Rosacea

Rosacea typically manifests in one or more of the following subtypes:

• Erythematotelangiectatic Rosacea (ETR): Characterized by persistent facial redness, flushing, and visible blood vessels called telangiectasias. This is the most common variant.
• Papulopustular Rosacea: Presents with acne-like bumps, pustules, and inflammation, often accompanied by facial redness and flushing.
• Phymatous Rosacea: Involves thickening and enlargement of the skin, typically on the nose (rhinophyma), although it can also affect other areas such as the chin, forehead, or ears.
• Ocular Rosacea: Affects the eyes, causing symptoms such as dryness, burning, itching, redness, and sensitivity to light. Ocular rosacea can lead to complications such as corneal damage if left untreated.

The exact cause of rosacea is not fully understood, but it is believed to result from a combination of genetic, environmental, vascular, and immune system factors. Demodex mites, microscopic parasites that naturally inhabit everyone’s skin, have been implicated in the development of rosacea. Higher densities of Demodex mites have been found in individuals with rosacea compared to those without the condition. It is believed that an overgrowth of Demodex mites or an abnormal immune response to these mites may contribute to the development of rosacea. Individuals with a family history of rosacea are more likely to develop the condition themselves. Common triggers for rosacea flare-ups include:

• Sun exposure
• Hot or cold weather
• Spicy foods and hot beverages
• Alcohol consumption, particularly red wine
• Stress and emotional factors
• Certain medications, such as corticosteroids or blood pressure medications
• Skincare products containing alcohol or other irritating ingredients
• Physical exertion or strenuous exercise
• Hormonal fluctuations, such as those that occur during menopause

Medical History

The team at Apex Skin Center will begin by asking about your medical history, including any symptoms you are experiencing, the duration and pattern of those symptoms, previous skin conditions or treatments, family history of rosacea, and any potential triggers or exacerbating factors.

Physical Examination

Board-certified dermatologist Dr. Knackstedt will conduct a thorough examination of the skin, looking for characteristic signs of rosacea. In some cases of rosacea, an eye examination by an ophthalmologist may also be necessary.

Skin Biopsy (if necessary)

In some cases, a skin biopsy may be performed to confirm the diagnosis of rosacea and rule out other skin conditions with similar features. During a skin biopsy, a small sample of skin tissue is removed and examined under a microscope by a pathologist to look for characteristic histopathological changes consistent with rosacea. In most cases of rosacea, this is not necessary.

Treatment for rosacea aims to control symptoms, reduce inflammation, and improve the overall appearance and health of the skin. Individuals can help reduce the frequency and severity of symptoms by identifying and avoiding triggers. Gentle skin care and sun protection are necessary.

Treatment options may include:

• Topical medications: such as metronidazole, azelaic acid, or ivermectin to reduce inflammation and redness.
• Oral antibiotics: such as doxycycline, minocycline, or erythromycin to control inflammation and reduce the number of acne-like bumps and pustules.
• Oral medications: such as isotretinoin (Accutane) for severe or resistant cases of rosacea.
• Laser therapy or intense pulsed light (IPL): to target visible blood vessels, reduce redness, and improve skin texture.