Did you know that Rosacea affects over 2 million Canadians? It can start initially as a blushing or redness that comes and goes, but it can also develop into something more persistent and visible over time.
Rosacea is most commonly apparent on the cheeks, forehead, chin and nose, and sometimes can affect the eye area, creating bloodshoot eyes that feel gritty.
Dr. Sapra, who you may remember from our previous interviews on acne and aging, is a dermatologist at the Institute for Cosmetic & Laser Surgery in Oakville. He kindly agreed to share his knowledge on the topic of Rosacea for your benefit.
What is Rosacea?
Nobody knows the cause of it. It is a chronic skin condition of which the exact cause is unclear. It is a reaction to minor bacteria in the skin.
It starts with redness and then acne can develop. Then as time goes on it can go to the eye. There are known triggers like sunlight and change in temperature and temperature extremes. Any foods that make you flush like hot drinks, wine, spicy foods. Exercise, stress, internal medications can cause it too.
Can Rosacea be cured?
The best way to treat mild rosacea is sunscreen and laser. IPL laser is what most people do, but we also use Cynergy, V-Beam and Excel V. At first you will need to get it done regularly, then only a few times a year for maintenance. You will be about 70% better, but with laser you’re preventing it from getting worse.
There is also a new medication, Orealtea ,which is a gel that contains Brimonidine, that constricts the blood vessels and can be used for 12 hours to get rid of redness. It’s pretty magical. So if you have a gala or something you need to go to, or if you know you are going to be a in a situation where you don’t want to flush, this product is perfect. However, they say that you can use it everyday, but we find that patients get a rebound redness if they use it all the time.
For those who suffer from both acne and rosacea, what can be done? What products should be used?
When you start getting the acne, that is when you have to go see the doctor. There is the Orealtea gel and also Azelaic acid or Sulfacet–we don’t know why these help, when it gets really bad you need to take oral meds. Then acne has to be treated medically.
I always say, ‘I don’t want to poison you, but I need to’, because nobody wants to take antibiotics. Doxycycline 100 mg is the usual generic form I use & there is a new lower dose version called Apprillon in Canada and Oracea in the USA. You’re usually only on medication for about 4 weeks.
Regular hormonal acne can be combined with rosacea, or you will see seborheic dermatitis. Scaling, flaking skin, often you need to treat both together.
If someone is in the midst of a flare-up, with a stinging, burning face, what is the best method to stop or reduce the flare up?
Avoid aggravating factors. Avoid changes in temperature, decrease alcohol, use sunscreen, get a prescription for the days you really need the Orealtea. Avoid triggers but there is nothing that will take it away.
What ingredients or textures should Rosacea sufferers look for when shopping for products?
Use the gentlest products you can find. Invest in a daily Sunscreen; avoid low SPFs, fragrance, and gel sunscreens as they may contain alcohol which can inflame the skin. Soap-free cleansers like La Roche-Posay Cleanser Bar. Avoid: anything with fragrance / perfumes, Benzyl alcohol, Glycolic acid, Isopropyl palmate, Lactic acid, Sodium hydroxide, Propylene glycol. The fewer ingredients, the better
Should Rosacea sufferers exfoliate?
No. No clarisonic, no micro-beads, no scrubs, no acids. Just gentle products.
Can Rosacea get worse with age?
Yes and it can change or get worse.
Are there other skin conditions with which rosacea can be combined?
Acne and seborrheic dermatitis.
Are there any supplements you can take to help minimise flare ups?
There is nothing proven in literature. If it works for you, bonus, but there is nothing proven to work.
What types of non-prescribed treatment products are best to deal with redness and also the small irritated pores?
There is nothing natural that will work. I’m sorry to say that but it needs to be treated medically.
Are there any eye-drops or products to help deal with suspected ocular rosacea?
Go see a family doctor, they’ll prescribe you eye drops that usually contain a bit of cortisone and antibiotic.
At what level of severity should one begin to consider laser treatment?
When you look in the mirror and you think about your rosacea 80% of the day, go get laser. (Unfortunately, laser is not covered by insurance.)
What SPF would you recommend for daily wear for those with rosacea?
30, 30 is a good number that lasts long enough. I like something made by Skinceuticals that is 50 that is a physical sunscreen. Any physical sunscreen will work though.
Will make-up like powder or foundation aggravate rosacea? If so, are there any recommended brands that can be used by rosacea patients?
It’s OK to wear makeup, but find something that suits your skin. Some products will contain a little green tint, look for those. Also look for mineral-based products.
Thank you again to Dr.Sapra!