There's More to the Red Face than Meets the Eye
Facial burning, stinging and itching are commonly reported by many rosacea patients. Certain rosacea sufferers may also experience some swelling (edema) in the face that may become noticeable as early as the initial stage of the disease. It is also believed that in some patients this swelling process may contribute to the development of excess tissue on the nose (rhinophyma), the condition that gave the late comedian W.C. Fields his trademark nose.
(PRWEB) May 23, 2005 -- It is often thought that fair-skinned patients who
tend to flush or blush easily are believed to be at greatest risk, while in fact
facial redness from rosacea is simply more obvious in lighter skin. A normal
blush or sunburn may appear the same, as can flushing from medications such as
niacin or some antihypertension drugs. Flushing occurs when a large amount of
blood flows through vessels quickly and the vessels expand under the skin to
handle the flow. However, people with extensive sun damage, certain skin types
and even treated rosacea patients can still have a red face or blood vessel
streaks, which is often misdiagnosed as active rosacea. This is because visible
blood vessels (telangiectasia) not only develop with rosacea (or were likely
always there), but there may be some residual persistence of redness from the
dilation of blood vessels during active disease. Unfortunately these patients
continue their medications unnecessarily while more appropriate treatments
include camouflage makeup, sunscreens, a vascular laser, or intense pulsed light
source.
Unlike some conditions, there are no histological, serological or
other diagnostic tests for rosacea. A thorough examination of signs (appearance
of bumps or pimples) and symptoms (redness, flushing, and swelling, burning,
itching or stinging) as well as a medical history of potential triggers lead to
the diagnosis.
The National Rosacea Society suggests that the most
common triggers of rosacea were sun exposure, emotional stress, hot or cold
weather, wind, alcohol, spicy foods, heavy exercise, hot baths, heated beverages
and certain skin-care products. In other words, almost anything that is
potentially stimulating is bad news for rosacea. Unfortunately for some, certain
conditions such as lupus, seborrheic dermatitis, drug eruptions, and even rare
forms of lymphoma can look just like rosacea and are often missed by the
untrained eye or worse when the patients are diagnosing
themselves.
Rosacea is not an infectious disease, and there is no
evidence that it can be spread by contact with the skin or through inhaling
airborne bacteria. However, there has long been a theory that parasites in the
hair follicles or oil glands or the face can stimulate inflammation by their
activity or even their presence. One such organism is the Demodex folliculorum
mite, which studies have shown to be more prevalent and active in rosacea
patients then in control groups. Early vascular and connective tissue changes
probably create a favorable setting for a growth of Demodex folliculorum. This
may represent an important cofactor especially in papulopustular rosacea, in
which a delayed hypersensitivity reaction is suspected, but it is not the cause
of rosacea. On the other hand, clearing rosacea signs after oral tetracycline or
sulfur ointment may not affect the resident demodex population.
The
incidence of demodex is age related. It was found up to 20 years in about 25%,
up to 50 years in about 30%, up to 80 years in about 50% and in all aged 90 or
older. In healthy persons, one can find one or more Demodex in every tenth
eyelash. This index rise with increasing age. In blepharitis or other external
eye diseases, demodex is found in about every sixth eyelash. Therapy of chronic
blepharitis in association with demodex may include antibiotics, steroids,
Quecksilber 2% or Lindane. Massage of lid margins is essential because local
treatment is of no effect as long as the mite remains deep in the pilosebaceous
complex.
As rosacea is characterized by flare-ups and remissions, and
research has shown that long-term medical therapy significantly increased the
rate of remission in rosacea patients, it behooves patients to use a maintenance
regimen. In a six-month multicenter clinical study, 42 percent of those not
using medication had relapsed, compared to 23 percent of those who continued to
apply a topical antibiotic. Therefore, treatment between flare-ups can prevent
them. A rosacea facial care routine often starts with a gentle a refreshing
cleansing of the face each morning. Sufferers should use a mild soap or cleanser
that is not grainy or abrasive, and spread it with their fingertips. A soft pad
or washcloth can also be used, but avoid rough washcloths, loofahs, brushes or
sponges. The face should be rinsed with lukewarm water several times and blot
dry with a thick cotton towel.
A new treatment available is seabuckthorn
oil (Hippophae rhamnoides), which is the active ingredient in Facedoctor soap.
Its activity is targeted against the mite to reduce the inflammation under the
skin and therefore provide relief of the mechanisms that cause the rosacea
complex of symptoms. The advantage that patients find with the soap is the
elegance of the cleansing vehicle in otherwise sensitive skin, the presence of
Vitamin E and aloe Vera which provide additional healing properties, and other
active ingredients such as astragalus membraceus and spirodela polyrhiza, useful
yeasts that augment the activity of the seabuckthorn oil.
My patients
have found this to be well tolerated and useful either as monotherapy or in
addition to their other topical and/or systemic medications. We conducted a
small placebo-controlled double-blind study in the office which showed that the
majority of patients had a reduction of symptomatic erythema as well as
reduction of response to triggers.
In conclusion, this study has
demonstrated the Face Doctor line of soaps to be an effective natural weapon
against the parasite and therefore the disease.
Neal Bhatia,
M.D.
Assistant Clinical Professor of Dermatology
UCSD School of
Medicine
Private Practice Dermatologist, San Diego
Corrado
Chiarello
China Mystique
www.facedoctor.ca
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Source : http://www.prweb.com/releases/2005/5/prweb242629.htm