The facial flush: Rosacea

Rosacea is more common than you may think, especially in women between 30 to 60 years. It is a frustrating condition that generally worsens if untreated. We often associate flushing and red faces with Rosacea. Patients complain of skin sensitivity, acne like bumps, flaky skin, tiny but noticeable blood vessels, and flushed faces. This flushing is generally seen in the central part of the face and is caused by telangiectasias, or tiny broken blood vessels, on the cheeks and nose. Flushing can be triggered by emotional factors, changes in the weather, the consumption of red wine, coffee or spicy food and can be aggravated by the sun and the wrong type of skincare.

Rosacea sufferers often have sensitive, dry, flakey skin. Counter this by using gentle water-soluble cleansers. Ingredients that worsen rosacea include fragrances, particularly plant extracts like rosemary, lavender and rose, essential oils, alcohol and witch hazel. Harsh cleansers and scrubs should be eliminated. Discard toners with alchohol and fragrance. While I love the clarisonic brush, avoid using this. It is important to avoid rich, greasy skincare that can cause spots. Eliminate irritating ingredients. Improve cell turnover. Wear sun protection. I recommend Skinceuticals Sheer Mineral Defense which has an SPF of 50. Retinols can be used and help reduce the inflammatory factors that contribute to rosacea. While these are practical and relatively simple recommendations, many rosacea sufferers will require prescription creams or tablets to help with the flushing and acne; it is important to treat the inflamed aspects of rosacea before treating tiny broken blood vessels with certain lasers.

Topical antibiotic medication such as metronidazole once or twice daily may improve rosacea. Azelaic acid is also an alternative treatment to help control redness and bumps or can be used in conjunction with metronidazole. Oral antibiotics such as tetracycline, doxycycline, minocycline and amoxicillin are also commonly prescribed to patients with moderate rosacea to help reduce inflammation and pimples in rosacea. Short-term topical steroid preparations of minimal strength may in occasional cases also be used to reduce local inflammation. Tretinoin, tazarotene, or adapalene can be used for acne or severe rosacea. Diode laser and intense pulse-light therapy may help to visibly improve the skin and complexion. Laser treatments may be combined with photodynamic therapy for more noticeable results.

Rosacea is a long term and chronic condition that we can try to control with an arsenal of treatments. It may wax and wane but we can try to minimize its affect on your life.


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