Rosacea subtype 1 (erythematotelangiectatic rosacea), that causes facial flushing and redness, can be difficult to treat with medical therapy.
A story in the summer issue of the Rosacea Review from the National Rosacea Society described rosacea subtype 1 as being characterized by flushing and persistent redness of the central face, that often occurs before or at the same time as the bumps and pimples of rosacea subtype 2 (papulopustular rosacea). Visible blood vessels may also be present, and in many cases the skin may be irritated and unusually sensitive.
According to dermatologist Dr. Jonathan Wilkin, Chairman of the NRS medical advisory board, identifying and avoiding lifestyle and environmental factors that trigger rosacea symptoms in individual cases can be especially effective in controlling the flushing and redness of (rosacea) subtype 1.
Standard management of rosacea subtype 1 involves the tracking of rosacea triggers with the assistance of a rosacea diary, and the ongoing avoidance of those triggers. Those with rosacea often have extremely sensitive skin, making it essential to select skin care products that do not irritate the skin. This may include using non-soap cleansers, washing with lukewarm water, and gently dabbing the skin dry with a soft towel rather than rubbing the skin to minimize irritation. The use of green or yellow cosmetics can also be used to counteract visible redness, and cover makeup may be used to conceal visible blood vessels and other signs of rosacea.
The visible blood vessels and persistent redness may be effectively treated with laser or intense pulsed light (IPL) therapy.
Dr. Wilkin added that, unlike with the red bumps and pimples of subtype 2 that may be treated with topical medications (Clenia, MetroGel, Finacea) and/or oral medications (Oracea), no drugs have been approved by the U.S. FDA to treat the persistent redness of rosacea subtype 1.
However, the use of certain medications can reduce some symptoms. For instance, aspirin, NSAIDs, antihistamines, and other medications may be prescribed to help reduce flushing caused by other triggers, such as alcohol or niacin.
In addition, beta-blockers (propranolol), normally used to control high blood pressure, may be prescribed to reduce flushing associated with emotional stress.
There has also been interest in the use of nasal decongestants, such as Afrin, on the skin to reduce redness.
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