Rosacea is a chronic, common problem for many adults and appears in many different forms and levels of severity. All forms of rosacea have at least one of three primary symptoms. These include 1) pimples similar to acne, 2) redness and/or prominent blood vessels, and 3) rhinophyma (an enlarged, bulbous, ruddy nose). A person with rosacea may have just one symptom, a combination of two symptoms, or all three. In my experience, rosacea affects men and women equally, although rhinophyma tends to be more common in men.
While all the symptoms are collectively referred to as rosacea, they should not be treated the same. Here are some examples of how I treat different forms of rosacea in my practice.
Pimples can often be controlled with topical applications like metronidazole, sulfur products, or azelaic acid. Oral antibiotics are commonly used. A stronger, but more difficult, option for more severe cases is isotretinoin. It’s important to note that these treatments are effective on pimples but don’t treat the redness or prominent blood vessels.
For redness caused by rosacea, I recommend using laser treatments to zap the offending blood vessels. Two of the more common laser treatments are intense pulse light (IPL) and pulsed dye laser. When IPL is used on the face, it’s called a photofacial and treats redness, blood vessels, and brown spots. There are some small studies that indicate that IPL does help pimples, and I have found this to be true. Pulsed dye laser is another machine used for blood vessels and redness. In my practice, we actually have four different machines for use, depending on the part of the face and blood vessels in question. A consultation is usually needed to determine the best treatment option.
Rhinophyma is the result of enlarged oil glands in the nose. For mild cases, isotretinoin can gradually shrink the oil glands. Treatments for more advanced rhinophyma are more dramatic – you must remove the excessive skin with an erbium or CO2 laser. In some instances, we’ll even use a scalpel or heated wire loop. All these treatments leave the skin totally raw, and the patient must wait for it to heal, which can take about 2 weeks. Fortunately, depending on the severity of each individual case, the results can last anywhere from 10 to 20 years.
These are all examples of treatments for rosacea and its various symptoms. You can also manage rosacea with lifestyle changes. Stress, alcohol, and heat seem to make it worse. The most important thing to keep in mind is that you need to find a good dermatologist. There are lots of options for treating this common condition, and only a qualified physician will help you find the combination that works best for you.
Click here check out the National Rosacea Society.