Rosacea
Video 1: What is Rosacea? (Source 4)
· Affects 16 million Americans, of every age and ethnicity (Source 10)
- Disorder of blood vessels of the skin causing redness of the face
- Experience constant redness, can last for months. Chronic, progressive, comes and goes early on.
- Can be accompanied by pustules/papules, telangiectasia, red nose, dry itchy eyes
- Stages: blushingà redness persistsà vessels swell and become visibleà red bumps
- In 50%, rosacea affects the eyes. Symptoms are burning, gritty, dryness, sometimes it can threaten vision (Source 7)
- Rhinophyma- thick skin of nose. It is rare and usually present in men (Source 1)
- 4 main subtypes
- Risk factors:
- 30-50
- Family hx
- Fair skin
- Women more than men (assoc with menopause)
- No known cause
- Possible causes include bacteria, inflammation, immune system dysfunction, demodex mites.
- Treatment plan- medications and lifestyle modifications, more effective if started early
Video 2: Treating rosacea (Source 9)
- No cure, only symptomatic treatment
- Environment can exacerbate rosacea.
- Triggers: light, temperature extremes, spicy food, alcohol, caffeinated beverages, strong emotional reactions, medications that dilate blood vessels. Exercise(Source 3)
- Protect face with SPF, avoid extreme temps, avoid food/drink/meds that trigger, relaxation
- Wash face often but gently, vigilance about cleansers and cosmetic products (Source 8)
- Medications- May be topical such as anti-inflammatories or anti parasitics.
- Take 1-2 months to improve
- Oral abx are used to help pustules - like doxycycline or minocycline. Isotretonoin can be used for more severe cases but has serious side effects. (Source 2,13)
- New medication approved is topical brimodine, a vasoconstrictor
(Source 5, 6) - Eye drops and antibiotics can be used for ocular symptoms
- Surgical Options
- Laser: pulse dye laser for redness/vessels, CO2 ablative lasers for disfiguring thickening of skin
- Dermabrasion removes scars/thickening (Source 11, 12)
- Aloi F, Tomasini C, Soro E, Pippione M. The clinicopathologic spectrum of rhinophyma. J Am Acad Dermatol. March 2000.
- Chang AL, Alora-Palli M, Lima XT, Chang TC, Cheng C, Chung CM, Amir O, Kimball AB. A randomized, double-blind, placebo-controlled, pilot study to assess the efficacy and safety of clindamycin 1.2% and tretinoin 0.025% combination gel for the treatment of acne rosacea over 12 weeks. J Drugs Dermatol. March 2012.
- Crawford GH, Pelle MT, James WD. Rosacea: I. Etiology, pathogenesis, and subtype classification. J Am Acad Dermatol. September 2004.
- Dahl M. Uptodate: Rosacea: Pathogenesis, clinical features, and diagnosis. August 2013.
- Fowler J, Jackson M, Moore A, Jarratt M, Jones T, Meadows K, Steinhoff M, Rudisill D, Leoni M. Efficacy and safety of once-daily topical brimonidine tartrate gel 0.5% for the treatment of moderate to severe facial erythema of rosacea: results of two randomized, double-blind, and vehicle-controlled pivotal studies. J Drugs Dermatol. June 2013.
- Fowler J, Jarratt M, Moore A, Meadows K, Pollack A, Steinhoff M, Liu Y, Leoni M. Once-daily topical brimonidine tartrate gel 0·5% is a novel treatment for moderate to severe facial erythema of rosacea: results of two multicentre, randomized and vehicle-controlled studies. Br J Dermatol. March 2012.
- Ghanem VC, Mehra N, Wong S, Mannis MJ. The prevalence of ocular signs in acne rosacea: comparing patients from ophthalmology and dermatology clinics. April 2003.
- Laquieze S, Czernielewski J, Baltas E. Beneficial use of Cetaphil moisturizing cream as part of a daily skin care regimen for individuals with rosacea. J Dermatolog Treat. 2007.
- Maier L. Uptodate: Management of rosacea. August 2013.
- Maier L. Rosacea: advances in understanding pathogenesis and treatment. Clinical Investigation. May 2011.
- Neuhaus IM, Zane LT, Tope WD. Comparative efficacy of nonpurpuragenic pulsed dye laser and intense pulsed light for erythematotelangiectatic rosacea. Dermatol Sug. June 2009.
- Papageorgiou P, Clayton W, Norwood S, Chopra S, Rustin M. Treatment of rosacea with intense pulsed light: significant improvement and long-lasting results. Br J Dermatol. September 2008.
- van Zuuren EJ, Kramer S, Carter B, Graber MA, Fedorowicz Z. Interventions for rosacea. Cochrane Database of Systematic Reviews 2011
Note: These are all the sources used for every video in this series, not every source listed was used in this specific video.