Saturday, July 29, 2006

Men and Rosacea

Men suffer from rosacea just as much as women, but many men ignore it, push it off to something else, like high blood pressure, too much sun, and best yet--just my NORMAL skin tone. Men are also less likely to seek help for a cosmetic problem-even when they know it is a problem. The problem with this approach is rosacea is progressive. In other words, it does not go away.

Since about 80% of the American public have never even heard of rosacea and have no idea what it is, rosacea becomes more that just a cosmetic problem. A simple job interview and to the interviewer, you look like a drunk. Your face is red, your eyes are bloodshot(ocular rosacea) and guess what? You are turned down for the position! Not because of your knowledge in your respective career, but forward thinking CEO's see you as a risk. "This guy drinks or just doesn't fit our corporate image." So they hire the guy with the pure white face and clear eyes and drinks like a fish, but no rosacea. Alcohol does NOT cause rosacea, but can trigger it. So can stress, sunshine, heat, many foods and you might just be at a permenant stage of redness with ocular rosacea.(I will talk about ocular rosacea in a later blog).

And what about you single guys? Do you think women like red, glowing or flushing faces. I think you already know the answer to that one.

So what can men do? First and most important get over your fear of doctors. We are here to help you. That's it! Second, we have NO torture machines in our offices. Those are just unfounded rumors. IPL or intense pulsed light works very well on most all men and can take the redness out of your face and in a lot of cases, clear up bloodshot eyes and ease flushing.

What does IPL feel like? Well, it does hurt a little. We do apply some numbing cream beforehand that takes the sting out, and cool gel during the treatment. In some cases, we can premedicate the patient until many of the rosacea targets are gone. For the most part, it feels like a snap of a rubber band(not a fully stretched out one) or a very brief hot poker feeling. Just kidding.

So guys, don't let your rosacea progress, get it treated and I think your entire life will improve. Visit my website if you like,

Wednesday, July 26, 2006

Treatment For Rosacea

Rosacea has had many treatments in the past-some work and some treatments just make your face much worse. The standard treatment for the past few years has been tetracycline and a metronitazole cream such a metrogel, metrocream or noritate. Other creams on the market work about as well, but the problem is most rosaceans can not tolerate anything on their face without causing it to flare or breakout. Avoiding triggers has always been popular, but heat and stress top the list of known rosacea triggers, making it extremely hard to avoid rosacea triggers.

Steroids such as cortisone is a known trigger for patients that have to use this class of drugs. Most rosaceans know that alcohol will cause them to flush and most do their best to avoid drinking, if they know they have rosacea. Certain spicy foods can set some of us off, and it does not take long to learn to stop eating things that turn your face bright red.

The sun is a definite no-no for most rosaceans. We must cover up, use sun screen lotions if our poor wretched faces can tolerate them, big hats, visors, etc.,etc. Most of us seem to just end up avoiding the sun altogether. This is where crimping of life-style really starts to hit home!

Once lasers started hitting the market such as the V-beam and Yag, some rosaceans started to get results, probably the best use was for spot treatment of visible blood vessels on the face. Then IPL or Intense Pulsed Light came out about 8 years ago, and things really started to happen!

IPL was the first real thing rosaceans could hang their hat on. The main reason is it really reduced background redness or erythema of rosacea. Plus, it curtailed the harmful flushing attacks most of us were having. The first machines were slow, 9-10 seconds between pulses. There were not a lot of options with the machine, most did not have the wavelengths or filters to pick from as we do today. Now we can split the energy in one pulse to 3 pulses milliseconds apart. I do not want to start to get technical here, only to say machines on the market today such as the Lumenis One are highly advanced and really work in the right hands. Rosacea can finally be really treated!!

Dr Steve Johnson

Sunday, March 12, 2006

Rosacea-What is it?

Rosacea is a mysterious disease. Many years ago Rosacea was called Acne Rosacea, which was a misnomer. The disease has nothing to do with acne. Yes, Rosacea patients can get papules and pustules that look similar to acne, but do not contain bacteria and the mechanism is different. All of Rosacea starts with flushing, and that seems to be the key. If you never flush, you probably do not have rosacea.

Rosacea has mostly been looked at as a skin disease, but the skin is only collateral damage to the Rosacea monster. Rosacea is a blood vessel disease. Celtic cultures and European northern climates are the classical heritage of Rosacea. Blood vessels in the face are genetically defective and can not take a lot of flushing. The vessels become damaged, start leaking, and this sets off an inflammatory response. The face becomes red, inflamed, very sensitive to any stimulation. Sunshine, stress, creams, soaps, make-up and most anything can set it off to become even worse. This can cause even more flushing!

Once the blood vessels in you face become leaky and defective you body tries to destroy them and build new ones. This is called angiogenesis. The old blood vessels just hang around in your face, doing nothing. Before long the new blood vessels begin to leak and the whole process starts again. The face becomes permanently red and extremely inflamed and sensitive. Flushing at this point becomes as easy as saying "good morning". So, is Rosacea genetic? Most likely. Can you physical and social environment set it off. You bet!!

Dr Steve Johnson

Sunday, February 26, 2006

Rosacea, the stealth disease

Rosacea is such a common disease, but nobody really seems to know what it really is. For those that have rosacea, we seem to just blend into society with our "ruddy complexions", too much sun, too much alcohol, high blood pressure, mad, hot, rosy cheeks (how cute!) and a host of many other disguises. But underneath, we are literally boiling!! We hurt, embarrass easily, seek medical help that generally does not help. We flush at a drop of a hat. Stress, foods sunlight, cold, heat, soap, almost anything can make us flush! Sooner or later the flush becomes permanent. Social events and even the work place is harder and harder to cope with. We soon begin to grasp at anything that might help. Prescription meds and creams along with supplements begin to pile up. Some work for a while, but rosacea always seems to win at the end of the day.

Rosacea strikes about 14 million Americans. There is no known cure. Rosacea is almost always progressive, meaning our redness gets worse, disfigurement of the nose and face, fibrosis of the facial skin and papules and pustules form. Broken blood vessels and capillaries appear over the T zone of the face and sometimes the entire face and neck. Neuropathic chronic pain may occur in the face. Depression is very common if not universal. Social isolation and missed opportunities become common place.

So, how do we deal with this very common but virtually publicly unknown disease? The first step is to recognise that we have rosacea. Most doctors would be able to tell if you do, but many have been misdiagnosed with other conditions. Many online help groups such as Rosacea Support Group at Yahoo is a good place to start. RSG has many achives of previous treatments that have been successful or not, and the members will walk you through the disease. The only thing that is discussed is rosacea and the treatment of rosacea. You will be in good hands and company, because everyone in the group has rosacea and is willing to help and offer advice.

Rosacea is hard to treat. The reason being not everyone responds the same way. Not everyone has the same symptoms and medicines and other treatments work for some and not for others. Another point to make is many rosaceans have ocular effects. The eyes become involved with infections, tearing, dryness and redness. Some rare cases of blindness have occurred.

I will talk about the pathology and treatment as we go along in this blog and welcome any comments.

Dr Steve Johnson