Posts Tagged ‘flushing’
April has been designated as “Rosacea Awareness Month” by the National Rosacea Society (NRS). Rosacea is a progressive skin disorder commonly characterized by flushing and persistent redness on the central portion of the face and visible blood vessels. It has been estimated more than 16 million Americans are affected by Rosacea. The effects of Rosacea can go beyond this visible symptoms, often causing discomforts such as stinging and burning. For the majority of rosacea suffers it effects self esteem, going as far as to effect professional interactions.
What is Rosacea
Rosacea is a progressive skin disorder with symptoms including flushing, redness, visible blood vessels, burning, and stinging. Rosacea can also cause acne like symptoms, such as little bumps called papuals, often refereed to as Acne Rosacea. In more severe cases, there is a thickening of the skin and the nose can present as bulbous with irregular nodularities and enlargement, known as Rhinophyma. There is also a subtype of Roscacea, known as Ocular Rosacea, where eyes are red or bloodshot with burning and stinging. Rosacea is a progressive disorder and, left untreated, will worsen in severity with time. Those with Rosacea often experience flare-ups, which can last for months. Only a doctor can diagnose Rosacea. If you suspect you have Rosacea, see a dermatologist.
What causes Rosacea
The exact cause of Rosacea is not completely understood. Suggested possibilities include auto-immune disease or defects in the nervous system which effects blood vessels or Demodex mites. It may be something there is a genetic predisposition to. What we do know is that there is a strong vascular component to Rosacea. We also know that there are “triggers” such as heat or spicy foods that can trigger flare-ups.
It is important to understand that there is not a cure for Rosacea, but it is something that can be treated to reduce severity and symptoms. First, those with Rosacea should work to understand what their specific triggers are. Avoiding triggers can reduce the frequency and severity of flare-ups. Finding skin care products that do not aggravate rosacea can be tricky. Consult with a Dermatologist and Esthetician for skin care recommendations appropriate for Rosacea skin.
Intense Pulse Light (IPL) remains the most effective treatment for addressing the redness and visible dilated blood vessels seen with Rosacea. Vascular lasers, such as a KTP or Yag, can be used to treat facial veins that are well visible and can be traced. Typically, 3-6 treatments are needed, scheduled about 3 weeks apart. Because there is no cure for Rosacea, a series of treatments may need to be repeated annually, depending on severity.
Botox injections have been shown to be effective when injected superficially in very dilute concentration to reduce the redness and flushing of Rosacea. Redness may be reduced for 3-6 months after injections. This treatment is currently considered “off-label”.
Facials will not correct any vascular component of Rosacea, but the appropriate facial can calm and sooth skin. Consult with your Esthetician Facialist for recommendations.
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Rosacea is primarily a facial vascular disorder in which blood vessels are functionally and structurally abnormal. Currently rosacea can’t be cured, however it can be effectively treated and controlled. Rosacea is a progressive skin disorder, that should be treated when symptoms first begin. Treatment should be aimed at treating the underlying vascular issues associated with rosacea. Vascular Lasers and IPL treatments are extremely effective at treating existing redness and broken blood vessels. In addition to avoiding rosacea triggers, topical products can be used to prevent flushing and further damage that can accelerate the progression of the disorder.
Laser and IPL Therapy
Both Laser and IPL therapy are very effective at treating telangiectasia (broken blood vessels), generalized redness and flushing. IPL therapy can also be enhanced with Levulan to get the added benefit of treating acne, rosacea papules and pustuals.
Lasers that are absorbed well by hemoglobin are used to treat vascular concerns. The laser energy is absorbed by the blood vessel and creates heat within the vessel which damages the vessel wall and permenatly closes that vessel. The treated vessels are then absorbed by the body. Although there isn’t a cure for rosacea, studies show that laser treatment can permantly remove damaged facial blood vessels and with repeated treatment blood vessels will not always be created to replace the old vessel. Facial blood vessels treated with lasers are sometimes replaced with connective tissue. This is good news, because this will permently reduce the number of blood vessels in the face, near to the level of vessels found in healthy skin.
Lasers have a single wavelength that work at a very specific depth. So any idividual laser has it’s limitations. KTP 532 nm and Pulsed Dye: 577 -585nm lasers are well absorbed by hemoglobin and are very effective at treating superfical blood vessels in the face, while Nd:YAG 1064nm lasers are also well absorbed by hemoglobin, they are effective at treating vessels that are located deeper in the skin.
Intese Pulsed Light (IPL)
IPL skin treatments are known by many names including Fotofacial, Photofacial, Photoderm and Photo rejuvenation. Intense Pulsed Light (IPL) differs from lasers because IPL uses a wide spectrum of wavelengths at the same time (for example: 500nm — 1200nm) that can target any chromophore in that range, while lasers have a single wavelength. You can think of the laser like a sniper that can precisely hit a single target with one shot, and IPL is like a grenade that hits several targets at once. IPL uses special cut-off filters that can be selected to target chromophors in a certain range within the skin. When treating rosacea or any vascular concern, the intended target is hemoglobin. The advantage IPL treatments have over laser treatments is that IPL can target vessels at different depths.
Combined Laser and IPL Therapy
Best results are achieved when you combine IPL and Laser treatments. IPL and Laser treatments can be done independently, however combining technologies at the same treatment time will provide a better result. This type of treatment is fairly aggressive and should only be done by someone that is very experienced in combining these technologies.
Oral and Topical Products
Topical Metronidazole Gel
Metronidazole is topical agent used to treat rosacea, available only by prescription. The primary action of Metronidazole is anti-inflamatory. Metronidazole is effective at reducing papules and pustules and has a fairly minimal effect at reducing inflammation. Unfortunately, it isn’t effective for treating broken blood vessels or flushing.
Antibiotics have long been used to treat rosacea, however they work primarily through their anti-inflammatory properties rather than antibacterial. Antibiotics are effective at reducing papules, pustules, and inflammation. The limitation with antibiotics is that they are not effective at treating telangiectasia or flushing.
Antihistamines are effective at reducing facial inflammation, swelling and burning associated with rosacea. Histamine contributes to swelling, itching and burning. Histamine has also been shown to play a role in inflammation and redness.
Sunblock with Zinc Oxide
UV rays can penetrate the skin and activate sensory nerves that release potent vasodilators, as well as creating heat in the skin causing facial flushing. Zinc oxide reflects both UVA and UVB rays, blocking out heat from the sun. Topical zinc oxide also has significant healing properties when applied to damaged skin and has been shown to decrease inflammation in both the epidermis and dermis.
Dimethicone is a silicone based ingredient with moisturizing ability. Dimethicone is also a protective ingredient that has been shown to reduce flushing caused by skin irritants.
Free radicals have been shown to cause structural damage to vascular walls and many free radicals are potent blood vessel dilators. Dietary and topical antioxidants help to block the damaging effects of free radicals.
Studies show that vitamin C can protect blood vessel walls from free radical damage and reverse existing vascular damage. People with rosacea should get plenty of vitamin-C in their diet, and may want to consider a vitamin-C supplement. In addition to being a great antioxidant, topical vitamin-C has anti-inflammatory qualities.
*This post is intended for informational purposes only.
Rosacea is a vascular disorder that affects facial skin and eyes, causing facial redness, inflammation, broken blood vessels and red bumps known as inflammatory papules. Rosacea is a progressive disorder beginning with mild symptoms, and if left untreated can become severe. Rosacea treatment should begin as soon as possible to slow the progression, with an emphasis on treating the underlying vascular disorder. With continued treatment and avoidance of rosacea triggers, suffers can control their symptoms and slow or prevent further progression.
This post is intended for informational purposes only. Only a Doctor can diagnose rosacea, if you suspect you have rosacea you should consult with a physician, as facial flushing can be a sign of other systemic disorders. If you do have rosacea it is a good idea to begin a rosacea diary to track your specific triggers. Begin treatment as soon as possible to control your rosacea and do your best to avoid triggers.
Rosacea Stages: The progressing of symptoms
Pre-rosacea is characterized by frequent, temporary bouts of flushing and blushing. Facial redness disappears immediately after the trigger is over.
Mild rosacea is characterized by flushing and redness that lasts for an abnormally long time after trigger is over (half hour or more). Broken blood vessels (telangiectasia) may be present and skin may be sensitive to products.
Moderate rosacea is characterized by facial redness that last days or even weeks. The nose and cheeks may have a semi-permanent redness, causing a sunburned appearance. Swelling, burning, broken blood vessels, and inflammatory papules may be present. Some people may experience eye symptoms such as irritation, dryness, crusting, sensitivity to light, swelling of the eyelids, and a feeling of a foreign body in the eye.
Severe rosacea is characterized by severe flushing, inflammation, burning and swelling. Inflammatory papuals, pustules and nodules may develop. Rosacea that progresses to this point can be painful. In some cases rhinophyma may develop, this is a bulbous enlargement of the nose.
Function and Structure of normal blood vessels in facial skin
Blood vessels deliver oxygen and nutrients to the skin, as well as remove waste generated from skin cells. It is important to understand that blood vessels help regulate internal body temperature. When the body internal tempeture is high, blood flow will increase through the vessel to release heat from at the skins surface.
Vessels are made up of several layers, each of which serves a specific purpose. When discussing rosacea, we are most concerned with the middle layer which is composed of vascular smooth muscle cells, and the inner layer which is composed of endothelial cells.
The smooth cells, or the muscular layer of blood vessels serve to control blood flow through dilation and constriction. When the muscular layer contracts the blood vessel will become more narrow and decrease blood flow through the facial skin. The constriction of these vessels will cause the skin to be less red. When the muscle relaxes, the blood vessel dilates or becomes wider which will increase blood flow through the skin. The dilation of facial blood vessels will cause the skin to be more red.
The endothelial cells line the inside wall of blood vessels and release potent dilator substances. When these dilators are released they diffuse to the smooth muscles cells and cause the vascular muscle to relax or dilate. When the vessel dilates, blood flow to the skin increases causing flushing and redness.
Function and Structure of Rosacea Blood Vessels
Rosacea is primarily a facial vascular disorder in which blood vessels are functionally and structurally abnormal.
With rosacea there are functional changes that take place in vessels. The blood vessels in facial skin become hyper-responsive to internal and external stimuli. Vessels may dilate to a substance that normal blood vessels would not respond to. They may also dilate or open more widely than normal blood vessels, and stay open for an abnormally long time.
The structural changes of facial blood vessels, lead to the progression of rosacea.
– Blood vessels may become permantly dilated, this is known as telangiectasia or broken blood vessels
– The muscular layer of the vessels may be thin and damaged.
– The (endothelial cells) inner layer of vessels may be damaged and dysfunctional
– There may be an abnormal growth of new vessels
– Blood vessels may be closer to the surface of the skin
– Vessels may fuse together forming abnormally large vessels that can carry large vollumes of blood to the surface of the skin
Heat will cause blood vessels to dilate, allowing more blood to flow to the surface of the skin and causing facial flushing. Heat from both external and internal factors will cause facial flushing. In rosacea skin this reaction is exaggerated.
Although cold temperatures initially cause blood vessels to constrict, over an extended time the skin cells can become deprived from oxygen and nutrients, which can trigger the release of potent dilators. Flushing caused by cold temperatures are influenced by the how cold and for how long skin is exposed to the cold factor. For example cool air will cause less constriction than cold air and would not deprive skin of oxygen and nutrients in the same way cold air does. Cool air will not cause flushing, but cold air may.
Facial nerves play a major role in rosacea flushing. Many medical experts believe that rosacea is a neuro-vascular disorder, meaning that the facial nerves release dilators onto blood vessels which intern causes flushing.
Sympathetic nerves help regulate thermoregulatory flushing, this type of flushing helps reduce internal body temperature and serves to protect the brain from heat. If the internal body temperature is to high, the brain activates sympathetic nerves, which release neurotransmitter substances on to blood vessels, telling them to dilate and causing flushing.
Consumeing hot beverages and food, as well as exercise can activate sympathetic nerves. Even emotional stress, anger and embarrassment can trigger these nerves.
Parasympathetic nerves are partially responsible for flushing caused by certain foods, crying, facial movement, and even facial pain. It is important to note that even mild foods can cause flushing, and each person may find they respond to different triggers.
Sensory nerves release potent vascular dilators and are responsible for flushing caused by skin irritations, and environmental factors such as wind, heat and sun.
can penetrate the skin and activate sensory nerves, as well as creating heat in the skin causing facial flushing.
Clinical studies suggest that blood vessels are often the first structure encountered by free radicals and can be the hardest hit. Causing structural damage including weakening the vascular walls. In addition to the vascular damage, many free radicals are potent blood vessel dilators.
[ Read more about Free Radicals and Antioxidants]