Dermatology and The Laser

Laser therapy is a procedure that emits an intense band of light. In medicine, lasers are used because those intense bands of light can be specially tailored for a particular purpose. Lasers can vaporize wrinkles off the surface of the skin and stimulate new skin, and they can remove pigmented age spots or tattoos.
For skin, we treat several different things. We treat things that are made out of blood vessels, which are red, and we treat things that contain pigment, which are brown. Different types of light are absorbed or interact with either red or brown colors. Skin pigment is varying shades of brown, and blood vessels are red. So these are the two colors that the laser interacts with. The reason we can destroy topical problems on the skin without harming anything else is that the laser energy is only absorbed by those spots and nothing else. So we can actually remove something without touching the rest of the skin as you would if you burned something off or cut it out.

Rosy Cheeks May Signal the Onset of Rosacea

Many people think of it as just rosy cheeks or adult pimples, or even a sign that someone spends a little too much time at happy hour.
But for 14 million Americans, it's really rosacea, an annoying and potentially disfiguring skin condition.
The good news, there are effective treatments.
"It would get really red on the 't' part of my face, like a sunburn, and it was red all the time. It was a constant red," said Carmen Coll.
Coll woke up one day to find what looked like a red rash on her cheeks, which worsened when she drank alcohol or sat in the sun.
It turns out it was a chronic skin condition called rosacea, which starts in the blood vessels.
"That's often the way it begins, as blood vessels that are very reactive and after awhile those blood vessels sort of get stuck in the open position, and then you can actually see the little wormy blood vessels in the face and it can be sensitive and stinging," said Dr. Laurie Polis, a dermatologist at Soho Skin and Laser in New York.
Most rosacea patients say it interferes with their careers, self image, and self confidence.
"I felt uncomfortable, like I knew what my skin was supposed to look like and then all of a sudden I had this redness to it," Coll said.
For some people, rosacea remains a cosmetic inconvenience, but it can get much worse, progressing to something like acne and giving the skin a very red, bumpy and even cauliflower texture.
But rosacea is treatable, beginning with avoiding what doctors call the "trigger factors."
"They know what makes them red. Hot showers, alcoholic drinks, hot coffee, sunlight," Dr. Polis said.
There are also prescription creams that can reduce the acne appearance in rosacea patients.
And for those who don't respond to that, there are lasers which constrict and seal off the tiny facial blood vessels.
"What people need to know about rosacea is that it's characterized by flares and remissions. That means you can think it's gone, and then a few months later it comes back," Dr. Polis said.

Final Stages of Review and Approval for Rosacea Grant

I am pleased to announce that we are in the final stages of review and approval for an exciting grant. We can't say yet what the topic is, but we are confident that our supporters will be delighted with the grant and the new opportunities for discovery and pathways into rosacea that it will open. We are hopeful that we can announce the title within a fortnight. The grant has already been through rigorous review, and should emerge from the final reviews and processing shortly. We expect that all of the currently available funds will go towards this grant. I'd like to sincerely thank all of our supporters for their generosity, we can all be proud of what we have achieved.

regards,davidp.

--David Pascoe,President, Rosacea Research Foundation, http://www.rosacea-research.org/mailto:http://health.groups.yahoo.com/group/rosacea-support/post?postID=0O13LgrwH5Gw3Wmyqr28Z1rUj4V9TdSlos4XHl-T3shJ5fdJecCoJ-leXWaxYspOoaIIA_GEgRNHBaRByowgtwr9-fHOuyQb

Rosacea Treatment Begins With Basic Rosacea Skin Care Treatment

Effective rosacea treatment begins with a knowledge of rosacea skin care. In the treatment of rosacea emphasis should be placed on the proper skin care treatment of the facial skin.

Increasing your fluid intake will increase the moisture to the skin. Increasing the skin's moisture is an effective way to treat the rosacea symptoms of skin sensitivity, redness, and irritation. All of these symptoms of rosacea result from dehydration.

Another consideration is proper cleansing of the skin to thoroughly remove all traces of makeup, dirt, pollution, etc. In the treatment of rosacea it is especially important to cleanse the skin well to avoid clogged pores. Without the proper cleanser you may find yourself scubbing too hard which can result in creased facial redness, and irritation.

In the treatment of rosacea, moisturizing the skin is an important factor in your rosacea skin care routine. Be sure that your moisturizer does not contain ingredients that may irritating to the skin. A good choice is Jojoba Oil. Very similar to the oil produced by the skin, this well tolerated by rosaceans in their skin care treatment.

Treating Rosacea with Retin-A

Retin A is an excellent medication for acne as well as effective anti-aging topical that works. It smooths the skin, unclogs pores and evens out the skin tone. However, there are no studies on what the short or long-term effect is on rosacea. This is because of 2 reasons: its photosensitizing effect and its angiogenetic (causes formation of more blood vessels) effect. I suspect that the vascular component in rosacea plays a more important role than we previously suspected. Many young rosacea sufferers in their 20's started out with mild rosacea as episodes of "easy to blush/flush" when stimulated by various stimuli, rather than with acne, seborrhea etc. Therefore, it is possible that Retin A may worsen the symptoms of rosacea.

The Effectiveness of Metrogel in the Treatment of Rosacea

The most commonly used agent in the treatment of rosacea is Metrogel (metronidazole). The following adverse experiences have been reported with the topical use of metronidazole: burning, skin irritation, dryness, transient redness, metallic taste, tingling or numbness of extremities and nausea.

The mechanisms by which METROGEL® (metronidazole topical gel) Topical Gel acts in the treatment of rosacea are unknown, but appear to include an anti-inflammatory effect.

Metrogel (by Galderma) is the rosacea medication that has been on the market the longest (about 10 years). It comes in 0.75% concentration. Not too long ago, the same company came out with Metrocream 0.75% which is more moisturizing. The recommended dosage for both is twice a day. Noritate Cream (by Dermik) is a newer medicatio which comes in 1% concentration. Its dosage is once a day. All 3 have the same active ingredient - metronidazole (generic). The gel is liked by those with oily skin while the cream is preferred by those with dry skin and seems to go better with makeup.

These topicals are very effective in mild cases, and are usually able to reduce some of the superficial symptoms in moderate to severe cases. However, while patients are often grateful for reduced symptoms, it must be stressed that topical metronidazole does not treat the heart of the vascular disorder and does not result in clearance of rosacea and facial flushing.

In fact, there are numerous medical reports suggesting that rosacea sufferers in the moderate to severe stages may only experience minor improvements while on topical metronidazole, or may not respond at all.

In a recent clinical article, topical metronidazolewas found to be ineffective in the treatment of 20 different rosacea sufferers. In a review of 27 rosacea patients, oral antibioticsand topical metronidazole were not effective in treating the vascular heart of the disorder such as facial redness, inflammation,flushing, and telangiectasia. Consistent with the above, Dr. Grousshansstates, "Tetracycline and metronidazole are very useful for therapy,but they only influence the cutaneous and ocular complications and do not act upon the basic vascular trouble."

In a 1999 medical review, Dr. Larry Millikan, aDermatologist at the Department of Dermatology, Tulane UniversityMedical School, emphasizes, "Metronidazole has been the most extensively studied therapy for rosacea, but not all patients show a response to it." Several medical reports indicate that topical metronidazole is effective for superficial papules and pustules, but is not effective on the facial flushing, redness, or telangiectasia that are key to rosacea. Two in-depth case reports documented that these rosacea sufferers did not respond at all to topical metronidazole. Other experts have documented that topical metronidazole is not effective at reducing facial flushing or telangiectasia, and is only mildly effective at decreasing redness in some rosacea sufferers.

Judging A Treatment's Effectiveness

When starting a new treatment it is best to stop any previous or current treatments and allow the skin a few days to "rest" before starting the new treatment. In this way you can be sure if your skin improves - what caused the improvement; and if your skin reacts, then you also know whta caused the reaction. Keep it simple: Try one treatment at a time.