Aesthetic Clinic in Singapore

A chronic skin disorder that causes inflammation of the skin particularly affecting the "blush" areas of the face, especially cheeks, forehead, nose, chin, and is more common in people who flush easily. This skin condition is characterized by symptoms including frequent flushing, irregular redness (erythema), burning, inflamed swelling, papules and pustules, small cysts, thickening of facial tissue especially the nose, fine red vascular lines (telangiectasia), rhinophyma(enlarged, bulbous red nose) and swollen, reddened eyelids. Rosacea is sometimes mistaken for rosy cheeks, skin sensitivity, sunburn, eczema or even acne. But unlike acne vulgaris, rosacea does not have blackheads, is uncommon in children, and tends to be more frequent in women but more severe in men. It is also less frequent in people with dark skin. Rosacea generally lasts for years, and if left untreated, tends to worsen over time.

Types of Rosacea

Erythematotelangiectatic rosacea: Redness, flushing, visible blood vessels.

Papulopustular rosacea: Redness, swelling, and acne-like breakouts.

Phymatous rosacea: Thickened skin with a bumpy texture.

Ocular rosacea: Reddened and irritated eyes, eyelids may be swollen, leaving them to resemble a sty.

What are the causes?

Health researchers notice that a variety of triggers such as alcohol consumption, spicy foods, certain medications, smoking, as well as climatic changes like strong winds, extended UV exposure and heat, are known to cause rosacea to flare. Emotional factors such as stress, fear, anxiety, or embarrassment may also produce blushing and aggravate rosacea. Other factors like genetics also play a part so it is possible to inherit the genes for rosacea. The body’s immunity may also play a role as scientists found that most people with acne-like rosacea react to a bacterium called bacillus oleronius. This reaction causes their immune system to overreact.

Rosacea sufferers are also found to have large numbers of demodex a mite that commonly lives on everyone’s skin, especially on the nose and cheeks. Additionally, abnormalities in the blood vessels of the face can also cause flushing, persistent redness, and visible blood vessels. But what is causing the inflammation of the blood vessels is still unknown.

Do's and Don't's

Do protect your skin from extreme temperatures

Overheating or winter weather conditions can aggravate rosacea. It is best to protect the skin with a scarf (avoid wool) to block the face from biting cold winds and apply a broad-spectrum sunscreen (those that contain zinc oxide or titanium dioxide) with an SPF 30 (or higher) every day. Avoid the midday sun and stay in the shade as much as possible.

Don’t use or do anything that’s abrasive to the skin

Use mild cleansers that are suitable for sensitive skin, but avoid alcohol-based toners, scrubs, facial massages and rubbing. Always be gentle with the delicate and sensitized skin.

Do find out what are your triggers

Spicy food and alcohol are known to be common triggers so take note of the flares.

Don’t skip the moisturizer

Moisturizers are an essential for your rosacea as they create a barrier that keep out the irritants. Choose a moisturizer that's oil-free, fragrance-free, and hypoallergenic – one with as little ingredients as possible. Do keep your skincare routine simple so that it’s easy to identify the triggers when there’s a flare up.   

Treatments

To diagnose rosacea, your doctor will examine your skin and your eyes.

Your doctor may also want to make sure you don’t have another medical condition which may resemble rosacea. Although there is no cure for rosacea, there are however treatments available to help reduce or eliminate signs of rosacea, ease any discomfort and prevent rosacea from worsening.

Topicals

These help reduce inflammation and redness and are applied to the skin either once or twice a day. They are commonly used in combination with some oral medications. Antibiotics like metronidazole, tretinoin, benzoyl peroxide, and azelaic acid are examples of commonly prescribed topical medications.

Azelaic acid

Research studies show that between 70 to 80% of patients have experienced noticeably less rosacea with the use of azelaic acid. You may feel some tingling or burning at first but this tends to go away with continued usage. If it persists, stop using and seek professional help. Another possible side effect is skin lightening. Be sure to tell your doctor immediately if it happens.

Metronidazole

Research shows that it can effectively reduce both the redness and the acne-like breakouts. With metronidazole, some patients are able to stop application and keep the results they gained. Possible side effects of using metronidazole gel or cream include itching, stinging, irritated skin, or dryness where you apply the medication.

Sodium sulfacetamide and sulfur 

These ingredients are considered safe for treating acne-like breakouts and surrounding redness. They are available in over-the-counter treatments such as a cleanser. In research findings, patients typically see a 65 to 78% improvement in 6 to 8 weeks. Possible common side effects include itching, dryness, temporary redness, or irritated skin. These tend to decrease as you use the medication.

Retinoid

Primarily a form of vitamin A that though can irritate the skin, can also help prevent flare-ups and reduce signs of aging. This option may not be suitable for everyone so check with your medical doctor if retinoid is right for you.

Oral

Antibiotics

Prescribed for their anti-inflammatory properties, oral antibiotics such as tetracycline, minocycline, and erythromycin tend to give faster results than topical ones. Patients are shown to have noticeably fewer acne-like breakouts within one month. Once under control, another treatment such as low-dose doxycycline will be recommended to maintain results to prevent antibiotic resistance.

Isotretinoin (Accutane)

Although approved to treat severe acne or inflammatory rosacea and shown to reduce the redness and acne-like breakouts, isotretinoin is a powerful drug that inhibits the production of oil by the sebaceous glands. Side effects may be severe such as birth defects so it’s not an option for every patient.

In-clinic Procedures

Light-Based Therapies

Laser or light therapy

Laser treatment options such as pulsed dye laser and Intense Pulse Light (IPL) can be useful in treating visible blood vessels of rosacea and reducing persistent redness. For rhinophyma, the Carbon Dioxide Laser can be used to reduce the thickness of the skin. During treatment, you may experience skin tightening, itch, or pain. After treatment, you may see some redness with other side effects like bruising, crusting of the skin, swelling, and rashes. But these effects will usually disappear within two weeks. To achieve optimum results, several treatment sessions may be required.