Tuesday, 1 November 2011

Rosacea is a common condition. Often there is lack of awareness but there is no need to suffer in silence.

Consider rosacea if you have suffered from any of the following-facial flushing, redness, broken blood vessels, coarseness of skin and inflammatory eruption resembling acne.

Rosacea is defined by persistent redness of the central portion of the face lasting for at least 3 months. Other symptoms include flushing, acne like eruptions and visible blood vessels. Often there is burning and stinging, swelling, plaques, a dry appearance, eye symptoms such as redness and stinging and a swollen, bulbous nose.

Frequent triggers to flushing include acutely felt emotional stress, hot drinks, alcohol, spicy foods, exercise, cold or hot weather, and hot baths and showers and some skin creams.

There are four different types of rosacea; each with their unique features and treatment may differ. Some other conditions can resemble rosacea but usually this is a clinical diagnosis. Occasionally blood tests are required to rule out other conditions.

Erythematotelangiectatic type [ETR]
Central facial flushing, often accompanied by burning or stinging, is the predominant sign. The redness usually spares the skin around the eyes. These patients typically have dry skin with a fine texture.

Papulopustular rosacea [PPR]
Papulopustular rosacea is the classic presentation of rosacea. Patients are women of middle age who predominately present with a red central portion of their face that contains small red lumps, some with white heads.

Phymatous rosacea
Phymatous rosacea is defined as marked skin thickenings and irregular surface nodularities of the nose, chin, forehead, one or both ears, and/or the eyelids. This is more common in men.
Ocular rosacea
This is rosacea, which affects the eyes causing blepharitis, conjunctivitis, inflammation of the lids and conjunctival redness. Symptoms include eye stinging or burning, dryness, irritation with light, or foreign body sensation.


As rosacea is a poorly understood condition there is no cure but we aim to control the symptoms. It is important to avoid or reduce precipitating factors such as stress, spicy foods and sudden changes in temperature.
Your GP may prescribe antibiotic gels, creams or tablets that help in papulopustular type of rosacea but do little to help flushing and blood vessels. Other medications are vitamin A based creams or isotretenoin and some medications to reduce flushing.

Laser treatment is mainstay for flushing and broken blood vessels. We use IPL and a variety of lasers to help reduce it. Broken veins disappear in a few sessions but flushing control need multiple sessions. LED or light emitting diode therapy can help as well.

Phymatous rosacea is treated very successfully with a combination of vascular lasers and CO2 laser to remove thickened tissue under a local anaesthetic.

Ocular rosacea is currently not treated with lasers. Further research is likely to produce more treatment options but for now we advocate laser therapy, which helps a majority of rosacea sufferers.


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