Leighanne McGill, PA-C

Derm with LRM

Welcome to my first post  of “DERM with LRM” for Dermatology and Laser Center’s blog. You are welcome to call me Leighanne (no doctor please, I’m a Physician Assistant). My full name is “Leighanne Rose McGill,” hence the nickname that my family and friends use “LRM,” (sounds like Lerm). I acquired this nickname in PA school, where my love of all things dermatology flourished. Today, I’m writing about rosacea because it is one of the most common conditions I see and there are a wide array of treatment options available for patients.

All About Rosacea

What is rosacea?

Rosacea is a chronic, inflammatory skin condition that can cause facial redness, bumps, and skin sensitivity. There are four general types of rosacea. Firstly, there is erythematotelangictatic rosacea, which is flushing or redness in the central facial skin, with or without visible facial vessels. Papulopustular rosacea has both facial redness accompanied by acne-like bumps, generally on the nose and cheeks. The least common and most severe type of rosacea is rhinophyma, which is most seen as a thickened, red nose. There is also a form of rosacea that affects the eyes, which is appropriately named “ocular rosacea.” Up to half of patients with rosacea will develop ocular symptoms, which can include itching/stinging of the eyes and eye redness.

What causes rosacea?

There are numerous proposed causes of rosacea, although the pathogenesis is not fully understood. An atypical immune response contributes to the vascular changes and inflammation found in rosacea. Skin microbes, including the naturally occurring bacteria found on the skin and the Demodex mite that live symbiotically in our hair follicles are associated with development of inflammation in rosacea. Ultraviolet radiation exposure has been shown to worsen the baseline flushing and facial vessels found in rosacea.

Common triggers for rosacea flushing include: eating spicy foods, heat, cold, alcohol, chocolate, hot beverages, and caffeine. If you have rosacea, you may already know your triggers.

Who gets rosacea?

Anyone can develop rosacea, although it most commonly occurs in ages 30 to 50. In our patient population, we have a significant number of teens and young adults with rosacea. Once thought to be a condition affecting only lighter skin types, we now know that rosacea is equally prevalent in darker skin tones but is under-diagnosed.

How do I prevent rosacea?

The most important preventative care for rosacea includes the following:

  1. Identify your rosacea triggers, such as spicy foods, and try to avoid them
  2. Use gentle, non-irritating skin care products designed for your skin type
  3. Protection from ultraviolet radiation is key! Any amount of sun exposure – large or small – worsens rosacea. Mineral sunscreens containing zinc and titanium ingredients are vital for those with rosacea.

Trust the team at DLC to help develop a custom skincare regimen to suit your needs, especially if you have rosacea/sensitive skin.

How do I treat rosacea?

Topical prescription creams can help prevent symptoms and bumps associated with rosacea. Washes and lotions containing elemental sulfur are particularly beneficial for those with any type of rosacea. Other prescription active ingredients include metronidazole, topical ivermectin, and topical minocycline. For those suffering with rosacea papules and pustules, oral medication is often needed to calm down the flare, transitioning to topical medication plan when the flare subsides.

Even the best prescription regimen will not reduce redness, facial vessels, and flushing. This is where laser treatment is a game-changer for patients with rosacea. At the Dermatology and Laser Center of Chapel Hill, we utilize our Sciton Broad Band Light device to reduce overall facial redness as well as treat stubborn facial vessels. The results are dramatic! Generally, a series of three BBL treatments spaced one month apart are needed for a significant reduction in redness, before transitioning to maintenance treatments.

In summary:

  1. Seek evaluation and treatment from a skincare professional at DLC to if you think you may be suffering from rosacea or facial redness
  2. Prescription medications can help treat bumps and pimples caused by rosacea
  3. Laser treatments improve flushing, red vessels on the face, and sensitivity caused by rosacea