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Q: I have had Rosacea for several years. It seems to be getting worse. It has become embarrassing during social situations. I have tried a few creams recommended by my doctor. I didn’t see much improvement. Can you recommend other options to try?
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A: Rosacea can be difficult to live with and tricky to treat. There is no cure for Rosacea. We can only treat the symptoms to make it easier to control. It generally requires more than one type of treatment to combat the symptoms. There are still many medical unknowns related to Rosacea. However, over the past few years, we have gained a much better understanding of how to reduce the symptoms of Rosacea.
My first recommendation is that you keep a journal for awhile to help you indentify the things that trigger your Rosacea symptoms. Once identified, try to reduce the exposure you have to your triggers.
Some triggers may include (but are not limited to) the following:
- Sun or wind exposure
- Cold or hot temperatures
- Spicy foods
- Alcohol consumption
- Stress
- Hot drinks
The proper treatment selection will depend on the symptoms you are experiencing. Papules or pustules are often treated with antibiotics such as erythromycin or tetracycline. Topical treatments (medicated creams…) can also be used in conjunction with oral medications. The topical treatments can also be used to reduce the burning sensation that is sometimes related to Rosacea. Redness may be reduced over time as well. If papules or pustules are present, low-concentration medical-grade glycolic acid peels may also be used in conjunction with the above mentioned treatments. This will help to thin the most outer layer of skin which may help to resolve some of the eruptions and can also encourage better penetration of the topical medications being used.
Telangiectacia (superficial broken vessels) is a universal component of Rosacea. It will not respond to the above treatments. A uniform treatment of light-therapy (Intense Pulsed light or laser) will improve telangiectacia and redness. Not all Intense Pulsed Light, laser systems or operators are equal. 
It is important to select an expert to plan your treatment program. Remember experience is the key to getting the results you want. Expect to have a series of light treatments, approximately 3-6 treatments about three weeks apart. Once the series is completed, the redness and telangiectacia should be much improved. Over time, it is likely that “touch –up” treatments will be needed to keep it under control.
I have not been that impressed with topical agents for redness in the past. However, about 1 – 1-1/2 years ago, we began using a new medical grade Rosacea cream. Within a few weeks our patients were reporting that they could see a reduction in facial redness. Our patients come back to the office to purchase more of this product BEFORE they run out of it. That tells me they are continuing to have long term success with this product. This product is an excellent choice for post light therapy maintenance.
A medical grade Rosacea skincare program designed by an expert may also give you additio
nal relief. Specific products can give much needed soothing, gentle exfoliation, hydration, and sun protection. Keep in mind that while exfoliation is still important, you should choose methods that do not include using abrasives or scrubs on your skin. I like the Retexturing Complex by Castillo Md Skin Science. It give effective, yet gentle, granule-free, exfoliation with anti-inflammatories, soothers and hydrators all in one product.
Camouflage can also be an option. Dr. Castillo carries medical-grade camouflage and mineral cosmetics in the Savoy (Champaign-Urbana area) office. You can schedule a camouflage appointment with me, Dr. Castillo’s skincare and laser specialist at no charge. I do not recommend camouflage if you are having active difficulty with acne-like lesions.
Controlling Rosacea requires persistently protecting your skin from sun exposure. Using UVA / UVB broad-spectrum sunscreen 365 days per year is of great importance. I would suggest a medical grade physical sun block containing high percentages of Titanium Dioxide or Zinc Oxide. Wear sun glasses and a wide-brim UV protected sun hat when you are outside for additional protection.
Roxanne, Skincare and Laser Specialist
Roxanne Hammond, RMA
Skincare and Laser Specialist
G. D. Castillo, M.D.
COSMETIC PLASTIC SURGERY
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This question was answered by Roxanne, Medical Skincare and Laser Specialist at Cosmetic Plastic Surgery Skin Restoration and Laser Institute. Please contact us for additional information at 217-359-7508 or 309-662-0436