Red Not - May 2007

"Rosacea can be very frustrating to deal with and can have psychological effects," says Dr. Diane C. Wong. She's had great results with IPL.

When Katherine Spiwak, a 36-year-old Toronto woman, was diagnosed with mild rosacea in her early 30s, she was relieved to find the answer but “frustrated and concerned the symptoms and flares would persist indefinitely. I was also extremely self-conscious of it and had difficulty wearing makeup,” she says.

Spiwak is not alone. Rosacea, a chronic skin disorder, occurs in about five per cent of Canadians and affects more women than men. “Rosacea can be very frustrating to deal with and can have psychosocial effects,” says Dr. Diane C. Wong, a cosmetic physician in Toronto, who also has mild rosacea.

The tell-tale signs of rosacea include persistent redness, flushing that worsens with stress, a hot shower, alcohol or spicy foods; pimples; swollen or scaly-looking skin that may sting or burn; spider veins; bloodshot or itchy eyes. Rosacea primarily targets the face, but the neck, chest, arms and back can also be affected.

Left untreated, rosacea can worsen over time – but there is help. “Rosacea cannot be cured but can be controlled with treatment,” says Dr. Martie Gidon, a cosmetic dermatologist and director of Gidon Aesthetics and MediSpa in Toronto. Accutane may be used for severe cases, says Dr. Gidon. Antibiotic pills, such as doxycycline, can reduce the clinical signs of rosacea, especially when combined with metronidazole topical lotion, says Dr. Wong.

For many, photorejuvenation with intense pulsed light (IPL) and/or Levulan photodynamic therapy can help. “They can clear the pimples, redness and spider veins,” says Dr. Gidon. Dr. Wong says she had great results with IPL on her own skin. The treatment typically involves six sessions, about four weeks apart, with minimal discomfort and no downtime.

Managing rosacea means controlling the symptoms, preventing flares and avoiding typical triggers, such as stress, alcohol, spicy foods, saunas and hot baths, long-term use of steroid creams and certain hypertension medications. Some facial products can worsen rosacea, including scrubs, toners or astringents with alcohol, products with perfume and certain makeup. Irritation can also be caused by over-the-counter rosacea products, glycolic acid (often in anti-aging creams), microdermabrasion or strong chemical peels. But, says Dr. Wong, what exacerbates rosacea in one person may have no effect on another. With summer just around the corner, those with rosacea should avoid the sun as much as possible, says Dr. Gidon, as sunlight can worsen it and create more spider veins. Your best defence? “Use sunscreen, wear a hat, seek shade and avoid sun exposure between 10 a.m. and 3 p.m.,” she says.

As for cleansers and moisturizers, milder is better. Spiwak found “glowing results” with The Body Shop Aloe Calming Facial Cleanser and Guinot Crème Hydra Beauté moisturizing cream. Dr. Wong prefers Vivier Pharma Redness Relief products. “I never had compliments on my skin prior to treatment, and now I get compliments all the time.”