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Flush Much?

By Joanne Togati, LMT
Posted On Jan 11, 2011
Laser technology offers relief from the red

WORDS BY HEATHER ONORATI

Not to be confused with blushing—a temporary emotional response to being embarrassed, modest or even in love—a red hue to the skin may indicate the chronic skin condition known as rosacea.

Rosacea is characterized by periodic redness of the cheeks, nose, chin or forehead. Over time, prominent spider-like blood vessels, swelling or skin eruptions similar to acne may also occur. The condition is most common in those with fair skin, often appearing between the ages of 30 and 50.

For 39-year-old Susan, it was as if someone else was looking back at her through the mirror. “You’re used to looking at yourself and now you look in the mirror and you see a different person, and it does affect your confidence,” she says.

“Of course this is my magic year, I turn 40. So that’s what I got for my birthday—rosacea,” says Susan, who adds that she had been experiencing periodic flushing for about a year and a half before seeking treatment.

“I had sort of like a butterfly rash over my nose. My forehead…and my chin [were] a little red. And I was a person who rarely had a pimple. So for me to have that on my face, it was kind of concerning,” she says. “It would come and go, and I never really knew what it was.”

Many people don’t realize their symptoms are treatable. They may assume they blush easily, are experiencing allergies or have sunburn.
Worried she was having an allergic reaction to a medication Susan sought treatment from Theresa Conologue, MD, an AACS fellow and dermatologist at Geisinger Medical Center in Danville, Penn.

Redness Relief

Although there are several types of rosacea, “Most of the people that I see fall into the telangiectatic or the papulopustular type of rosacea,” Dr. Conologue says.

Telangiectatic rosacea is characterized by flushing and persistent redness, and may also include visible blood vessels. Papulopustular rosacea may show as redness with small white bumps and pimples, also with visible blood vessels. Rosacea can also affect the eyes, which may feel dry and gritty. If rosacea is left untreated, it can gradually cause thickening of the skin around the nose, making it appear swollen.

Unfortunately, there is no cure for rosacea. However, there are multiple therapies available to manage the symptoms.

If you have the papulopustular type, your doctor may start you with a redness relief gel applied at night before bedtime, and move from there to oral antibiotics. These antibiotics are intended to slightly decrease the redness after two to three months, a result of improvement in the inflammatory acne-like lesions.

Dr. Conologue says, however, that almost all of the patients she sees have a considerable amount of visible blood vessels contributing to redness—for both telangiectatic and papulopustular rosacea—which do not resolve with antibiotics. To treat this redness, she uses a pulsed dye laser to perform vascular laser treatments, after which a noticeable improvement can be seen within a few weeks.

This is the treatment that Susan ultimately opted for in tackling her rosacea, because she felt it was more convenient, economical and quicker.

Setting Expectations

Initially patients will require anywhere from two to four treatments every six weeks to get their redness under control. Because the laser treats the symptoms of rosacea—the blood vessels and some of the resulting flushing—and does not get rid of the disease, patients need to be aware they’re going to probably need touch-ups every six months to a year.

As far as the experience and side effects, Dr. Conologue says the treatment is fairly painless. “It feels like a warm rubber band snapping at your skin, otherwise [pain is] very minimal.” After the treatment, a little bit of swelling and bruising is natural, but the downtime is minimal. Patients usually undergo the treatment on a Thursday or Friday so they can go back to work Monday.

To maintain results Dr. Conologue advises patients to apply sunscreen every morning, with at least an SPF 30. She also talks with patients about avoiding things that may aggravate rosacea. Typical triggers include really hot food. “Not necessarily spicy food but the temperature of food,” she says. “Some people will be triggered by red wine.” Everyone is different she says, but educating patients on triggers makes them aware, so they can begin to identify things that cause flare-ups.

Susan says that after only one laser treatment she’s already getting comments about her skin from friends and colleagues. “It makes me not so worried about what my face may look like if I have a glass of wine [or] about being out in the sun and wondering why my face was red. I’d say my face has improved probably 50 percent with just one treatment. So it’s a huge benefit to me.”