Article was written by Bev Fast and was placed in the Saskatoon Star Phoenix 03-20-2008 

Most of us blush. An unexpected compliment can cause a rosy pink colour across our cheeks; a dressing down at work or school might cause a hot red blush all the way up to our ears. It usually fades as quickly as it appears … unless you’re one of an estimated 30 million North Americans with rosacea who do not return to baseline skin tone.

Rosacea (pronounced row-zay-sha) is a chronic skin condition characterized by facial flushing or redness. Rosacea sufferers can also experience blemishes (often mistaken for acne), sensitive skin, visible veins and enlarged swollen pores.

"Rosacea is not the only skin condition to cause facial redness and veins, and so the diagnosis should not be assumed on the basis of rosy color," says Dr. Rose Genesis, M.D.,CCFP, ABFP, medical director of Nirvana Laser Hair & Skin Clinic in Saskatoon. "Most of the time the flushing is localized to the central high points of the face – the nose, between the brows, the high cheeks and the chin, but others experience confined flush zones such as the chin. Even the ears will turn crimson and embarrass some."

Over time, the rosacea flush may become redder and the skin more sensitive. Some adults diagnosed with adult acne are actually suffering from rosacea. In severe cases, the nose can become enlarged with excess tissue, W.C. Fields being the classic example. For years, society attributed the large nose, red face and spidery web of veins to excessive alcohol consumption. Today we know better.

"People with rosacea have a very low threshold for flushing, and will flush with classic triggers such as stress, hot sun, cold wind, exertion, spicy foods, a glass of wine. Great emphasis used to be made over lifestyle modifications to reduce the flushing and reduce the condition, but this was when there was little else to offer. Fortunately, the rosacea sufferer may experience remission without drastic lifestyle modifications," Dr. Genesis says.

Rosacea is not life-threatening, but its psychological impact can be severe. In a 2007 survey by the U.S.-based National Rosacea Society, 76 percent of rosacea sufferers said the condition lowered their self-confidence and self-esteem. During flare-ups, 61 percent of people with severe rosacea avoided face-to-face encounters and 38 percent cancelled meetings and social engagements.

Despite its prevalence in North America, rosacea is not well understood. "The sebaceous glands or oil glands, overgrowth of highly reactive blood vessels and aging skin are all implicated, but the most hotly debated theory is that of a mite that dwells normally in human skin, but seems to become aggressive and proliferative in the rosacea sufferer. This mite is known as Demodex folliculorum," says Dr. Genesis.

"Until recently, the therapy for rosacea was poor. The availability of modern treatment alternatives should be good news, but it does not appear to be widely known, even amongst medical practitioners," Dr. Genesis says.

Cortisone should not be used, as it initially suppresses and then fires up the dermatitis.

So what does work? Topical creams containing antibiotics can be useful in the inflammatory phase as they help reduce the redness, flushing, blemishes and sensitivity. Intense Pulsed Light (IPL) with Vasculight is cleared by Health Canada as a safe, effective treatment for facial redness, blushing and veins, usually with no significant downtime.

But because not all IPL devices are the same, Dr. Genesis advises people to do their homework on the type of machine and its capabilities, as well as the experience of the operators. "The Vasculight IPL is a class 4 medical device and when dealing with the powerful devices, you want to know that the technicians are very capable."

Another modern treatment alternative is ALA-PDT dynamic therapy, which Dr. Genesis describes as a selective chemical peel that targets the abnormal blood vessels, overgrown sebaceous glands and inflammatory and infectious elements within the pores.

"PDT and IPL both have good science behind them to support regular application in people with rosacea. The data is impressive. For example, IPL has been shown to reduce abnormal blood vessels by up to 80% in four treatments. And there’s a growing body of evidence that suggests off label use of ALA-PDT is safe and efficacious for rosacea."

For more information on effective rosacea treatments, talk to your family doctor or call Dr. Genesis at the Nirvana Laser Hair & Skin Clinic for information, 1015 8th Street East, 931-8828, or visit www.laserhairandskin.ca

Get the red out! Lasers offer best option for rosacea

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