Rosacea Treatment

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Diagnosis
Remember you must have a diagnosis from your Doctor. Other skin disorders and illnesses may appear like Rosacea and some serious illnesses may produce Rosacea type symptoms.

Treatment
Usually the first treatment for Rosacea prescribed by Doctors is antibiotic tablets (such as tetracycline). Topical gels containing the antibiotic Metronidazole are now available. These have the advantage because they are applied directly to the affected skin, do not cause stomach upsets and thrush. Be aware that some gels have alcohol bases. Water based ones are now on the market and are kinder on the skin, they are usually known as creams. Please remember your Doctor may tell you to continue taking treatment even after the symptoms have gone. This is because many people find their symptoms return if they stop treatment.
There are also various light and laser treatments now available of which I've had postive and negative reports.

Trigger factors
Flushing may be triggered by certain foods, stress, exercise, the wind, rain, sunshine, too moist an atmosphere, too dry an atmosphere, steam from washing the dishes, (cooking, bath or shower), Talking to people, the thought that you might be flushed or nothing you can identify. In other words it’s a right pain in the nether regions!

Trigger foods
Trigger foods (of which no-one has a definitive list), that might cause flushing and therefore flare ups (a general worsening of symptoms) may include, spicy foods, smoked and pickled items, foods with added niacin, (niacinamide may be preferable), alcohol. Caffeine and hot drinks. Always consult your Doctor before embarking on a program of food avoidance or diet.

Thread veins (telangiectasia)
These can be treated using surgical lasers (argon and pulsed dye lasers). The laser works by matching the wavelength of the laser light to the colour of the broken veins so that only the broken veins take up the heat of the laser light and are destroyed in a millionth of a second with no damage to surrounding tissue. This ensures no scarring. However treatment may need to be repeated if the thread veins return.

Electrodessication
Electrodessication uses an electric current to destroy and remove the veins. A very fine needle or electrode is inserted into the blood vessel and an electric current is passed through it.

Enlargement of the nose (rhinophyma)
And which bloody comedian thought of that name. The drug isotretinoin used to treat acne, is now used to reduce nose enlargement caused by Rosacea. However, if this is not effective surgical treatment may be necessary.

The Eyes
About half of Rosacea patients will have Ocular Rosacea. To what degree the eyes are affected appears to bare little relation to the severity of inflammation of the face. For instance you may have severe Rosacea on the face and little or no problems with the eyes. Similarly mild Rosacea may be accompanied by severe Ocular

Rosacea.
Common complaints are a dry and gritty feeling in the eyes, these symptoms may be alleviated by over the counter eye drops but this is not treating the condition you must see your Doctor and perhaps take some literature with you that shows the connection between facial Rosacea and Ocular Rosacea as the condition remains underdiagnosed.

Symptoms of Ocular Rosacea may be:
Blepharitis, inflamed, dry and crusty eyelids probably at it’s worse in the morning.
Conjunctivitis, feels like grit in the eyes, caused by inflammation of the white part (conjunctiva) of the eye.
More serious problems arise in about 5% of those with Ocular Rosacea:
Iritis, inflammation of the iris causing pain.
Keratitis, ulceration of the cornea. This may lead to visual dysfunction, rarely blindness.

Treatment will be to reduce the inflammation of the affected part of the eye. Steroid eye drops may be prescribed. Tetracycline antibiotics also used to treat facial Rosacea has been shown to reduce inflammation and with early intervention can prevent blindness. Your Doctor may refer you to an Opthalmic specialist at a hospital, essential with the more severe forms of Ocular Rosacea. Check to see if there is an eye casualty department at your hospital that you could visit if your eyes are causing you problems.

Skin Care
Always use mild products usually described as non-comedogenic and hypoallergenic. Use water based products and avoid those that contain; denatured alcohol, witch hazel, tea tree oil, acetone, eucalyptus oil, clove oil, peppermint oil, menthol, lanolin or mineral oil. You may want to avoid anything on your skin that you aren’t sure of and then gradually reintroduce products once your symptoms have eased. Men should use an electric shaver. Include a product containing a UV filter when out in the sun.

Controlling the flushing
One of the most distressing aspects of Rosacea is that people with it tend to Blush/flush easily. This is not to do with embarrassment, but can be to do with nervousness (no matter how slight), anxiety (again it could be miniscule), general stress (which is an all encompassing term!) or nothing that can be identified.
If you are flushed knowing that your flushing may make your Rosacea worse is stressful. Stress leads to further flushing now you have a really flushed face which is embarrassing which makes you anxious, being anxious causes you to flush more and on and on. Rosacea is nothing if not a very vicious circle. This kind of vicious circle can lead to panic attacks and avoidance of social activities. Do not be afraid to tell your Doctor how Rosacea is affecting you. It is a good idea to put your thoughts down on paper and give that to your Doctor at the consultation.

The menopause can cause flushing in some women which may aggravate Rosacea.
The flu or any illness accompanied by a high temperature can aggravate Rosacea (as if you didn’t feel bad enough).

High blood pressure may aggravate Rosacea.

When flushing is attended by itching, diarrhoea, headaches or difficulty breathing please consult your Doctor.

Vasodilator drugs used in the treatment of cardiovascular disease may aggravate Rosacea.

Drugs & Surgery to treat flushing
There are drugs available from your Doctor that can help blushing/flushing and therefore lead to an improvement of Rosacea symptoms. They are;
Dixarit (i.e. Clonidine).
Propanolol beta-blockers.

A surgical procedure is available to treat facial blushing and facial sweating, it is called an Endoscopic Thorasic Sympathectomy (ETS). It involves keyhole surgery using an endoscope, with incisions being made under the armpit and a skilled surgeon then cutting or preferable clamping (this gives some hope of reversal if side effects are noted in the fortnight after surgery) sympathetic and kuntz nerves in the chest cavity (hence thorasic). The autonomic nervous system controls many of the body’s unconscious functions heart beat, blood vessel constriction/dilation, saliva in the mouth, blushing. The autonomic nervous system is divided into two parts the sympathetic nervous system and working in opposition to it the parasympathetic nervous system. The nerves cut during the surgery are those that transmit signals to tell the face to blush and sweat and coincidentally the hands to sweat.