Treating Rosacea

There is no cure for rosacea but you can take steps to limit your symptoms. In this video, Dr. Bobby Buka explains some of the triggers as well a

There is no cure for rosacea but you can take steps to limit your symptoms. In this video, Dr. Bobby Buka explains some of the triggers as well as certain steps you can take to limit the redness in your face.

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This video features Bobby Buka, MD. Dr. Buka is a section chief at Mount Sinai School of Medicine. Dr. Buka is also a diplomate of the American Board of Dermatology and the Society for Pediatric Dermatology.

Duration: 3:59. Last Updated On: Nov. 8, 2017, 6:14 p.m.

Reviewed by: Suzanne Friedman, MD, Preeti Parikh, MD . Review date: July 16, 2015

00:00 [MUSIC]
00:06 There's no cure for rosacea, but you can take steps to control your symptoms.
00:11 Environmental factors can exacerbate rosacea.
00:14 So the first step in managing rosacea, is for you to learn your personal triggers.
00:19 Common triggers are sunlight, temperature extremes, certain foods and
00:24 beverages like spicy meals, alcohol, hot drinks, and caffeinated beverages.
00:30 Strong emotional reactions like stress and anger, even embarrassment.
00:34 And medications that dilate blood vessels.
00:37 Knowing this and
00:38 practicing the following lifestyle habits may help ease your symptoms.
00:42 Protect your face from the sun by using a sunscreen of SPF 15 or higher.
00:47 Avoid extremes of temperature.
00:49 For example, exercise in a cool room, and wear a mask or
00:52 scarf on your face in cold weather.
00:55 Avoid the foods, drinks, and other medications that trigger your symptoms and
01:00 learn stress relaxation techniques.
01:03 Consider these other helpful actions as well.
01:06 Wash your face often, but be really gentle.
01:09 Rubbing, scrubbing, or massaging the face can even cause a flare-up.
01:13 Be vigilant about cleansers and other products you apply to your skin.
01:17 Read labels and avoid facial products with alcohol.
01:21 Look for products labeled Non-Comedogenic.
01:23 These clog pores less often than most other products.
01:27 If you're experiencing menopause, talk to your doctor about symptom control.
01:32 Recognizing and avoiding rosacea triggers and
01:35 making other lifestyle changes can help you manage your symptoms.
01:38 However, most people benefit from medication as well.
01:42 The most common are topical medications,
01:45 meaning they are directly applied to the skin.
01:47 The two main types are anti-inflammatory medications and anti-parasitic
01:52 medications, which are used to treat rosacea caused by the demodex mite.
01:56 While the creams and lotions work in different ways,
01:59 they all typically take time before visible improvements are seen.
02:03 Generally one to two months.
02:06 Oral antibiotics can sometimes be effective in clearing up inflammation and
02:10 the pustules more quickly than topical medications.
02:14 You may be prescribed Minocycline or Doxycycline.
02:17 There is also a low-dose doxycycline available that can be
02:20 effective in relieving inflammation.
02:23 More difficult cases of inflammation may be treated with the oral
02:26 medication Isotretonoin.
02:29 It can have very serious side effects, so your doctor will use it sparingly, and
02:33 monitor you very closely if you both decide it's a necessary treatment.
02:38 There are several surgical procedures that can address the visible effects
02:41 of rosacea.
02:42 These include laser surgery.
02:45 This can be used to treat blood vessels or
02:47 remove excess tissue, which can develop into more advanced stages of rhinophyma.
02:52 There are two main types.
02:53 The first is called a pulsed dye laser, and it's more commonly used for
02:57 the redness associated with rosacea.
02:59 That is, prominent dilated blood vessels near the skin's surface.
03:04 Carbon dioxide ablative lasers are used for more serious cases where there's
03:08 disfiguring thickening of the skin, usually on the nose and on the cheeks.
03:14 Dermabrasion, a resurfacing technique for smoothing the skin
03:17 surface is sometimes used to remove scars or thickening of the skin.
03:22 This method is mainly used for severe cases of rhinophyma, which are rare.
03:27 Finally for patients with Ocular Rosacea, prescription eye drops or
03:31 oral antibiotics may provide relief.
03:34 A better understanding of what causes Rosacea may lead to a cure in the future.
03:38 For now there are many lifestyle changes you can make and
03:41 medications available that help make Rosacea more manageable.
03:46 Thanks for being a part of HealthiNation.
03:48 Check out other videos in our library to become more informed and
03:51 take charge of your health.
03:53 [MUSIC]

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)

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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.
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Neuhaus IM, Zane LT, Tope WD. Comparative efficacy of nonpurpuragenic pulsed dye laser and intense pulsed light for erythematotelangiectatic rosacea. Dermatol Sug. June 2009.
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Note: These are all the sources used for every video in this series, not every source listed was used in this specific video.