Rosacea is a troubling skin disease that affects more than 16 million Americans. The largest population afflicted with rosacea is Caucasian women in their 20’s-50’s. However, rosacea can affect skin of color and men as well. As a board-certified dermatologist and member of the American Acne and Rosacea Society, Dr. Kate Holcomb is passionate about diagnosing and treating rosacea in all skin types and races. “We now know that treating rosacea improves patients’quality of life.” Studies demonstrate that people miss work and cancel social engagements due to their rosacea. Dr. Holcomb is both a speaker on rosacea treatments and was involved in the ANSWER clinical trial for combination therapy of FDA approved treatments for rosacea.
Doctors used to classify rosacea into types but we now understand that patients often have varying presentations and that a patient’s rosacea may change over time. Some patients will have pimples and pustules, with or without dryness. Other patients may have no bumps, but they will have broken blood vessels or complain of a red face. Patients often complain of very sensitive skin with stinging and burning or red flushing of the face due to certain foods, heat, alcohol, or out of the blue which can be very socially troubling. Other long-term complaints of rosacea are prominent pores and thickened skin. Patients may have a combination of these features.
Perioral dermatitis is another complaint that often responds to rosacea treatment. It can have bumps and dryness around the mouth or eyes, occurs in children and adults, and is socially troubling.
The eyes can also be affected by rosacea with irritation, dryness, redness or that patients describe a feeling of having something in the eye.
In the last 5 years, the number of treatments for rosacea has increased with multiple very effective prescription medications, great professional grade skincare as well as over the counter options, and effective and safe in-office peels and procedures.
Dr. Holcomb recommends that all patients with rosacea use very gentle products that have no fragrance and always wear sunscreen daily. There are new theories on how heat, in addition to sun, plays a role in worsening rosacea; therefore, Dr. Holcomb recommends that rosacea patients only wear sunscreens that contain physical blockers, titanium dioxide and zinc oxide, which reflect light away from the skin.
Aside from prescribing medications for rosacea, Dr. Holcomb performs chemical peels and lasers tailored for each patients’ skin needs. We used to think that rosacea patients could not tolerate chemical peels, but now there are options which perform well and give beautiful results. Dr. Holcomb suggests doing your research to make sure that you are seeing a board-certified dermatologist capable of using combination therapy on sensitive rosacea skin.
The exact cause of rosacea is unknown and there is no cure. New theories include the following: neurovascular dysregulation,meaning the nervous system and blood vessels are involved, overactivity of the innate immune system and its messaging (cathelicidins), or reaction to the demodex mite found on all skin but more irritating in rosacea. The good news is that treatment can control many of the signs and symptoms of rosacea and improve patients’ quality of life.