We asked a derma: Here's what you need to know about rosacea
Nothing makes you look quite as blooming as a pretty, pink flush that you get when you’re in love or after a good workout. But if you constantly look like you’re blushing from embarrassment or turn bright red after just five minutes under the sun, you may need to check with a derma if you actually have a skin condition. We talked to Dr. Angeli San Pedro-Garcia, a Philippine Dermatology Society fellow, on what you should know about rosacea.
What is it?
While rosacea is a chronic disease most common in Caucasians, we Asians and those of African descent can also get it, too. It can occur in both sexes but men often report more severe symptoms as they not likely to consult with a doctor until symptoms have worsened. It also typically begins after age 30 but may also develop in children, adolescents, and young adults.
Typically, rosacea affects the center of the face (forehead, cheeks, chin, glabellar area). There are four types of rosacea, and it’s possible to experience more than one type at a time:
- Subtype 1 (erythematotelangiectatic rosacea) is when unexplained facial flushing lasts up to 5 minutes. When the rosacea becomes chronic, the redness becomes a permanent feature of the skin. Blood vessels may also look more obvious.
- Subtype 2 (papulopustular rosacea) also displays redness, accompanied by swelling, and acne-like breakouts. Patients often complain of a burning or stinging sensation on their skin, even without stimulus .
- Subtype 3 (phymatous rosacea) typically shows thickened skin, enlarged nose, and bumpy features.
- Subtype 4 (ocular rosacea) presents as red and irritated eyes that are sometimes swollen. Patients may also experience dry and flaky skin.
What causes it?
The cause of rosacea is still unknown though it has been suggested as being caused by blood vessel abnormalities that compromise the blood vessel-supporting structures under the skin. It is most common in fair-skinned individuals after the age of 30, but it can occur in younger ages too.
Though the redness may be constant, it’s possible for the skin to flare-up if it comes into contact with a trigger. Some of the most common ones include hot or cold temperatures, sunlight, wind, exercise, spicy food, alcohol, stress, cosmetics, topical irritants, menopausal flushing, and medications that promote flushing. It’s best to quickly identify your own triggers so you can avoid them, and make sure to always have photoprotection (by way of sunscreen).
How is it treated?
All rosacea patients have sensitive skin, so using a soap-free cleanser and light moisturizer is best. Avoid harsh products and ingredients like toners, astringents, menthol, camphor, and sodium lauryl sulfate. A protective gentle moisturizer should be applied first before application of other products.
There are many medications available that can help relieve the symptoms of rosacea: azelaic acid gel 0.75% and 1% metronidazole are in creams, gel and lotion; 10% sodium sulfacetamide, 5% sulfur (in cleansers, lotion, creams). Other topical agents are also equally effective, like benzoyl peroxide, clindamycin, calcineurin inhibitors, and retinoids.
Oral medication can be used as a short term solution that can rapidly control symptoms. There are also some other drugs with off-label uses that work for rosacea. For moderate to severe flushing, tetracycline or isotretinoin maybe use for initial control. Other medications include metronidazole, oral contraceptive agents, and spironolactone. All medication and pharmaceutical drugs should only be used under the guidance of a doctor.
Vascular lasers and intense pulse light (IL) are useful alternatives to oral medications. It can be used as adjunct treatments with the topical and oral medications for a faster and more complete treatment. Generally, two to four laser treatments are required to achieve the best outcome for rosacea.
If you still want to wear makeup, a light liquid foundation is the best choice for patients with sensitive skin. Green-tinted corrector makeup is also usually applied before foundation to mask the red areas before topping with the face base.
At the end of the day, always consult with your derma if you’re struggling with anything skin-related! Are you suffering from rosacea? What are the ways you do to keep the redness at bay? Share with us your experiences below!
Special thanks to Dr. Angeli San Pedro-Garcia from Re-Enhance Dermatology and Cosmetic Surgery Clinic in Butuan City for letting us do this interview!