Ever wonder what the redness on the cheeks might represent? What about broken blood vessels that seems to increase in number overtime? Are they pimples…but seem to behave a little different than acne?
Rosacea is a chronic inflammatory skin condition affecting more than three million Canadians. While rosacea is traditionally felt to affect those with fair skin, it is actually under-diagnosed and unfortunately, not adequately treated in those with skin of colour. Read more on strategies to manage rosacea across the skin spectrum.
If you notice that after a glass of red wine, having a steamy bowl of soup or with eating spicy food the face feels red, hot and uncomfortable, these are examples of what we refer to as triggers that could cause a flare-up of rosacea. Avoiding known triggers that could drive the progression of rosacea is an important management step. Common triggers can include fluctuations in temperatures (e.g. of the environment or of the food we eat), sun exposure, stress, alcohol and spicy meals.
Photoprotection is critical in those with rosacea as the sun is an aggravating factor. The use of sunscreen is an important part of a sun safety program including sun avoidance during peak hours, clothing protection and seeking shade. Generally, mineral sunscreens containing zinc oxide and/or titanium dioxide (e.g. SkinCeuticals® Physical Fusion SPF 50 ) are preferred, as they tend to be better tolerated in those with sensitive skin, including virtually all patients affected by rosacea. Mineral sunscreens need not to leave a whitish residue when applied to darker skin - there are ones that come in different shades for blending into the natural skin tone of different individuals (e.g. Colorescience® Sunforgettables SPF 50 brush). Bland emollients, moisturizers and cleansers are also more gentle and less irritating on sensitive skin. Harsh products such as alcohol-based exfoliating agents should be avoided. In patients with rosacea, it is particularly helpful when using a new skincare product, to apply it to a test-spot area for at least several days first to determine tolerance prior to more generalized use.
There are many established prescription treatments for rosacea management. These may include topical and oral medications that are evidence-based. Generally, these options can be used across the skin spectrum. Of course, always speak to your board-certified dermatologist to see which treatments are right and safe for you.
Lasers and light therapies
Laser and light devices can be used to reduce superficial blood vessels and to resurface possible textural skin changes that arise as rosacea progresses. Special consideration is needed when using these options in those with skin of colour due to an increased risk of post inflammatory hyperpigmentation following treatment. In general, a 595 nm pulsed dye laser (for example, the VBeam Perfecta® ) can be used to reduce redness that can often be seen on the facial skin of those affected by rosacea.
You’re not alone - rosacea affects many individuals. Not sure where to start? Your family physician or dermatologist can help you navigate options that are customized to your skin concerns and needs.