Blog | Advice | Media | Testimonials | Honors

Rosacea is a very common disorder characterized by symptoms of facial flushing and a collection of other clinical signs such as facial redness, broken capillaries, coarseness of the skin, and an inflammatory eruption that may be similar to acne.

The hallmark of rosacea is persistent redness in the central portion of the face that lasts for at least three months. This redness may be associated with flushing, broken capillaries (medically called telangiectasias), and an acne-like skin eruption. However, unlike acne, the skin eruption in rosacea does not have any blackheads.

Patients often find that the first symptom of rosacea is a tendency to flush or blush easily. The condition generally starts in the center of the face and then extends to involve the cheeks, forehead, chin, and nose. Then over a long period of time, potentially years, the condition progresses to a persistent redness with visible blood vessels and possibly also pimples and bumps. With time, the redness tends to become ruddier and more persistent. In the more severe cases the nose may grow swollen and bumpy, a condition known medically as rhinophyma. (It is believed that W.C. Fields had rosacea which caused a rhinophyma on his nose.)

Rosacea is very common. It is estimated that over 14 million Americans have rosacea. It is most common in individuals with light complexions, blonde hair, and blue eyes. It can affect people of any age, including children, but is most common between the ages of 30 and 50 years old.

Rosacea Subtypes

Because rosacea is a complex condition, it has been divided into subtypes, which are determined based on the appearance of the skin. This subdivision helps classify rosacea. However, patients may have the findings of more than one subtype at the same time.

• Subtype 1 – Facial Redness

  Subtype 1 (medically called erythematotelangiectatic rosacea) is characterized by persistent facial redness and flushing. Broken capillaries, called telangiectasia, may be present, and the skin may feel irritated and uncomfortable.

• Subtype 2 – Bumps and Pimples

  Subtype 2 (medically called papulopustular rosacea) is characterized by facial redness and acne-like bumps and pimples.

• Subtype 3 – Skin Thickening

  Subtype 3 (medically called phymatous rosacea) is characterized by skin thickening and enlargement, especially around the nose. When the nose is involved in this manner, it is referred to as a rhinophyma. It is believed that W.C. Fields had this type of rosacea involving his nose.

• Subtype 4 – Eye Irritation

  Subtype 4 (medically called ocular rosacea) is characterized by the presence of eye symptoms, including watery eyes, red eyes, foreign body sensation, eye burning, dry eyes, and blurred vision. Ocular rosacea should be treated by an ophthalmologist.

Causes of Rosacea

Although the cause of rosacea is not known, several factors are known to play a role in its development. The condition is more common in women than in men. In addition, genetics is also clearly a factor, and the condition may be inherited. Evidence suggests that sun exposure is also a contributing factor in the development of rosacea.

There are also certain "triggering factors" that may exacerbate a patient's rosacea. When present, these need to be identified and avoided as much as possible. Common triggering factors are hot and cold temperatures, wind, hot drinks, caffeine, exercise, spicy foods, alcohol, certain emotions, and medications that cause flushing.

Rosacea Treatments

At the Rosacea Treatment Center, Dr. Amerian, Dr. Anterasian, and their talented staff utilize the most modern research, the most effective medications, and the best lasers and lights available to treat and improve rosacea.

Rosacea symptoms may vary widely from patient to patient. For example, some patients may have only redness and flushing, while others may have bumps, pimples, thickened skin, or eye involvement. For this reason, our treatment plans are always customized based upon each individual patient's unique needs.

The goals of rosacea treatment are the following:

1. Bring inflammation and irritation from rosacea under control
2. Treat the flushing, redness, and broken capillaries to improve the skin appearance
3. Leave our patients with healthy and glowing skin

Depending on each patient's unique needs, these three goals are accomplished by using a combination of medications, lights, and lasers.

These treatments work best when used in combination. The good news is that by combining several skin care modalities, an experienced skin care professional will be able to control nearly every case of rosacea.

We have listed below the most common rosacea treatments that we use.

Sunscreen and Sun Protection

All patients who have rosacea should use a broad-spectrum sunscreen that protects against UV-A and UV-B light. In general, we prefer the physical blockers in which the sunscreen is based on titanium dioxide or zinc oxide rather than chemical sunscreens. The sunscreen should have an SPF of at least 15, and it should be reapplied every few hours.

In addition, individuals who have rosacea should seek shade and wear a wide-brim hat to further protect themselves from the sun.

Vbeam Perfecta Pulsed Dye Laser

Blood vessel lasers are one of the mainstays of rosacea treatment. At the Santa Monica Laser and Skincare Center, we use the Vbeam Perfecta pulsed dye laser. When this type of laser is fired, the light from the laser is selectively absorbed by red blood in the face. Following the laser pulse, the laser energy is transmitted to the blood vessel wall, which leads to a narrowing of the blood vessel wall and a shrinking of the size of the blood vessel. This in turn leads to a reduction in facial redness.

Generally, our patients receive from three to five treatments with the Vbeam Perfecta laser, which are given at monthly intervals. To learn more about the Vbeam Perfecta laser, click here.

Red Light LED Treatment

Red colored light has an anti-inflammatory and calming effect on the skin. In rosacea treatment, the use of red light can reduce skin inflammation, leading to a reduction in redness and an improvement in the cosmetic appearance of the face.

Medications

• Topical metronidazole is a commonly used medication for rosacea. Although metronidazole is widely known as an antibiotic, it is more likely that it is the anti-inflammatory property of metronidazole that improves the rosacea.
• Doxycycline is another antibiotic that can be used to treat rosacea. Like metronidazole, when doxycycline is used to treat rosacea, it is used for its anti-inflammatory properties rather than for its antibiotic properties. Doxycycline is a medication that is taken by mouth.
• Azelaic acid is effective against mild to moderate rosacea. It is applied as a gel or cream to the skin, and also works by reducing inflammation.
• Sodium sulfacetamide and other sulfur products are also useful to treat rosacea when the rosacea is somewhat acne-like in its appearance. These medications reduce skin inflammation.
• Cortisone containing creams can be used to reduce the redness of rosacea. When they are used, their use should be limited to no more than two weeks.

We welcome all patients to the Rosacea Treatment Center who need help with their rosacea or with skin redness. Please feel free to call our office for an appointment at 310-829-9396 or click here.