Many patients I see have tried
everything to control their rosacea
but aren't sure which treatments they should use.
Today, I will teach you all about rosacea
and let you in on my seven best Rosacea treatments.
Hey guys, my name is Dr. Sam.
Firstly, I want to give you a quick overview about rosacea
and then I'll dive into the best treatments
in 2020 for rosacea.
So first up - what is rosacea?
And who gets it?
Rosacea is a really common skin rash
that affects different part of your face.
Symptoms may first appear in your early
20s but the usual age people get this
is in their 30s to 60s.
It's more common if you have fair skin,
blue eyes and are of Celtic origin.
I.e. People like me!
What causes rosacea?
Annoyingly, we don't know what causes it.
There are certain factors that are associated,
but none are proven to cause rosacea.
Genetics may be a factor, as rosacea
tends to run in some families.
It is thought that sun damage and an abnormal
immune reaction happens in the skin,
which leads to inflammation.
And this then causes tiny, tiny blood vessels
under the skin to become leaky.
Also higher numbers of a tiny mite called
demodex folliculorum are found on the
skin of people with rosacea.
On a positive note, rosacea is not contagious
so it can't be spread between people.
What does rosacea look like?
Well Rosacea is often mistaken as acne,
as they look a little similar.
But they are really quite different conditions.
You may notice flushing, which is often the first
symptom for months or years before
anything else develops.
The interesting thing is that flushing is caused by
particular triggers, like sunlight.
I'll link the most common triggers in
the description for you.
You may get redness of the face that looks like sunburn,
and small tiny blood vessels also become
more obvious.
The skin may become more sensitive
and sting or burn when using face creams.
You may get spots that look like acne,
and men can get thickened skin,
especially around their nose.
People can develop eye symptoms with rosacea,
so please see a doctor if you develop
eye pain or visual symptoms and you have rosacea.
How is Rosacea diagnosed?
Well, it's usually diagnosed by a doctor
based on your symptoms and what the
rash looks like.
What are the best treatments for Rosacea?
Okay into the good stuff!
Thankfully, there are quite a few
treatments available and I'll go through
the seven main treatments for rosacea.
So the first one is home basics.
And when I say this I mean there are simple things
that you can do at home.
Particularly, minimize your exposure
to hot or spicy foods, alcohol, hot showers and baths.
Use water-based makeup and avoid oil-based
facial creams and protect yourself from the sun.
Some patients find they can
reduce redness temporarily by holding an
ice block in their mouth
between their gum and cheek.
Number two is antibiotic tablets
and these help to treat the redness, acne and
eye symptoms but they aren't a cure for rosacea.
They work through the anti-inflammatory effects rather
than treating a bacterial infection.
So usually six to twelve weeks of an antibiotic,
like Doxycycline 50 milligrams, once daily
is recommended.
Sometimes other antibiotics such as
Co-trimoxazole or Metronidazole or
Minocycline are used when Doxycycline
isn't working.
Number three are creams and gels.
There are four different
topical treatments that have
anti-inflammatory effects on rosacea.
So firstly, there's metronidazole cream or gel,
which can be used now and then or
long-term.
Then there is Azelaic acid cream,
which is also quite useful for mild rosacea.
You apply this twice daily to the red areas of rosacea.
Then there's Brimonidine Gel
which can reduce the facial redness temporarily.
The brand name for this is Mirvaso
and you apply it once daily to the
affected areas of your face.
Finally, Ivermectin cream or soolantra
is helpful to treat the acne pustules of rosacea.
Number four is Isotretinoin tablets.
And when antibiotics aren't working,
and things are looking a bit grim you
can use isotretinoin in a low dose,
for the long term
and for some patients they
need to take this for years.
I wouldn't recommend this as a
first-line medication to take,
as it has its own set of problems.
But it can be quite effective in treating rosacea.
Number 5 is anti flushing tablets.
Now there are certain oral medications that
help reduce flushing, redness and inflammation.
These are available on prescription and
include Clonidine and Carvedilol.
Essentially, they are blood pressure pills
and work by constricting blood vessels.
Overall they are moderately well tolerated and
can be quite beneficial for rosacea,
but they should be started under guidance
by your doctor.
Number six is Vascular laser or IPL.
Now, this is one of my favorite treatments
for telangiectasia which is the
small tiny blood vessels that start
appearing on your face.
It's usually very successful and has very few drawbacks
to this treatment.
Number seven - finally - there is surgery.
Now dermatologists or plastic surgeons can
reshape the nose and surgically correct
the skin thickening called rhinophyma.
Which can happen with rosacea.
My other secret ingredient for those of you with
rosacea is to use moisturizers
that contain niacinamide.
In at least two studies moisturizers containing
nicotinamide or niacinamide have been
shown to improve skin barrier function.
Which lead to diminished skin reactions
to cleansers in cosmetics.
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Thanks for watching :)