What is this skin condition?
Rosacea treatment is performed in our clinic specialized in dermatology and cosmetic surgery, based in Lausanne, Switzerland.
In addition to a genetic predisposition, many environmental factors have been attributed to the development of rosacea. Ultimately, the cause is still unclear.
Recent research suggests that rosacea is the result of an exaggerated immune response. It is believed that there is a basic abnormality in the facial vascularization, resulting in flushing and permanent erythema. This results in a dysregulation of antimicrobial peptides in the skin’s immune system, which may promote increased colonization by Demodex folliculorum, a mite usually found in facial follicles. It is this small parasite that is currently suspected to be responsible for the inflammatory phenomenon resulting in papules and pustules.
Rosacea has four stages:
Stage I: vascular
It is characterized by a diffuse erythema of the face and small telangiectasias, mainly present on the cheeks. In addition, there are flushing episodes: sudden bursts of paroxysmal redness of the face and neck, with a sensation of heat lasting a few minutes. These “flushes” are mainly triggered by stress, temperature changes, hot drinks, alcohol or spicy foods.
Stage II: papulo-pustular
It is characterized by persistent papules and pustules. The lesions can be very extensive but respect the perimeter of the mouth and eyes. There is no comedo or scarring.
Stage III: rhinophyma
It is characterized by a thickened nose, diffusely red with dilated pores. It mainly affects men, usually after the age of 50.
Stage IV: Ocular
It is characterized by a tearing attack with occasional stinging, photosensitivity, hypertrophy of the eyelids and conjunctiva.
What medical treatment can I consider?
The papulo-pustular form can, in its mild form, be treated with 0.75% metronidazole creams with two applications per day for 3 months. The alternative treatment is azelaic acid or anti-Demodex creams. In its more severe form, general antibiotic therapy with cyclins alone or in combination with topical metronidazole for a period of 3 months is prescribed.
Currently, no medication has any real effect on the vascular stage (diffuse redness and small vessels). Vascular laser treatment is very effective and is the best treatment for rosacea today.
Each treatment reduces the intensity of the redness, and several sessions are necessary to reduce the redness. The number of treatments is determined by the type of rosacea.
Laser
Vascular laser to treat rosacea:
The diffuse redness and telangiectasias typical of the central facial area present in rosacea patients can be treated with vascular laser.
CO2 laser to treat rosacea:
Rhinophyma will be eliminated by CO2 laser sessions that will destroy the abnormal proliferation of the sebaceous glands of the nose.
LED
Light therapy to treat rosacea:
Just as in acne, when anti-inflammatory drugs are insufficient, contraindicated or undesirable, light therapy can provide an effective alternative to the papulo-pustular form.
