An Unwanted Rosy Complexion: Rosacea

Fourteen million Americans between the ages of 30 and 60 struggle with a skin disease that resembles teenage acne. Although these men and women are not experiencing the hormone changes that cause acne during the adolescent years, they suffer from an inflammatory skin disease that causes small, red bumps—rosacea.

Dr. Scott Li

“Rosacea is more common in women, but men frequently display more severe signs of the disorder,” explains Scott Lim, D.O., an osteopathic dermatologist practicing in Erie, Pa. “While it isn’t life-threatening, it certainly affects patients’ appearance and self-esteem.”

Further, Dr. Lim explains that rosacea will recur and worsen over time without treatment.
“Patients experience a break-out for weeks or months and then the symptoms subside for a while before they flare up again,” he explains.

Dr. Lim says that rosacea appears through myriad signs and symptoms. Primary features include flushing of the face, persistent redness of the face (non transient erythema), bumps and pimples, and visible blood vessels. Those affected with rosacea may also have any of the various secondary features, including burning or stinging, raised red patches of skin (plaques), dry appearance to the skin, swelling, eye irritation, skin thickening, and areas of skin affected away from the face.

While most people know that rosacea is a skin condition, few know that the disease can spread to their eyes. Ocular rosacea affects more than 50 percent of the people suffering from rosacea. This type of rosacea can result in a burning or gritty sensation in the eyes. Ocular rosacea can also cause the skin on the inside of the eyelids to appear inflamed or scaly.

“Patients frequently notice an increase in the flaky, eye product that most refer to as ‘sleepy eyes’, with ocular rosacea,” explains Dr. Lim.

While treatment exists for the different symptoms of rosacea, the cause is still unknown. “Treatment varies depending upon the classification and severity of the condition,” explains Dr. Lim. “But most treatment plans include taking prescription medications and using products designed for sensitive skin.” Antibiotic gel or lotion is prescribed to reduce inflammation. Oral antibiotics have an anti-inflammatory benefit and may also be prescribed at the beginning of treatment to jump-start recovery, as they absorb into the bloodstream faster than gels or lotions. In select cases, electrosurgery, the use of a high-frequency electric needle with heat, might be used to treat the affected area. However, Dr. Lim says that it is much more common to diminish the appearance of broken blood vessels and redness with a laser or intense pulse light (IPL) treatment.

Dr. Lim explains that most rosacea patients tend to have sensitive skin. So, he recommends speaking with your family physician or dermatologist about non-soap cleansers and make-up that works best for your skin. Another important issue to discuss is sun protection. Protection from the sun should include a broad-brimmed hat; broad-spectrum sunscreen that blocks both UVA and UVB light; and sunglasses with 100 percent UV protection.

In addition to sunlight, Dr. Lim explains that patients should minimize exposure to any item or activity that might aggravate the disease. While sunlight is a trigger for all patients, other triggers can vary depending upon the individual. Some common triggers include:

* Extreme hot or cold temperatures;
* Stress;
* Exercise and other activities that induce stress, anger or embarrassment;
* Steam from hot baths or saunas;
* Hot or spicy foods and beverages;
* Any medications that dilate blood vessels, including some blood pressure medications; and
* Alcohol.

Dr. Lim emphasizes the importance of patient education in the process of treatment, and that there is more than just prescribing medication. He notes the importance of helping patients first understand the nature of rosacea, the trigger factors and taking a history to determine what trigger factors may be influencing their disease. With more avoidance of trigger factors, Dr. Lim says it could mean less drug therapy.

“Remember, the symptoms of rosacea are treatable but without treatment the disease will only get worse,” explains Dr. Lim. “So, if you or someone you know is experiencing the symptoms of rosacea, visit your family physician or dermatologist.”

Preventive medicine is just one aspect of care osteopathic physicians (D.O.s) provide. Osteopathic physicians are fully-licensed to prescribe medicine and practice in all specialty areas including surgery. D.O.s are trained to consider the health of the whole person and use their hands to help diagnose and treat their patients.

July 20, 2007
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