Rosacea treatment is a difficult subject due to the fact that it is not entirely understood and there is no one known cure for Rosacea.
Rosacea can be managed and treated in different ways from at home treatments to advanced aesthetic treatments using a range if different types of laser.
Rosacea is a very common skin condition that mainly affects the face. Rosacea is a long-term condition that causes
There are different types of rosacea
Erythematotelangiectatic Rosacea (ETR):
Often this is when people first notice rosacea and it presents persistent redness on the face especially cheeks, nose and the forehead.
Sometimes telangiectasia is visible (small blood vessels).
People with the first stage of rosacea tend to blush easily and their skin is sensitive.
Papulopustular Rosacea:
Often this is mistaken with Acne. Along with redness you also see red bumps and pus-filled pimples on the cheeks, chin and again the forehead.
Skin is often oily and sensitive.
Unlike acne where blackheads are generally present with rosacea they are not.
Phymatous Rosacea:
This presents itself with the skin thickening and becoming bumpy. It generally affects the nose where it becomes enlarged and bulbous (rhinophyma). The condition can also be seen to affect the chin, forehead, cheeks and ears. This form of rosacea is more common in men.
Ocular Rosacea:
This form of rosacea affects the eyes. Symptoms include
Eyelids become red, swollen and crusty. In severe cases this can lead to light sensitivity and blurred vision.
Curing Rosace is very difficult but managing the symptoms can help keep flare ups under control.
Rosacea is not fully understood and the cause is likely to be a combination of several factors. Some of the factors are
There is no known cure for rosacea. Treatment for rosacea is done by management of triggers with lifestyle adjustment and can also be treated by a range of aesthetic treatments. Aesthetic treatments range from topical and oral medications to laser and light treatments and for extreme situations surgical intervention
This method to manage Rosacea is the cheapest but also the easiest and something can be done straightaway.
Key lifestyle changes are knowing your triggers and avoiding them.
What are the triggers of Rosacea and management
This is a big one and simply wearing SPF 30+, seeking shade and wearing hats can help with this
These can simply be avoided and letting hot drinks cool can also help
Protecting your face with hats and scarfs
Protecting your face with hats and scarfs
Finding healthy ways to manage stress is good like exercise in a cool environment. Other things such as hobbies or meditation can also help with stress.
In a cool environment
Alcohol can be limited and avoiding red wine
These can be avoided where possible. Foods with anti-inflammatory properties, like those found in a Mediterranean diet, might be beneficial.
Let them cool
By using gentle, fragrance free for sensitive skin can help eliminate the triggers.
It is always wise to have a good skin care routine and this will help manage rosacea. Skin care routine should consist of
Cleanse Gently - using a mild, non-soap cleanser with lukewarm water. Do not rub the face and do this morning and evening
Moisturise - A gentle non-comodogenic solution can help smooth the skin and protect. To be used after cleansing.
Sunscreen - is a must and using sunscreens containing zinc oxide or titanium dioxide is well tolerated.
You can also get makeup that is rosacea friendly which is mineral based, fragrance free and non-comodogenic. Green-tinted primers or concealers can help with redness.
There a few things that can be bought over the counter to help with Rosacea such as
For more severe and persistent rosacea sufferers’ oral medications may be used often working on the premise to reduce inflammation.
Oral Antibiotics (Tetracyclines)
Antibiotics such as doxycycline, minocycline, and tetracycline, are often the first-line oral treatment. Their effectiveness in rosacea is their anti-inflammatory effects. Examples of these are Doxycycline, minocycline, tetracycline and lymecycline and are often used for several weeks and months.
Oral Metronidazole
An anti-inflammatory antibiotic can be used orally or topically.
Oral Isotretinoin
There are other types of oral medications less commonly used like beta-blockers and clonidine to manage flushing and work by constricting blood vessels.
Brimonidine gel (Mirvaso)
Is used to treat persistent facial redness an associated symptom of rosacea. It is FDA approved for this purpose. The gel is an alpha-adrenergic agonist. It caused the blood vessels in the face to constrict and shrink so making the appearance of the blood vessels to be less apparent and in such diminishing the redness. It takes a mere 30-minute minutes to be a effective and can last up to 12 hours
Light based treatments for rosacea are common and often performed in aesthetic clinics as well as medical clinics and consist of
Intense Pulsed Light (IPL) therapy is popular and effective in managing some aspects of rosacea and is particularly good at reducing redness and vocable blood vessels. It uses a broad-spectrum of light pulses to target the vascular issues of the skin. The light emitted is absorbed by the haemoglobin in the blood vessels causing them to heat up and collapse. This helps reduce the redness and visibility of the blood vessels and reduces inflammation. The IPL treatment can also improve the overall skin tone and texture as well as stimulate collagen.
After the procedure there may be some redness and selling but these subsidies very quickly. It is important to use high factor sunscreen after. Treatments may take 3-6 to see a marked improvement but should be gradual after the first treatment.
Remember to consult a professional before any treatment and IPL is not recommended for people with darker skin tones. For best result combination therapies are recommended,
Light emitting diodes cane be used either as an in home solution or in an aesthetic/beauty clinic. LED therapy is gentle and non-invasive as a management strategy for rosacea. It involves the skin being exposed to light of a certain wavelength which in turn addresses different aspects of skin conditions.
Red light 630nm-700nm
This reduces inflammation which is a key benefit for rosacea management. The red light penetrates the skin targeting blood vessels and reduces redness and flushing. It also promotes healing and collagen production improving skin elasticity and texture.
Blue light 415nm-470nm
This is known for antibacterial properties and particularly useful for people with papulopustular rosacea. It also to a lesser extent reduces inflammation.
Yellow light 570nm-590nm
yellow light is believed to reduce redness and improve circulation by targeting blood vessels and promoting lymphatic drainage. It also helps improve blood flow which aids overall skin health. It has a calming and soothing effect which also helps with rosacea flare ups.
Green Light 520nm-560nm
This may help with hyperpigmentation and redness associated with rosacea. It can even our skin tone and reduce redness. It is less commonly used for treating rosacea.
LED therapy will require multiple sessions to see results often in the same week. LED is best used as part of a combination strategy for the management of rosacea.
There are different types of lasers that are used for rosacea and are an effective way as an in-office procedure to manage rosacea. Different types of laser target specific symptoms of rosacea.
Pulsed Dye laser (PDL) often called the gold standard laser for rosacea as it is very effective at treating redness and visible blood vessels associated with rosacea. A pulsed dye laser emits 585nm-595nm light that is highly absorbed by haemoglobin in the blood vessels. This causes them to collapse and become less visible.
Potassium-Titanyl-Phosphate (KTP) Laser is very similar in nature to PDL lasers where they used 532nm to target redness and small blood vessels and this wavelength is also effectively absorbed by haemoglobin
Nd:YAG Laser utilises 1064nm which penetrates deeper into the skin. It is used to target larger, deeper blood vessels. These blood vessels may feed the smaller blood vessels so will cause them to shrink and become less visible. Nd:YAG also reduces general redness and flushing.
Diode Laser (808nm-810nm) can also be used to target visible blood vessels and redness though are not considered to be the most effective.
CO2 10600nm lasers are ablative and used to remove the outer layer of skin and are used for the treatment of rhinophyma thickening around the nose in severe rosacea cases.
Erbium YAG lasers 2940nm are used to remove the outer layer of skin and are used for the treatment of rhinophyma thickening around the nose in severe rosacea cases.
Fractional lasers which can be either Co2 or erbium and are used to address symptoms of rosacea but again are not considered the first line of defence. They create thousands of microscopic treatment zones (think of pixels on a screen) while leaving the surrounding skin intact. This allows for faster healing and reduces downtime compared to traditional ablative lasers.
Fractional lasers can be ablative (removing the outer layers of skin) or non-ablative (heating the underlying tissue without removing the surface).
Q -Switched lasers have some role in management aspects of rosacea such as redness and vascular lesions. The very short, high-energy pulses break down the pigment or blood vessels into smaller particles that the body can eliminate. The Q switch 532nm can also target haemoglobin in blood vessels causing them to heat up and collapse, making it less visible. By targeting and reducing the network of tiny blood vessels contributing to facial redness, Q-switched lasers might lead to an overall improvement in the erythematous component of rosacea.
Laser treatments are quick and relatively painless but a cooling gel or air cooling can be used during and after treatment. Redness and swelling is possible after treatment but it quickly resolves up to a week. There may be some bruising and skin is sensitive to light so SPF is a must.
Treatments are done in a course between 1-5 treatments spaced weeks apart and results are long-lasting but not permanent. Again, lasers are best deployed as part of a combination therapy.
The cost to treat Rosacea depends on
Remember a combination therapy is likely to lead to the best outcomes.
Prescription medication such as:
NHS prescriptions are £9.90 if they can be obtained that way
Over the counter products vary greatly in price from a few pounds to significantly more for premium brands.
Led costs are likely to be £50-£100 per session
IPL costs are likely to be be £50 -£300 per session
Lasers cost are likely to be £50 -£600 per session
All light based treatment costs depend on
This requires caution and a must to speak to a clinical professional before any treatments are undertaken.
Over the counter treatments and skincare are considered the safest way to manage rosacea and lifestyle changes to avoid the triggers for rosacea.
Topical medications are considered low risk but again need to be prescribed.
Oral antibiotics and Laser and light treatments generally are avoided.
Rosacea is a difficult condition to treat and manage and is an ongoing concern that whilst can be managed will not go away on its own.
