Rosacea can be controlled with therapy, lifestyle changes

A remedy for the underlying cause of rosacea has yet to be discovered. However, the condition can improve significantly with long-term medical therapy and lifestyle modifications. Rosacea is a chronic and progressive disorder that usually first appears as redness on the cheeks, nose, chin, or forehead that comes and goes. As the condition progresses, the redness becomes more severe and permanent, and spidery visible blood vessels called telangiectasia may appear. Bumps and pimples often develop, and if left untreated the nose may become swollen from excess tissue, a condition known as rhinophyma .

Initial treatment

Dermatologists often prescribe initial treatment with fast-acting oral and topical antibiotics to bring rosacea under immediate control. This is quickly followed by long-term therapy with the topical medication alone. It is believed that in cases of rosacea, the medication works by reducing inflammation.

Long-term treatment

Topical ointments

Long-term use of oral antibiotic tablets has been associated with a number of side effects, including nausea, gastrointestinal upset, photoxicity and yeast infection. As a result, topical therapy is used to avoid side effects. Topical ointments work directly at the site of inflammation. Blood levels of the drug used in topical ointments are either very low or nonexistent. Moreover, in clinical studies, long-term daily use of a topical antibiotic alone was shown to maintain remission of symptoms in most rosacea patients.

Laser removal of spidery blood vessels

After medical therapy removes the redness, papules and pustules, any telangiectasia previously hidden by the redness often become more visible. In most cases, a surgical device called a pulse dye laser can be used in the doctor's office to erase these tiny blood vessels virtually without pain or discomfort. The short pulses insure that only the blood vessels are targeted. This reduces or eliminates the chance of damage to surrounding facial tissue.

Laser removal of excess tissue on the nose

Likewise, the unsightly excess tissue of rhinophyma can also be corrected with a pulse dye laser. Early treatment often shrinks the nose and helps prevent further development of the condition. However, if necessary, a CO2 laser can be used as a bloodless scalpel to effectively recontour the nose. Other options for treating rhinophyma include dermabrasion, hot-loop electric coagulation and resculpting with a scalpel.

Maintaining remission

In addition to medical therapy, rosacea sufferers can reinforce their chances of maintaining remission by identifying and avoiding lifestyle factors that trigger flare-ups in their individual cases. While there are a vast number of triggers that affect various individuals, nearly all seem to be related to flushing. However, what triggers a flare-up in one sufferer may not affect another.

According to a survey by the National Rosacea Society, the most common rosacea triggers in descending order include:

• Sun exposure
• Emotional stress
• Hot weather
• Alcohol
• Spicy foods
• Exercise
• Hot baths
• Cold weather
• Hot beverages
• Humidity
• Skin-care products
• Certain types of drugs

As with most conditions, treatment of rosacea must be tailored by the doctor to meet the needs of each individual. They keys to minimizing the effects of this conspicuous and embarrassing disorder are early diagnosis and faithful compliance with medical therapy and any lifestyle modifications that may be necessary.