Rosacea on Face

Rosacea

Rosacea is a chronic inflammatory skin disorder with symptoms that generally begin with blushing or modest flushing on the cheeks, nose, forehead, and chin that affects approximately 5-10% of people worldwide.

Symptoms typically worsen as the condition progresses, presenting as permanent diffuse redness, visible blood vessels, swelling, and fluid filled ‘pimples’. Patients may also present with itching, stinging, pain and burning sensation in the skin.

A classification system has been developed by the National Rosacea Society based on primary lesion presentation.

  • Erythematotelangiectatic
  • Papulopustular
  • Phymatous
  • Ocular

There is a high prevalence of Rosacea among Caucasian adults between the ages of 30 and 60 with fair, sun-sensitive skin (Fitzpatrick skin types I and II) however, it does affect individuals of all races and age groups.

There is no known cure for Rosacea and the cause is still not fully understood, however there are many factors that seem to contribute to the condition including genetics and immune dysfunction, with environmental triggers often being ultraviolet radiation (eg. the sun), sudden dramatic shifts in temperature (eg. moving from heated room to a cold one and vice-versa), exercise, emotional stress, spicy foods, and alcohol to name a few.

Treatment options and how we can help

The treatment plan for rosacea starts with repairing and maintaining the skin barrier with products for gentle cleansing and broad-spectrum sun protection, evolving into a variety of prescribed treatments and products that have been shown to reduce the symptoms.

Rosacea is primarily managed with oral and topical medications. A range of in clinic treatment options are available including lasers, micro needling, and topical application of skincare products containing some key ingredients.

Laser and light-based treatments have been shown to provide safe and effective treatment of the vascular component of the condition. Our Nd:YAG 1064nm is a great treatment option for reducing facial veins as well as the background redness associated with rosacea.

Over the past 10 years there have been many studies exploring the safety and efficacy of topical tranexamic acid for the treatment of Rosacea with promising results. In 2018 it was shown that combining Tranexamic Acid with microneedling saw significant improvement in visible signs of Rosacea.

The full mechanism of how Tranexamic Acid reduces clinical signs of rosacea are not fully understood, although recent studies have shown Tranexamic Acid inhibits the amino acid serine protease, which improves the skin barrier, while overproduction of blood vessels are suppressed, reducing visible redness in the skin.

In 2014, a study showed the effects of a topical lotion containing caffeine, zinc gluconate, bisabolol, Eperua falcata bark extract, and palmitoyl tripeptide-8 in patients who had been successfully treated with topical or oral therapy for papulopustular rosacea but were still unhappy with the persistent moderate-severe facial redness. There was a significant improvement seen in redness, flushing, skin texture, radiance, skin tone (evenness) and overall rosacea severity as well as improvement of general skin characteristics such as skin texture, radiance and overall skin appearance.

If you’d like to discuss your option in more detailed, please book in for a Clinical Consultation so that we can develop a treatment plan specific to you.

References

Cardwell, L., Farhangian, M., Alinia, H., Kuo, S. & Feldman, S. (2015) Psychological disorders associated with
rosacea: Analysis of unscripted comments, Journal of Dermatology & Dermatologic Surgery, 19(2), 99-103. https://doi.org/10.1016/j.jdds.2015.04.003

Rainer, B. M., Kang, S., & Chien, A. L. (2017). Rosacea: Epidemiology, pathogenesis, and treatment.
Dermato-endocrinology, 9(1). https://doi.org/10.1080/19381980.2017.1361574

Weinkle, A. P., Doktor, V., & Emer, J. (2015). Update on the management of rosacea. Clinical, cosmetic and
investigational dermatology, 8, 159–177. https://doi.org/10.2147/CCID.S58940

Micali, G., Gerber, P. A., Lacarrubba, F., & Schäfer, G. (2016). Improving Treatment of Erythematotelangiectatic Rosacea with Laser and/or Topical Therapy Through Enhanced Discrimination of its Clinical Features. The Journal of clinical and aesthetic dermatology, 9(7), 30–39.