When you are a famous actress, your face is your fortune. That’s why Cynthia Nixon, star of Sex and the City was surprised when red acne-like spots began appearing on her face in her early 40s.

She chalked it up to adult acne, but learned subsequently she had rosacea, a chronic vascular condition caused by inflammation.

Nixon, 46, who has three kids and is a breast cancer survivor, found stress was a big trigger for rosacea. Other triggers for Nixon: wine and drastic changes in temperature, like taking a hot bath.

According to the National Rosacea Society, rosacea affects more than 16 million Americans – and 78 percent of Americans don’t know they have it – or how to recognize it.

Now that beauty norms dictate that any blemish or off-color patch requires immediate care, it’s become harder to remain calm for rosacea sufferers. In recent years, a slew of lotions and cleansers that cater to the red-faced has entered the market. Not to say that rosacea — which is characterized by redness on the cheeks, nose, chin or forehead, or by visible blood vessels, bumps on the face — hasn’t been around for centuries.

Rosacea symptoms include facial redness, eye irritation, thickened skin and permanent visible blood vessels, and common triggers include sun exposure, exercise and spicy foods.

Experts aren’t exactly sure why some people get rosacea, but inflammatory response and facial vessels may play an important role. Rosacea typically occurs between the ages of 30 and 50, and while there is no cure, topical medications, laser treatments and systemic therapy can keep the condition under control.

Hope for Rosacea

Julie, a rosacea sufferer, has long been plagued by an unsightly network of broken capillaries on her nose. While she says that rosacea did not affect her life in anyway, she wanted to get it treated for aesthetic reasons. So she underwent Vbeam laser treatment, which collapsed the offending blood vessels.

“Vbeam for rosacea sufferers helps minimize the redness and flushing that they experience, they usually undergo a series of sessions depending on the severity of their condition” says Dr Kenneth Lee of the Sloane Clinic in Singapore.

Rosacea is often mistaken for acne but it should not be treated with anti-acne creams such as benzoyl peroxide, a common ingredient in acne remedies. According to doctors, using acne treatments for rosacea is not going to help, and in fact, can do more harm than good. Therefore, it is important not to misdiagnose rosacea as acne.

#1 Natural remedies

Rosacea skin tends to be fairly sensitive. Any home treatment or attempts for natural remedies should therefore be approached with caution. As with any rosacea therapy, some people may experience sensitivity or irritation with treatment. If that is the case, stop treatment and seek medical help. Several possible natural remedies include dilute vinegar cleansing and green tea applications.

Dilute white vinegar facial soaks or cleansing daily or weekly using approximately 1 part regular table vinegar to 6 parts water may be helpful. Vinegar is thought to help as a natural disinfectant and can help decrease the number of yeasts and bacteria on the skin. Since vinegar may flare rosacea in some people, a small test area should be tried before applying to the entire face.

Green tea soaks to the face may also help decrease the redness and inflammation seen in rosacea. Green tea is thought to have anti-inflammatory properties. A few commercially available products also use green tea as the active ingredient.

#2 Topical creams

Topical antibiotic medication such as metronidazole (Flagyl) applied one to two times a day after cleansing may significantly improve rosacea. Azelaic acid (Finacea gel 15%) is another effective treatment for patients with rosacea. Both metronidazole and azelaic acid work to control the redness and bumps in rosacea. These are prescription creams which are only available from your doctor.

#3 Oral antibiotics

Oral antibiotics are also commonly prescribed to patients with moderate rosacea. Tetracycline, doxycycline, minocycline and amoxicillin are among the many oral antibiotics commonly prescribed and they actually help reduce inflammation and pimples in rosacea. A newer low-dose doxycycline preparation called Oracea (40 mg once a day) has been used in rosacea. The dose may be initially high and then be tapered to maintenance levels. Common side effects and potential risks should be considered before taking oral antibiotics.

#4 Other medications

Short-term topical cortisone (steroid) preparations of minimal strength may in occasional cases also be used to reduce local inflammation. There is a risk of causing a rosacea flare by using topical steroids, furthermore, prolonged use of topical steroids on the face can also cause irritated skin around the mouth and thinning of skin. Consult your doctor before startng any creams for rosacea. Use only low strength steroids and limit their use to less than a week if possible.

Some doctors may also prescribe tretinoin (Retin-A), tazarotene (Tazorac), or adapalene (Differin), which are prescription medications also used for acne.

#5 Isotretinoin (Accutane)

Isotretinoin is infrequently prescribed for severe and resistant rosacea. Often it is used after multiple other therapies have been tried for some time and have failed. Close physician monitoring and blood testing are necessary while on isotretinoin. Pregnancy is absolutely contraindicated while on isotretinoin.

#6 Cleansers

In addition, prescription or over-the-counter sensitive skin cleansers may also provide symptom relief and control. Harsh soaps and lotions should be avoided, whereas simple and pure products such as Cetaphil may be less irritating. Patients should avoid excessive rubbing or scrubbing the face.

#7 Laser and intense pulsed light

Many patients are now turning to laser and intense light treatments to treat the continual redness and noticeable blood vessels on the face, neck, and chest. Often considered a safe alternative, laser and intense pulse-light therapy may help to visibly improve the skin and complexion.

Multiple treatments are typically necessary, during this time, sun avoidance is necessary. The most popular lasers used are the Vbeam laser which is a pulsed dye laser effective for treating the redness and flushing associated with rosacea.

#8 Photodynamic therapy

Photodynamic therapy (PDT) is one of the newly available treatments. PDT uses a topical photosensitizer liquid applied to the skin and a light to activate the sensitizer. The use of PDT in rosacea is considered off-label use to some extent, since it is primarily designed for regular acne. PDT is thought to work at reducing the inflammation, pimples, and also improving the skin texture. PDT is an in-office procedure performed in your physician’s office. Strict sun avoidance for approximately one to three days is required after the treatment. There is mild discomfort during the treatment and a mild to moderate sunburn appearance after the treatment is common.

#9 Glycolic peels

Glycolic-acid peels may additionally help improve and control rosacea in some people. The chemical peels can professionally be applied every two to four weeks. Any peel can irritate very sensitive skin and cause flares for some people so this treatment may not be suitable for all rosacea sufferers.

#10 Sun protection

Sun exposure is a well-known culprit for many rosacea flare-ups. Sun protection is a must for rosacea sufferers. The use of an appropriate daily sunscreen lotion and overall sun avoidance is recommended. Zinc-based sunscreens (SPF 30 or higher) provide superior sun protection.

#11 Avoid Triggers

There are numerous so-called triggers of rosacea: red wine, spicy food, going from cold to hot temperatures, prolonged sun exposure or vigorous exercise. If any of these triggers apply to you, then take steps to avoid them.

Mild rosacea may not inspire sympathy or scorn, but the worst cases are hard to miss. However, with more awareness of this condition, and the available treatments, hopefully rosacea sufferers are no longer dismissed as being “acne sufferers”. With appropriate treatment and care, rosacea is a condition that can be successfully kept under control.


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7 thoughts on “The Red Face of Rosacea”

  1. i saw a term who told me the only way to treat my prob was medicines and condemned all lasers as snake oil. then i found out it was because not many docs own the Vbeam laser used to treat rosacea. i finally went to get Vbeam laser and after 4 sessions, my skin was cured! no more antibiotics! so be careful of these terms condemning all other treatments but oral meds. always seek alternative opinions. in fact, beware of any doc who spends more time condemning other docs.

  2. for me, the pulsed dye laser was the best thing that happened to me. it really cleared up the redness and i was finally medicine-free! i am suspect of docs who push oral medicine over laser treatments. Just because these doctors don’t own the correct laser, doesn’t mean they should deny others of the therapy. Selfish behavior clouding their judgement.

  3. my rosacea cleared with a combination of Vbeam and creams. I truly believe that the lasers made a huge difference. unfortunately, many dermatologists in my country don’t actually own a Vbeam laser, maybe that’s why they don’t advocate lasers.

  4. i saw an old dermatologist who left me on oral medications for years without once mentioning to me alternative options like lasers. when i finally asked, he said they will never work on me…. then i found out he didn’t own any lasers, and so only prescribed medicines. My skin improved somewhat on lasers and though it wasn’t a miracle cure, i was glad to have another option besides oral meds which was giving me side effects.

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