Rosacea

Rosacea is the fifth most common diagnosis made by dermatologists. Rosacea is not acne however; often it is referred to as “adult acne.” It begins as a tendency to flush or blush easily and progresses to persistent redness in the center of the face that may gradually involve the cheeks, forehead, chin, and nose. With time, small blood vessels and tiny pimples begin to appear on and around the reddened area. When rosacea first develops, the redness may come and go.

Dermatologist, Dr. Neal Schultz author of It’s Not Just About Wrinkles, offers this definition of rosacea. “Rosacea, a chronic disease that affects men and women in their thirties, forties, and fifties, is characterized by redness (blotches or telangiectasias) of the central area of the face due to dilation of small blood vessels.”

How to Recognize Rosacea

Small red bumps, papules and pustules appear on the face. These may be accompanied by persistent redness and the development of many tiny blood vessels on the surface of the skin. In more advanced cases, the oil glands enlarge causing a bulbous, red nose, and puffy cheeks. Thick bumps may develop on the lower half of the nose and nearby cheeks. This condition called Rhinophyma occurs more commonly in men.

“Rosacea is more common in certain ethnic groups, in particular Celtic and northern European people,” according to Dermatologist Dr. Nicholas Lowe, author of Away with Wrinkles. Fair skin adults between the ages of 30 and 50 may develop rosacea. Since it may be associated with menopause, women are affected more often than men.

The International Rosacea Foundation identifies four stages:

1. Patients experience repeated episodes of flushing or blushing and often leads to a more persistent redness that become more noticeable to all with hard raised lesions (papules) and pus filled acne pimples (pustules).


2. Areas of the face are persistently red; telangiectasia becomes more prominent along with papules and pimples appearing on the nose and cheeks. The skin may take on a roughened, orange peel texture with large open pores.


3. Patients appear quite grotesque with nodules, hyperplasia, and being quite noticeable as they have already entered rosacea treatments in an earlier age. Their disfigurements include severely inflamed, thickened, edematous skin with large pores and with coarse features of thickened skin folds.


4. A seasoned older weathered appearance of skin layering appears due to extensively inflammatory infiltration, connective tissue hypertrophy, massive fibrous and elastosis, diffuse sebaceous gland hyperplasia, and extreme enlargement of individual sebaceous glands forming dozens of yellowish unbilicated papules on the cheeks, forehead, temples and nose.

What causes Rosacea?

No one knows for certain what causes rosacea. According to the International Rosacea Foundation, researchers have suggested several factors that may be related to its development:

• A disorder of the blood vessels that causes them to swell, leading to flushing.


• A genetic predisposition combined with certain environmental factors that may irritate the skin.


• Clogging of the sebaceous gland openings with skin mites called Demodex Folliculorum, which live in facial-hair follicles.


• Vitamin-B deficiency, local infection, hydrochloric-acid (stomach acid) deficiency, infection with Helicobactor pylori, and/or digestive disorders.

Treatment

Many people with rosacea do not recognize it in its early stages. Identifying the disease is the first step to controlling it.

Dermatologists often recommend a combination of treatments tailored to the individual patient. Creams, lotions, foams, washes, gels, and pads that contain various topical antibiotics, metronidazole, sufacetimide, benzoyle peroxide, and retinoids may be prescribed. A slight improvement can be seen in the first three to four weeks of use. Greater improvement is usually noticed in two months.

Oral antibiotics tend to produce faster results than topical medications. Cortisone creams may reduce the redness; however, they should not be used for longer than two weeks since they can cause thinning of the skin and flare-ups upon discontinuation. The persistent redness may be treated with a small electric needle (electrodessication) or by laser surgery to close off the dilated blood vessels.

The key to successful management of rosacea is early diagnosis and treatment. It is important to follow all of the dermatologist’s instructions. When left untreated, rosacea will get worse and may be more difficult to treat.

Home Care for Acne

Whether you are 12, 22, in your 40’s or 55 and over, acne is not just a phase to be tolerated or “gotten through.” It can be embarrassing and infuriating. It is not caused by improper cleansing or poor diet, though it may be aggravated by one or both.

Acne is not a disease to be cured; rather it is a condition that can and should be controlled with daily and periodic care. Acne is a genetic disease affecting the skin by a series of recurrent, infected breakouts such as blackheads, milia, pimples and cysts. Most cases of adolescent or adult acne can be controlled with topical treatments from one or more of the following sources:

1. Daily home care with professional skin care products
2. Clinical treatments by a licensed skin care therapist
3. Medical treatments by a physician or dermatologist

Excellent skin care and hygiene are vitally important to remove the excess oils and bacteria that stimulate acne.

Why do some people in their forties, fifties and sixties start having breakouts?

Stress and hormonal changes are the primary cause of the re-emergence of acne for adults between the ages of 40 and 60. According to researched compiled at The International Dermal Institute, "several factors can make a person more susceptible to acne breakouts. People who are prone to breakout should only use products that are non-acnegenic or non-comedogenic. Many of these skin-sensitizing products contain ingredients such as lanolin, artificial fragrance and colours, S.D. alcohol or mineral oil which can clog and irritate the skin.” Dermalogica’s products are non-greasy and completely water-soluble, making them ideal for breakout-prone skin. For more information visit their website http://www.dermalogica.com/.

Follow a Strict Regime in Caring for Acne Blemishes

1. Cleanse twice a day with tepid (not hot) water.

2. Use over the counter skin care products or professional skin care products faithfully; proper use can help prevent, as well as clear up, blemishes.

3. Sleep no less than seven hours per night on a consistent basis. Your body works best on a regular routine and with plenty of rest.

4. Eat a healthy balanced diet with plenty of variety and fiber.

5. Drink 6-8 glasses of water every day. Water flushes wastes from the body and helps to maintain a balance.

6. Limit seafood, salty foods and dairy; all contain iodine, which can trigger acne breakout in sensitive individuals. Avoid iodides in the diet:

Fast foods, all processed foods, seasoned salt, soy sauce, products with MSG, seaweed, sushi, Chinese food, Mexican food, nuts, processed meats (lunch meat, deli sandwiches, bacon, franks, sausage),vitamin supplements and condiments containing kelp. Cheese is one of the major acne aggravators. Hormone-laden foods, including wheat germ and peanut products, should be avoided. Some cold and flu medications contain bromides and can aggravate acne.

7. Get regular exfoliating treatments like enzyme peels with steam, or light peels (glycolic, lactic, PolyGel). They help topical medications and exfoliants, to penetrate better, and boost your home care efforts. Do not use a washcloth or buffing pad. Do not rub your face dry with a towel. These “mechanical” exfoliation methods can over-exfoliate your skin, cause excessive irritation, and can make your acne care products sting and irritate. What can be helpful is after cleansing, apply a thick coat of Peter Thomas Roth Sulfur Cooling Mask, allow it to dry for 7-10 minutes, and rinse off.

8. Change pillow cases and sheets more frequently; oils and bacteria from your skin can build up in bedding and further aggravate the matter. Wash your clothes in fragrance-free detergent, use 25% less detergent, and wash 25% less clothes at a time. Whenever possible, run an extra rinse cycle. Avoid fabric softeners, especially “sheets” thrown in the dryer. Use a white satin pillowcase laundered in fragrance-free detergent without fabric softener.

9. Stop PICKING! Picking pushes acne lesions and ingrowns deeper into the pores, slows down the healing process, can cause scarring, and can turn ordinary breakouts into larger black, brown, red or purple spots. Rub ice cubes in a circular motion on red, inflamed lesions twice a day for 2 minutes to help reduce inflammation and swelling.

10. Be certain you remove any residue of hair care products from your skin. Avoid oily products containing isopropyl myristate and its chemical cousins, cocoa butter, coconut oil, vitamin E, fatty acids and natural oils, except safflower, sunflower and mineral oil.

Facing Acne

Lifestyle changes can often improve your skin. Stress is the Number One acne aggravator so try to do whatever it takes to reduce stress in your life. Limit your intake of caffeine and cigarettes, which stimulate the adrenal glands to wreak havoc on the skin’s natural processes. Minimize your sun exposure and reapply oil-free sunblock often when exposed to direct sunlight.

Most importantly, avoid oily cosmetics and products that may also contain D & C red dyes including blushes and powders. Some “oil-free” products actually contain synthetic oils (called fatty acids), D & C red dyes, detergents, etc., that are known acne-aggravators.


With the numerous advances in skin care formulations, increasingly more people are combating their acne with regular facial treatments and complementary at-home regimens.