Medical Services - Rosacea

Rosacea is a common and chronic inflammatory skin disorder which typically affects the face. Dermatology and Laser Institute of Colorado is a referral center for patients with rosacea from Lone Tree, Highlands Ranch, Castle Rock, Parker, Littleton, Centennial, Denver, and surrounding areas. Rosacea is typically seen in adults older than 30 and is more common in people with fair skin. The exact cause for rosacea is unknown. Some evidence links rosacea to an overabundance of Demodex mites on the skin although a causal link is unproven.

Rosacea typically affects the central part of the face, especially the cheeks, nose, chin, and forehead. Rosacea can affect the skin in several different ways. It often causes flushing and redness of the central face along with visible red blood vessels. The redness is usually episodic at first but may become permanent over time. Triggers for facial flushing may include emotional stress, hot drinks, alcohol, spicy foods, exercise, cold or hot weather, and hot water.

Patients with rosacea also commonly experience bouts of acne-like inflammation with red papules (bumps) and pustules visible on the skin. This is known as papulopustular rosacea. Long-term, rosacea can rarely lead to chronic edema (swelling) of the skin and an enlargement of the nose known as rhinophyma. Rosacea can also cause eye problems such as blepharitis and conjunctivitis.

Treatment

While there is no cure for rosacea, effective treatment does exist. Because rosacea can cause varied changes in the skin, treatment must be tailored to the individual.

Topical therapy

Several topical therapies are commonly used to treat rosacea. Metrogel^® (metronidazole) and Finacea^® can help to control papulopustular rosacea. A newer topical called Soolantra^® can help improve inflammatory rosacea by targeting the Demodex mite. Another topical called Mirvaso^® can give temporary control of facial redness by causing vasoconstriction of blood vessels. It is important to avoid using topical steroid creams on the face since they can worsen rosacea.

Oral medicine

Oral antibiotics such as doxycycline and minocycline have been used for many years to control papulopustular rosacea. While this is often effective, there is concern that long-term use of oral antibiotics can cause side effects such as the development of bacterial resistance. A newer approach is to use a low dose formulation of doxycycline such as Oracea^® (sub-antimicrobial dosing). It is believed that this low dose of doxycycline does not target bacteria but instead improves rosacea through its anti-inflammatory properties.

Patients who suffer from episodic flushing or redness may benefit from an oral beta-blocker. Beta-blockers are thought to help with flushing by blocking the beta receptors on the smooth muscles of blood vessels, causing vasoconstriction. Carvedilol is a newer beta-blocker with antioxidant and anti-inflammatory properties which has been used successfully to control flushing.

Laser

Dr. Ort specializes in the use of lasers to treat facial redness, flushing, and visible blood vessels. He has treated thousands of patients with lasers since 1998.

Dr. Ort has extensive experience with the pulsed dye laser (PDL) which is considered the gold standard laser for vascular (blood vessel) conditions. He currently utilizes the advanced Cynergy^® pulsed dye laser, combined with cold air cooling, to protect the skin and minimize patient discomfort. Multiple treatment sessions are usually required for best results. It is important to note that PDL treatment typically causes temporary but visible purpura or bruising of the skin which can take a few days to resolve.

BBL^™ BroadBand light is another common treatment that we use to treat rosacea. BBL^™ utilizes a broad-spectrum of light to target redness and blood vessels. Skin cooling is provided through an ice-cold sapphire tip that is placed in contact with the skin. BBL^™ is an excellent treatment for sun damage because it also targets pigmentation and brown spots in the skin. Unlike pulsed dye laser, BBL^™ does not typically produce bruising so patient recovery after treatment is easier.

Another laser that we find very useful is the Varilite^™ laser. This laser uses a tiny spot size to trace out individual blood vessels such as those commonly found on the nose, cheeks, and nose. A special magnified/ polarized headlamp allows us to see blood vessels up close. Blood vessels treated with this laser typically disappear in front of our eyes, which is nothing short of amazing!

We also utilize the long-pulsed Nd:YAG laser to treat larger blue veins which are commonly found under and around the eyes. We are one of the few centers in the country who treat these types of veins. Special precautions are necessary to protect the eyes during this treatment. We have had excellent results treating blue veins around the eyes with this laser.

Please note: If you are planning to schedule any laser treatment, we strongly recommend that you avoid getting a tan prior to treatment. Wear a broad-spectrum sunscreen and protect your skin from the sun. We reserve the right to cancel any scheduled laser treatment due to excessive sun exposure and the presence of a tan.