By Dr. Arthur J. Sober,
Associate Professor of Dermatology,
Harvard Medical School
Rosacea might be called the disease of the '90s because, as awareness has increased, its frequency has been found to be much higher than once believed. Fortunately, significant progress has been made in learning about its characteristics and developing effective treatment options.
Extensive clinical experience has found certain topical antibiotic formulations to be widely effective in reducing rosacea's symptoms and keeping it under control on a long-term basis. An initial course of an oral antibiotic is also often prescribed to bring rosacea under control more rapidly. However, continuing therapy is often effective with topical agents alone.
Because blood levels from topical antibiotics are either absent or minuscule, it has the advantage of avoiding the possible side effects associated with long-term use of antibiotic tablets, such as nausea, gastrointestinal upset, phototoxicity and yeast infection. Since so many different bacteria are targeted by the antibiotics that are effective against rosacea, it is believed that their therapeutic action is not bactericidal but anti-inflammatory.
When treating rosacea, special care is required to avoid the use of any skin care products that might be irritating. Also, to treat the flushing that is often characteristic of rosacea, occasionally an antihypertensive agent may be helpful in selected cases.
In addition to medical therapy, many rosacea sufferers may need to make lifestyle changes to avoid those factors that trigger flare-ups in their individual cases, such as sun, stress, hot beverages, alcoholic beverages and spicy foods.
Visible blood vessels, which may become more noticeable following the reduction of the redness of the skin that accompanies rosacea, can be effectively treated with the use of a laser. Likewise, excess tissue that may develop on the nose can be treated with surgical procedures, including laser therapy.
As with most conditions, treatment of rosacea must be tailored by the physician to the needs of each individual patient. The keys to minimizing the effects of rosacea are early diagnosis and faithful compliance with your treatment program.