From Red to Pink: Tips for Managing Rosacea
April is Rosacea Awareness Month. When the fresh spring air invites us out of our winter shells and into the sunshine, the increased wind and sun exposure, as well as seasonal allergies, can aggravate rosacea.
Manhattan dermatologists Dr. Michael Shapiro and Dr. Ariel Ostad provide tips for recognizing it and keeping rosacea-prone skin healthy pink rather than angry red.
How to Recognize
Dr. Michael Shapiro: Rosacea is characterized by redness of the face. This may or may not be associated with acne-like red pimples. In addition, patients with rosacea exhibit marked sensitivity of the face.
Dr. Ariel Ostad: Major symptoms are small red bumps, pink eyes, pink or red patches, itchy eyes, thick skin on and around the chin, cheeks, and forehead; swollen noses, and acne. Rosacea patients usually have redness and flushing on their cheeks and nose and chin.
In advanced cases of rosacea, the person may develop a red, lobulated nose.
Diseases Mistaken for Rosacea
Dr. Ostad: There are various other diseases that resemble rosacea, the condition can be confirmed only through clinical diagnosis. Other diseases that may have similar symptoms to rosacea are connective tissue diseases, like polycythemia Vera, photosensitivity, carcinoid syndrome, contact dermatitis, and mastocytosis.
The long-term use of topical steroids also can cause rosacea-like symptoms.
Risks of Rosacea
Dr. Ostad: The condition generally is harmless unless the eyes are affected.
Dr. Ostad: The exact cause of rosacea is not known.
Dr. Shapiro: Certain triggers classically make rosacea patients flare, such as emotions (laughter, anger, embarrassment), spicy foods, red wine, or any alcohol, and temperature extremes (sun, wind, humidity, cold).
Dr. Ostad: Anything that increases body temperature can aggravate rosacea i.e. exercise, hot beverages, spicy foods. It is very important to use bland products and nothing that irritates skin as it aggravates redness.
Who is Affected
Dr. Ostad: People affected by rosacea tend to be fair-skinned and Caucasian. Rosacea can afflict both genders; however, it occurs three times more often in women than in men. Rosacea can begin at any age.
Sunscreen So Important
Dr. Shapiro: Sun exposure, even if it is low-grade but for an extended period of time, can result in the development or exacerbation of rosacea.
Apply New Creams with Caution
Dr. Shapiro: The application of any topical may cause skin irritation. Have a degree of skepticism before applying topical products to the face. If you think you may have rosacea, you should apply a new topical to a small portion of the face and see if it irritates the skin before spreading the medication liberally on the face.
When to Visit a Doctor
Dr. Shapiro: Marked sensitivity of the face, increasing redness, and the development of pimples should all stimulate individuals to visit a dermatologist.
Dr. Ostad: People should see a dermatologist at first sign of rosacea because over the counter treatments can make the rosacea worse. Treating it early can stop it from getting worse; treatment controls the disease.
Dr. Shapiro: Treatment of rosacea includes avoiding sun (and other triggers), using topical medications, and oral agents like: low dose antibiotics, which are used for their anti-inflammatory effects; standard antibiotics, which are used for their antimicrobial properties; and certain anti-inflammatory vitamins.
Dr. Ostad: Depending on the severity of the condition, laser treatments, antibiotic pills or creams can be used to treat pimples and redness.
Vascular laser helps to reduce flushing and redness and improve the acne component by shrinking oil glands. This is a noninvasive lunchtime procedure that helps to reduce need for oral antibiotics.
Tips for Managing
Dr. Ostad: It is important to moisturize regularly as dryness worsens rosacea. Learn what triggers your rosacea (foods, beverages, temperature, weather, medication, emotional influence, and skin care products). Follow a rosacea skin-care plan
Dr. Michael Shapiro, M.D., FAAD, ACMS, is a board-certified New York Dermatologist and the medical director of Vanguard Dermatology. He has offices in SoHo, Greenpoint, Sheepshead Bay, Forest Hills, and Staten Island. vanguarddermatology.com
Dr. Ostad M.D. is a board-certified Dermatologist and Dermatologic Surgeon, and Clinical Assistant Professor in the Department of Dermatology at New York University Medical Center. He has a private practice on the Upper East Side. www.drarielostad.com