Written by Dr. Ringpfeil
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.
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.
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.
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.
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.
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.
The Philadelphia Dermatology Center serves patients in our local area as well as surrounding cities and out-of-town. Find the most convenient route to our Philadelphia office, by selecting an area near you.