Rosacea: The practical guide
Rosacea is a very common skin condition, especially in European and Celtic ethnicities.
If you notice persistent red flush on your check, burning sensations, little red vessels, and always tend to experience redness you might have rosacea.
I always like to explain to my patients that rosacea is like a skin type! There are treatment options but you will always have to look out when buying skincare that certain products could also make it worse again.
What is Rosacea?
A chronic skin condition that causes redness focusing on the central face. However, it can involve the eyes too!
Further clinical aspects are papules and pustules without comedones (black and white heads). Comedones are typical findings in acne.
Cause of Rosacea
We still have not fully understood the cause yet. At this point, genetics, neurovascular inflammation, the environment, and microorganism like demodex mites play a role. Sun exposure is the most common trigger. For others heat, stress, alcohol or spicy food can provoke new flare ups.
Rosacea in darker skin types
The goal you and your dermatologist should set is to achieve clean skin ! The CLEAR-Study showed that the quality of life improves and that these patients also experience less flare-ups in the future.
Even though rosacea occurs more often in lighter skin types rosacea might be underreported in skin of color.
With redness (erythema) sometimes difficult to see experts notice delayed diagnosis and greater morbidity, meaning that these patients might be in more severe stages of this skin condition.
A granulomatous subtype with perioral (lip swelling) and periocular ( eyes) manifestation is more frequent while ocular manifestation (eyes) is found more often in patients from Saudi Arabia, Italy, and Korea.
How to diagnose:
Patients self-report:
Warm, burning sensation
do you recognize redness?
positive family history
can you identify specific triggers?
Practical tips for the diagnose:
causing the skin for blanching by using a magnifying glass can show redness even in darker skin
also look for lesions in the central area of the face
being able to identify non-comedonal papules rules out acne
How to treat
Basics treatment regimens are equal for all skin tones, however, in darker skin types we need to address post-inflammatory hyperpigmentation (PIH) and dyschromia.
The goal is always CLEAR, meaning complete clearance should be the goal your dermatologist and you want to achieve because studies showed that quality of life will increase while flare-ups will decrease.
Typical topicals that will be prescribed to you according to your clinical status: Metronidazole, Ivermectin or Doxycyclin
What can you do ?
Practical tips:
gentle cleanser fragnance-free (foam, creams might be less irritating)
light make up (preferably powder)
physical and mineral sunblock (eg with zinc oxide)
Products to avoid:
Alkohol-based cleansers or abrasive harsh exfoliators
for some: chemical sunscreens
My source for this article:
The clinical spectrum of rosacea, highlighting skin of color: Review and clinical practice experience written by Dermatologist Andrew Alexis and further colleagues will be summarized in this chapter:
