Jeffrey C. Poole, M.D., Dermatologist
Dermatologist Jeffrey C. Poole, M.D. provides an overview of rosacea treatment options and describes how they are shaped by the type of rosacea.
“Erythrotelangiectatic rosacea (rosacea subtype 1) may be the initial phase of rosacea for many people. Patients are red, flush easily from various stimuli such as alcohol, caffeine or temperature changes. Sun protection is key to prevent long term progression of this stage, which may progress. Coverup makeups can be used, and the newer mineral makeups seem to work well and are non-irritating”, says Dr. Poole.
Dr. Poole adds that for rosacea subtype 1, “the best treatment is the Pulsed Dye Laser (PDL) or intense pulsed light (IPL). These lasers and light sources target the blood vessels that are the cause of this condition. Generally 3-4 treatments are sufficient for excellent results.”
Dr. Poole points out that most of the prescription medications for rosacea target papulopustular rosacea (rosacea subtype 2). Topical medications (metronidazole and azelaic acid) and oral medicines, such as doxcycycline (Oracea) and minocycline, are very effective in decreasing the red pimples and bumps. Long-term use of rosacea medications is the rule, and flares tend to recur as rosacea medications are weaned. Dr. Poole added that “pulsed dye laser treatment may improve rosacea subtype 2 symptoms and decrease the frequency of flares.”
Rhinophyma, seen with rosacea subtype 3, generally only occurs with men and less commonly than a few generations ago. Treatment of rhinophyma can be with ablative lasers such as the CO2 laser, or with an electrocautery unit. Dr. Poole stated that “Many patients find improvement in their sleep and less snoring, as well as a improved cosmetic appearance, with treatment.”
Dr. Poole is a board certified dermatologist in Metairie, Louisiana. In addition to his private dermatology practice, Poole Dermatology, Dr. Poole is also an Assistant Clinical Professor of Dermatology at both the LSU and Tulane Schools of Medicine, acting as their Pediatric and Adolescent specialist, and remains a board-certified pediatrician. He is a Fellow of the American Academy of Dermatology, the American Society of Dermatologic Surgery, the American Society of Laser Medicine and Surgery and the Society for Pediatric Dermatology.
Will staying out of the sun or using sunblocks help reduce the appearance of rosacea?
Sun exposure is the most commonly reported trigger of a rosacea flare. 81% of respondents to a survey by the National Rosacea Society stated that sun exposure leads to a worsening of their rosacea symptoms. (See other rosacea triggers at http://www.rosacea.org/patients/materials/triggersgraph.php.)
So staying out of the sun helps to prevents a flare. However, sun avoidance alone does not make the rosacea go away. Other treatments are necessary to bring rosacea under control.
Thanks Dr. Mark.
Is there a limit to how long you can conyinually use a drug like Oracea?
Sounds like the laser is the answer. Sounds better and simpler than staying on medications.