restore your confidence in your skin.

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About Rosacea

Rosacea affects both men and women, typically between the ages of 30 to 50. It varies in severity, but almost always causes background redness on the cheeks, nose, forehead, or chin of affected individuals. This redness can worsen when exposed to certain triggers. Intermittent inflammatory and pus-filled bumps are another common symptom.

Additional symptoms include:
  1. A tendency to blush easily
  2. Persistent redness in the center of the face
  3. Telangiectasias (small visible blood vessels)
  4. Burning, stinging, itching, or tightness on the face
  5. Dry skin on the face
  6. Swelling on the central face
  7. Thickening of the skin on the nose, cheeks, and/or forehead,
  8. Rhinophyma (bumps on the nose that may develop if rosacea is left untreated)
  9. Eye burning, itching, or watering
  10. Eyelid swelling
VBeam Perfecta is the gold standard laser for the treatment of Rosacea
Rosacea - before and after treatment
Rosacea – Before and after treatment
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Treatment Options According to Type of Rosacea

Treatment is designed to combat the specific type of rosacea that affects the individual. Three types of rosacea we commonly treat at our practice are 1. telangiectatic rosacea, 2. inflammatory rosacea, and 3. ocular rosacea. We use a combination of oral & topical medications, lifestyle modifications, laser and light therapies, chemical peels, and surgical procedures to give you the best results possible.

1. Telagiectatic Rosacea

Telagiectatic Rosacea
Telagiectatic Rosacea

Telangiectatic rosacea causes background redness and involves a tendency to flush or blush easily. It can temporarily improve with topical medications, like Mirvaso ®, that aim at reducing facial blood flow and background redness for several hours. Permanent reduction of background redness can be achieved with pulsed dye laser (Vbeam) treatment. Retreatment every 7 to 10 years can be performed as new vessels form or dilate due to the underlying inflammatory state.

2. Inflammatory Rosacea

INFLAMMATORY ROSACEA
Inflammatory Rosacea

Inflammatory rosacea causes persistent redness, pimples, and visible threadlike blood vessels in the center of the face that can spread to the cheeks, forehead, chin, and nose. Topical azelaic acid, anti-mite, or antibiotic creams can effectively reduce the inflammation that is caused by this type of rosacea. Quelage peels, performed in the office, can also help to calm inflammation. When topical treatments are not enough, low dose oral antibiotics, such as doxycycline and Oracea ®, can be used in combination with topicals to help reduce inflammation. These oral antibiotics are safe to use because they function at a sub-microbial dose, meaning that you benefit from their anti-inflammatory properties without endangering the good bacteria in your intestines.

3. Ocular Rosacea

OCULAR ROSACEA
Ocular Rosacea

Ocular rosacea causes burning, itching, or watering of the eyes. We can improve these symptoms with artificial tears or cyclosporine eye drops. Oral antibiotics can also be used for symptomatic and worsening eye involvement.

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Triggers

Common triggers that can worsen rosacea symptoms are stress, anxiety, heat (from sunlight, shower, or exercise), food (spicy or hot), alcohol, and weather changes (hot, humid, cold, and wind). While avoidance of these triggers can help prevent rosacea flare-ups, we realize that complete avoidance of all triggers is sometimes impractical. Additionally, not everyone with rosacea is affected by all of the above triggers. Therefore, we recommend that you keep a daily diary to identify your specific triggers. Furthermore, we encourage all individuals affected by rosacea to wear sunscreen with UVA/UVB protection, wear sunglasses, moisturize dry skin, control indoor temperatures (especially when exercising), stay well-hydrated, and manage stress.

PATIENTS ASK, DR. RINGPFEIL ANSWERS

Please feel free to use the form below to ask Dr. Ringpfeil questions that might be of interest to others.

10 Comments on "Rosacea"

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Donna
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Donna
March 27, 2015 10:39 am

I just started used Mirvaso for severe redness and it is working but I am not breaking out with the little pimple like imflamation on my cheeks. I also have used and still use at night the Metrogel which will work when used for a long period of time. I was wondering if I could use these 2 medications together or should I just use the metrogel at night and the mirvaso during the day? Thanks so much for your answer.

Rachel
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Rachel
April 2, 2015 12:02 pm

Hello Dr. Ringpfeil, For the past few years I have suffered with Rosacea with mild acne on my cheeks (I do have some mild scars leftover from acne during my teenage years 15-20 years ago). I’m very interested in receiving pulse dye laser treatment and am curious if this is something that would work on this condition for my current rosacea and cheek redness.

Kristin
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Kristin
July 28, 2015 5:20 am

I have two questions regarding pulsed laser dye for rosacea:

(1) I’ve seen photos on the Internet of red blotches/bruising on the skin. Does this indicate stronger and therefore more effective treatments? Or can treatments be just as effective without the bruising?

(2) I am trying to become pregnant. Could I still have the laser procedure?

Also, regarding Mirvosa, I’ve read that it can be extremely effective, but also read anecdotal stories from patients of terrible rebound effects. What is accurate regarding the drug?

Thanks

Becca
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Becca
October 15, 2015 6:19 am

Hi, I was just diagnosed with possible rosacea from one of your dermatologists. I have a small amount of bumps, but mostly redness on my cheeks. I was prescribed Metrocream and Sumaxin wash. The dermatologist told me this should get rid of bumps, but I was wondering what will get rid of the redness. Also, if I do have rosacea, will it get worse? Is there any tips you recommend for someone experiencing mostly redness. Thanks

Bojana
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Bojana
December 10, 2015 11:38 am

If you have rosacea, will insurance cover the cost of the laser treatment? What treatments for rosacea are covered?

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