Rosacea is a skin condition common in people of Northern European ancestry. It is not a disease so much as an acquired condition. Rosacea is also known as adult acne and was the cause of W.C. Field’s big red nose and in one of our recent former presidents. Rosacea commonly affects the oil glands, causing them to become inflamed and engorged. Rosacea can also affect the eyes most commonly by causing chronic inflammation leading to dry eye symptoms and red eyes. Rosacea can become more severe with some hormonal changes and even some medications such as some medications for cancer. Styes, hordeolum, and chalazion are inflammations and/or infections of the oil glands in the eyelids and are more common in people with rosacea.
Along with causing dry eye and inflamed glands and eyelids, Rosacea can in some cases be associated with blood vessels growing in the cornea and with corneal ulcerations. These later findings of rosacea are found in some infants and children without the associated acne
type changes. Interestingly, the corneal ulcers associated with rosacea do not correlate with the severity of the skin conditions.
At Price Vision Group, we consider IPL the Gold standard of treatment for Rosacea. During a consultation at Price Vision Group, meaningful diet modification will be discussed. Diet modification, along with IPL (Intense Pulsed Light) have shown remarkable improvements in patients with rosacea. IPL is not a laser treatment, instead it is just what it says: an intense light in a particular wavelength that are absorbed by the red blood cells stimulating the glands to function better and decrease the inflammatory response. IPL also appears helpful with the common infestation of Demodex in the glands. IPL for rosacea is performed typically as a series of 5 treatments 3 to 4 weeks apart, in some cases of severe rosacea we may do more treatments. Moreover, depending on the situation, a follow-up treatment is recommended every 6 to 12 months.
With IPL, we have found our patients might no longer need oral medications that can come with a multitude of side effects, which makes IPL a safe alternative treatment for Rosacea. We have also found that IPL is a great treatment for styes, hordeolum, and chalazion; and IPL can avoid the need for antibiotics, and topical or injected steroids into the eyelids both of which can cause scarring of the tissue. We can usually avoid surgical drainage or removal of chalazion with IPL.
The doctors at Price Vision Group have had an interest in treating rosacea for over 40 years. During that time, they have gone through a myriad of treatments for rosacea including oral antibiotics like doxycycline, creams like metronidazole, and some diet modifications including the avoidance of spicy foods. These commonly used treatments can play havoc with the body’s own natural biosystem. There are many side effects of taking antibiotics including digestive disturbances and yeast infections, especially in women. While antibiotics help the functioning of oil glands in the face and eyelids, they disrupt the normal bacteria in our intestinal system. Bacteria and even parasites like Demodex (small mites) play a role in rosacea, there are non-pharmaceutical ways to treat them.
The avoidance of spicy foods really has no physiologic basis from our standpoint. Though spicy and acidic foods cause vasodilation of the already more prominent blood vessels in the inflamed glands, we have not found they directly make rosacea worse. They just highlight the problem. The most effective treatments will decrease inflammation and decrease abnormal blood vessels. Topical, or systemic cortico-steroids initially can make things look better because these steroids decrease inflammation. However, long-term use promotes the abnormal functioning of the oil glands and acne is a common side effect of taking steroids.
Metronidazole is a commonly prescribed medication for rosacea. In the oral form it has been shown to be carcinogenic in animals, however, the carcinogenic effect with topical applications is unknown at this time.