Is it Really Rosacea?

The following other conditions can have symptoms similar to rosacea:

Acne is the term for plugged pores (blackheads and whiteheads), pimples, and even deeper lumps (cysts or nodules) that occur on the face, neck, chest, back, shoulders and even the upper arms. Acne affects most teenagers to some extent, but can also affect adults in their 20s, 30s and 40s. While there is no permanent cure for acne, it is controllable.

Psoriasis causes the skin to become inflamed, while producing red, thickened areas with silvery scales. This persistent skin disease occurs most often on the scalp, elbows, knees, and lower back. In some cases, psoriasis is so mild that people don't know they have it. At the opposite extreme, severe psoriasis may cover large areas of the body.

Eczema is used to describe all kinds of red, blistering, oozing, scaly, brownish, thickened, and itching skin conditions.
The word atopic describes a group of allergic or associated diseases that often affect several members of a family. These families may have allergies such as hay fever and asthma, but also have skin eruptions called Atopic Dermatitis. The disease can occur at any age, but is most common in infants to young adults.
Eczema/Atopic Dermatitis in infants occurs mainly on the face and scalp, although spots can appear elsewhere. In teens and young adults, the eruptions typically occur on the elbow bends and backs of the knees, ankles and wrists and on the face, neck and upper chest.

The Pro Active Approach to Treating Rosacea

An effective rosacea treatment must begin with an understanding of what causes or influences a rosacea flush. Effective skin care for rosacea must address the flushing issues. Rosacea sufferers have more facial blood vessels than the norm or their blood vessels are severely damaged. Consequently, anything that stimulates facial dilation cannot be handled easily or properly. Treating rosacea through lifestyle management can bring about a lifetime of results.

Interesting Theory on MSG and Rosacea

Many people affected by MSG complain of Rosacea and other skin disorders, including a red, peeling rash with blisters. Rosacea, according to medical sources is based on vasoactivity, and inflammation. These two causes, are directly affected by MSG.
Glutamate is a calcium channel opener, and has proven vasoactive effects in the human body.
Glutamate is a nervous system stimulant. That is why it is used - it stimulates nerve cells in the mouth. However, there are glutamate receptors all over the body (the pancreas, the retina, the hypothalamus, even the hair cells of the ear) . Based on the latest research from Johns Hopkins in May 2001, nervous system stimulation can cause the immune system to over-react. Hypersensitivity of the nervous system triggers the immune system to release its arsenal of inflammation weapons.
Allergy and immune response are big triggers for rosacea according to the following links:
http://www.emedicine.com/derm/topic377.htm
http://www.dermnet.org.nz/index.html
If MSG causes the body to unleash its inflammation response because of it's effect on the nervous system, and it also changes the dilation of the blood vessels because of its action on the calcium channels, it is not surprising that some people sensitive to MSG, would complain of rosacea symptoms.

Laser: A Rosacea Treatment But Not A Cure

While medications have long been used to keep the inflammation -- the bumps (papules), pimples (pustules) and some of the related redness -- of rosacea at bay, many dermatologists have found certain types of lasers and light sources offer important options for addressing components of the disorder that are more difficult to treat.
"Laser technology is now well established as an effective means of removing telangiectasia (visible blood vessels), and it may also be used to reduce severe redness," said Dr. Jeffrey Dover, associate clinical professor of dermatology at Yale University School of Medicine.
Vascular lasers, in which wavelengths of powerful light destroy targeted blood vessels as heat from the laser's energy builds in the vein, are frequently used as an elegant and relatively painless way to eradicate telangiectasia. These specific wavelengths of light are well-absorbed by the hemoglobin, or red blood cells. Short pulses target only the blood vessels, reducing the chance of damage to surrounding facial tissue.1
"Typically, three or more treatments at four- to six-week intervals are required," Dr. Dover said. Side effects may include redness and swelling within the first day or so. However, bruising that may last up to five to 10 days is uncommon with the newest techniques. "The visible blood vessels will disappear almost immediately, but some recur within six weeks, hence the need for further treatments," Dr. Dover said.
In a controlled study of laser therapy for rosacea, one side of the faces of 12 patients was treated with a pulsed dye laser, while the other side remained untreated as a control. The investigators noted a reduction of visible blood vessels by 75 percent, as well as a 55 percent reduction in flushing and a 50 percent reduction in redness.2 The treatment had no effect on papules and pustules.
Other, non-laser light sources called intense pulsed light (IPL) devices are also increasingly used for the redness, visible vessels and flushing of rosacea, Dr. Dover said. These devices are similar to lasers but generate a broader spectrum of light to treat a broader spectrum of tissue. Like the newer lasers, IPL devices used properly are associated with little or no bruising.
In addition, certain lasers can be used to correct the enlargement of the nose from excess tissue, often associated with subtype 3 (phymatous) rosacea. According to Dr. Dover, a device known as an ablative laser -- such as a CO2 or erbium YAG laser -- may be used, as can an electric cautery device to shave off and vaporize the area to reshape and resculpt the nose.
"Patients need to realize that lasers are a treatment, not a cure, for rosacea," Dr. Dover said. "This is a chronic condition that usually requires long-term preventive measures such as medical therapy and avoidance of lifestyle and environmental factors that trigger flare-ups. Because underlying rosacea remains, laser treatment may again be required one to three years after a series of treatments."

Associated References
Goldberg DJ. Lasers and light sources for rosacea. Cutis. 2005;75(suppl 3):22-26.
Clark SM, Lanigan SW, Marks R. Laser treatment of erythema and telangiectasia associated with rosacea. Lasers in Medical Science. 2002;17:26-33.

ROSACEA AND SUNSCREENS

While many are aware that protection from sunlight is important to prevent skin cancer, rosacea patients have even further reason to minimize their exposure. In fact, beyond being the top trigger for rosacea flare-ups named by 81 percent of patients in a National Rosacea Society survey, researchers have found that sun exposure may be linked to the visible blood vessels (telangiectasia) often associated with rosacea.
"Although many people with rosacea may know they should avoid the sun, sometimes it's difficult to do this, especially in the summer," said Dr. Zoe Draelos, clinical associate professor of dermatology, Wake Forest University. "Whenever possible, rosacea patients need to limit the amount of time in direct sunlight, especially between the hours of 10 a.m. and 4 p.m. when the sun is strongest. It's best to stay in the shade whenever possible, and to use a sunscreen the year round."
Dr. Draelos explained that most sunscreens today are labeled with an SPF -- sun protection factor -- of varying degrees. "We suggest that rosacea patients use a sunscreen with an SPF of 15 or higher and make sure the label also indicates that it is effective against UVA and UVB radiation as well," she stressed.
In research funded by the National Rosacea Society, doctors from the department of dermatology at Boston University found that sun exposure -- aside from triggering redness -- appears to stimulate a substance in the body that may lead to the development of visible blood vessels. The research potentially sheds significant light on the vascular component of rosacea -- which could be attributed to damage from the sun.1
"Rosacea patients with very sensitive skin may also experience irritation from some sunscreens themselves," Dr. Draelos said. "To minimize irritation, patients might want to try a pediatric sunscreen formulation, or one with a moisturizer or a skin protectant such as dimethicone."
Dr. Draelos also advises rosacea patients to use a sunscreen that prevents the skin from becoming warm, such as those containing physical barriers like zinc oxide or micronized titanium oxide, which reflect rather than absorb UVB and UVA radiation. Finally, patients should remember to apply sunscreen liberally at least 30 minutes before going outdoors.

Associated Reference
Kosmadaki MG, Yaar M, Arble BL, Gilchrest BA. UV induces VEGF through a TNF-alpha independent pathway. Federation of American Societies for Experimental Biology Journal. 2003;17:446-448.

National Registry For Accutane Users

Everyone who uses the acne drug Accutane will have to enroll in a national registry, along with every doctor who prescribes it and every drugstore that sells it — tough new restrictions aimed at preventing women from becoming pregnant with this birth defect-causing drug.

The Food and Drug Administration announced the long-anticipated program Friday, more than a year after the agency’s scientific advisers urged the extra curbs because repeated safety warnings have failed to stop Accutane-damaged pregnancies.
Both male and female patients will have to enroll in the registry, called iPLEDGE, by Dec. 31 or they can no longer receive Accutane.

All patients also must sign a document informing them of Accutane’s risks, including the possibility that it contributes to depression or suicidal thoughts — a warning that FDA also strengthened on Friday.

But birth defects are the biggest concern with Accutane and its generic version, isotretinoin, medicine that is supposed to be prescribed only for severe acne but that critics say too frequently is given for more minor cases.

Since the drug began selling in 1982, the FDA has reports of well over 2,000 pregnancies among users. The vast majority ended in abortion, but the FDA counts more than 160 babies born with drug-caused defects. Critics note there likely were many more pregnancies because doctors haven’t been required to report Accutane-linked pregnancies. Friday’s new rules mandate that they do.

The registry actually opens on Aug. 22, giving time for doctors, patients and pharmacies to understand how it will work before the provisions become mandatory. Wholesalers and pharmacies will have to register starting Oct. 31 or the drug’s manufacturers can no longer ship them supplies of the pills.

What Is Pityriasis Rosacea?

Pityriasis rosacea is an acute inflammatory disease of the skin with severe scaling and flaking of the outer layer, often in circular patches. The cause appears to be unknown, although it is thought to be the result of a viral agent. This skin disorder affects both male and female, producing low-grade fever and headaches. A further symptom is that it can cause moments of real distress prior to the occurrence of the skin eruptions. Fortunately, the lesions do not often appear on the facial skin, but when present they display themselves mostly on the palms of the hands and the soles of the feet. These can become very dry and cause cracks, coupled with intense skin irritation.

Ocular Rosacea Skin Care

People with rosacea have a tendency to be overall more dehydrated than others. The body is approximately 65% water while the eye is 96% water. Increasing your water intake will increase the moisture in the eye (thereby decreasing irritation and dryness). It has been found that increasing the amount of water consumed daily can ease the symptoms of ocular rosacea for many.

The key to controlling ocular rosacea is to keep the eyelids and eyelashes clean. Home treatment should begin by soaking a clean washcloth in hot tap water. Place the compress on closed eyelids for five minutes, and then repeat. Next, gently scrub the eyelids with a washcloth or cotton swab soaked in a mixture of equal parts of baby shampoo and water. Afterward, rinse the lids thoroughly with warm water.

This treatment may need to be repeated two to three times daily for two weeks, and then reduced to once daily. There is no cure for ocular rosacea; but with treatment, it can be controlled. Anti-inflammatory and antibiotic treatment drops or ointments may be necessary for flare-ups or more severe cases. Remember to remove all mascara before going to bed.

A Rosacea Picture Can Be Used To Chart Your Progress

A rosacea picture can be effective in the treatment of rosacea. The chronic progressive skin disorder of rosacea can be tracked by a picture taken at various intervals of the treatment process. A chronological picture file is needed is useful in determining the progression of your rosacea condition and in judging the possible benefits of current treatment. It is difficult to tell from a picture of rosacea what degree of rosacea-related skin sensitivity may be present.