ROSACEA– Half Environmental and Half Genetic

The month of April has been designated Rosacea Awareness Month.Rosacea is one of the most frequent concerns today in general dermatology. The National Rosacea Society estimates that more than 16 million Americans suffer from the disease. Former President Bill Clinton is among them. Uncontrolled, the disease can worsen and diminish someone’s quality of life. In surveys, more than nine in 10 patients have reported waning self-confidence and self-esteem, per the rosacea society.

Patients with rosacea typically experience facial redness, acne-like breakouts, and visible thin reddish-purple blood vesselsThe actual cause of the disease has been elusive to researchers. However, a recent tudyin JAMA Dermatology was performed to determine whether environmental factors or genetics are to be blamed for causing rosacea (Jama Dermatol. 2015 Nov;151(11):1213-9).  In this study, identical and fraternal twins were used since they share their genetic makeup. Researches performing the study concluded that genetics appears to contribute to 46% of rosacea risk. The remaining 54% of the risk was attributed to environmental factors. These factors include excess sun exposure, smoking, drinking alcohol, older age, higher body mass index (BMI), and heart disease. 

Although there is no cure for rosacea, this new study can be used to develop proper treatment plans to help control the condition. If you have a strong family history of rosacea (unfortunately genetics cannot be altered!), more attention should be paid to environmental factors and life style modifications.Seeking a board-certified dermatologist can help manage and correctly treat your rosacea.

TIPS FOR MANAGING ROSACEA

All patients with rosacea can benefit from:

1. Identify and avoid your trigger: common triggers for rosacea include becoming overheated, having cold wind blowing on your face, eating spicy foods, or drinking alcohol. These may — or may not — cause your rosacea to flare. People have different triggers.It’s important to find out what causes your rosacea to flare and avoid those triggers.

• Protect your skin from sun: use of sun protection is still the No. 1 recommendation for patients with rosacea. American Academy of Dermatology (AAD) recommends that everyone use a sunscreen that hassun protective factor (spf) 30 or higher and is water resistant. Appling a cosmetically pleasing sunblockthat has physical blocker properties (i.e.titanium or zinc oxide) and protects against bothUVAand UVB is ideal.  As per AAD, sunscreen should be reappliedapproximately every 2 hours, or after swimming orsweating. In addition to wearing sunscreen, AADrecommends taking the following steps to protect yourskin: seek shade (especially between 10 AM and 2 PM),wear sun protective clothing (long-sleeved shirts,pants, wide-brimmed hat, and sunglasses), and useextra caution near water, snow, and sand (as theyreflect the damaging rays of the sun)
• Lifestyle Modifications:reducing alcohol intake, smoking cessation, avoiding stress, consuming a healthy diet and exercising regularly.

• Keep your skincare routine simple:many skin care products can irritate skin with rosacea. Avoid products that contain alcohol. Some skin care habits, such as scrubbing your skin clean, can cause rosacea to flare. Using mild skin care products and being gentle with your skin can help prevent flare-ups.

MEDICAL AND LASER TREATMENTS FOR ROSACEA

Rosacea treatment can include topical or oral antibiotics, other topical creams, or laser procedures.

Prescription topical medications such as Mertocream or Soolantraare helpful for reducing inflammation and acne-like lesions. For moderate to severe cases, oral antibiotics are usually recommended. Topical and oral medications are effective in the treatment of the small red bumps of rosacea, but they are not effective for the redness/flushing and broken blood vessels. 

Only vascular laser treatments (V-beam laser or Excel -V laser) can improve facial redness and eradicate superficial broken blood vessels.  The laser specially targets hemoglobin, the major component of red blood cells. This in turn causes the blood vessel to collapse and fade naturally with time. While one treatment will produce some improvement, four to sex treatments will probably be needed to achieve the best results. Treatments are usually performed four weeks apart. Rosacea treatments are well tolerated with very mild discomfort and require no anesthesia. Although you may see some redness and swelling post-laser treatment, there is typically no associated down time. Unfortunately, the laser treatments are not covered by insurance, but are an effective treatment solution.

If you think you may be suffering from rosacea, please schedule an appointment with a provider in our office for an evaluation and recommendation for treatment.