Rosacea

Rosacea is a chronic inflammatory condition of the skin frequently referred to as “adult acne.” It is characterized by redness, broken blood vessels, and flushing of the face and scalp. Patients may also experience pimples, swelling, itching, and scratchy eyes. It is also common for rosacea patients to have seborrheic dermatitis-basically dandruff of the scalp and face, characterized by rashes with greasy scale of the forehead, eyebrows, and around the nose. Rosacea is most often seen in patients with lighter skin color, although we do see it in all skin types. Triggers for rosacea include sunlight, caffeine, alcohol, spicy foods, hot liquids, and extreme temperatures. There is no cure for rosacea, but fortunately, there are many excellent treatment options available for patients today.

At Dermatology & Laser of Alabama, Dr. Sarah Sawyer may prescribe topical and/or oral antibiotics to help get your rosacea under control. These medications are good for the pimples and inflammation associated with rosacea. However, they are generally only somewhat beneficial for the underlying redness, flushing, and broken blood vessels. Fortunately, at Dermatology & Laser of Alabama we have a number of laser treatment options available that work beautifully for this problem. The gold standard for treating rosacea is the V-Beam laser. Dr. Sawyer is fellow ship trained with this laser and it is one of the most popular treatments that she performs.  Patients with long-standing severe rosacea may develop rhinophyma, or bulbous thickening of the nose (“W.C. Fields” nose). Dr. Sawyer is also able to treat this problem with surgery or laser.

Once your redness and inflammation is under control, our providers will also review the importance of a maintenance regimen for your rosacea. In addition to topical and/or oral antibiotics, sunscreen and avoidance of rosacea triggers will be an important part of the routine.

Many patients are now turning to laser and intense-light treatments to treat the continual redness and noticeable blood vessels on the face, neck, and chest. Often considered a safe alternative, laser and intense pulse-light therapy may help to visibly improve the skin and complexion.

Photodynamic therapy treatments are recommended in three- to six-week intervals; during this time, sun avoidance is necessary. 

Photodynamic therapy (PDT) is one of the newly available treatments. PDT uses a topical photosensitizer liquid that is applied to the skin and a light to activate the sensitizer. Levulan (aminolevulonic acid) and blue light, commonly used to treat pre-cancers (actinic keratosis) and acne vulgaris, can also be used to treat some rosacea patients. The use of PDT in rosacea is considered off-label use to some extent, since it is primarily designed for regular acne. PDT is thought to work at reducing the inflammation, pimples, and also improving the skin texture. PDT is an in-office procedure performed in your physician’s office. The treatment takes anywhere from one to one and a half hours to complete. Strict sun avoidance for approximately one to three days is required after the treatment. Mild discomfort during the treatment and a mild to moderate sunburn appearance after the treatment is common. Some patients have experienced remissions (disease free periods) of several months to years from these types of treatments. Other patients may not notice significant improvement.