Many people suffer from persistent redness of the cheeks, nose and sometimes the entire face. Usually, but not always, these red blotches and visible small blood vessels are seen in patients who have fair skin and blush easily. These skin changes can affect all races and gradually worsen over time if left untreated. Many adults with these symptoms of facial redness, easy flushing, broken capillaries and pimples, actually have a skin condition called Rosacea.

• Fair complexions, people who blush easily most often affected
• Gradually worsens if left untreated
• Many patients actually have a skin condition called Rosacea

Rosacea is an inherited skin condition that usually doesn’t appear before the age of 30 and tends to go unrecognized because it develops gradually. Yet rosacea is a common skin condition that affects 14 million U.S. men and women. Left untreated, rosacea can potentially disfigure the nose and face as in the case of W.C. Fields, whose bulbous nose was due to severe rosacea.

Rosacea starts as redness on the cheeks, nose, chin or forehead. At first, this redness comes and goes but is especially noticeable after exercise, hot or spicy food and beverages, and alcohol consumption. After a while, the redness deepens and lasts longer with the gradual development of visible blood vessels. If left untreated, pimples and bumps may become more frequent and the nose enlarges, developing a characteristic "spongy" texture and prominent pores. Some patients may also notice an accompanying irritation or "gritty" sensation in their eyes, which is termed ocular rosacea.

• Inherited skin condition; not contagious
• Appears in adulthood (> 30 years of age)
• Common
• Left untreated, rosacea can be disfiguring
• Begins as facial redness, progressing to visible blood vessels and pimples
• May also involve the eyes causing a “gritty” irritated sensation

There is no complete "cure" for rosacea. Fortunately, however, there are some very good treatment options. When begun in the early stages, treatment of rosacea can work wonders.

Lifestyle
The first step is lifestyle change. Though rosacea is genetic in nature, there are lots of “triggers” that make it worse. These include sun exposure, stress (causes flushing), alcohol, spicy foods, irritating facial products. Avoidance of these triggers can result in dramatic improvement in symptoms and lessen the incidence of rosacea flare-ups.

Known triggers:

• Sun exposure
• Stress
• Alcohol
• Spicy food
• Irritating facial products
• Hot beverages and food

Medications
The first line medical treatment is antibiotics, available in either topical or oral form. Antibiotics keep blood vessels from dilating and lessen the inflammation and redness of the skin caused by rosacea. We usually start by prescribing topical metronidazole in cream, gel or lotion form. Topical azelaic acid may also be prescribed in the form of Finacea gel. Other topical antibiotics may be used as well, in addition to oral antibiotics (usually a tetracycline-type) which are the most effective in severe or resistant cases of rosacea. When oral antibiotics and topical products do not help, we may prescribe Accutane which is an oral retinoid medication. This can be very effective, but requires monthly blood tests and office visits to monitor for side effects.

• Topical antibiotics
• Azelaic acid
• Oral antibiotics
• Accutane

Non-Prescription Topical Products
At the Menkes Clinic, we offer the latest and most effective topical cosmeceutical products available. We know the importance of routine skin care and can help you find the best products to keep your skin looking radiant and healthy. For patients suffering from facial redness, the use of proper cleansers, sunscreens and moisturizers are vital to reduce and prevent irritation. Antioxidants including vitamin C as well as mild retinoic acid creams can be specifically recommended after a skin consultation with our dermatologists. We also offer redness relief creams and serums specifically formulated for patients with rosacea and sensitive/reactive skin types. Careful evaluation of each patient’s skin type is performed by Dr. Menkes or Dr. Soohoo to assess the most appropriate skin care regimen, removing the “guess work” and eliminating any risk for irritation.

• Customized skin care regimen for each patient
• Moisturizing sensitive skin products
• Antioxidants
• Redness relief serums and creams
• Sunscreen

Lasers and Intense Pulsed Light (IPL)
Once symptoms such as flushing, pimples and red blotches have been controlled, the cosmetic correction of visible blood vessels and facial redness can be effectively addressed. At The Menkes Clinic, we have state-of-the-art lasers (Iridex) and light sources (IPL) to erase broken blood vessels as well as dramatically reduce facial redness. These treatments are performed during an office visit or can be scheduled at your convenience, and result in minimal discomfort and downtime.