Rosacea

Rosacea is a very common disorder of primarily the facial skin in middle aged females. It is sometimes mistaken for acne.

Rosacea can cause flushing, persistent redness, broken/dilated blood vessels (telangiectasia), pimple like lesions of the central face and sometimes thickening of the skin of the nose.

To deal with flushing, one may want to consider oral medication such as beta-blockers and anti-cholinergics. However, side effects are common with these medications.

Persistent redness can be treated with Brimonidine cream which constrict the superficial blood vessels temporarily. The redness will return after several hours of use. Persistent redness and dilated blood vessels can also be treated with a vascular laser such as V beam or KTP laser.

Pimple like lesions are treated with topical antibiotics or anti-inflammatory medications such as metronidazole (Metrogel, Metrocream, Noritate cream), ivermectin (Rosiver cream), dapsone gel (Aczone gel), azelaic acid (Finacea cream) and sulfacetamide (Sulfacet R). When severe, oral antibiotics such as tetracyclines (tetracycline, minocycline and doxycycline) or isotretinoin (Accutane, Clarus, Epuris) can be used.

People with rosacea often have sensitive skin and may complaint of itching and burning. Occasional, eczema like lesions are seen and the term Rosacea Dermatitis can be used. Mild topical steroids or calneurin inhibitor (a non-steroidal treatment) can be used to calm rosacea dermatitis.

Rosacea often co-exists with seborrheic dermatitis/eczema (a form of eczema). Seborrheic dermatitis typically presents with redness and scaling of eyebrows, around the nose and the mouth area, scalp, chest and folds. It can be itchy and require different treatment to the rosacea. Anti-yeast treatment and mild topical steroid are used in this form of eczema.

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