Conditions

Rosacea a chronic skin disease, the cause is still unknown and there is no known cure.It is often mistaken for acne and has even been given the name acne rosacea due to its resemblance with acne spots, but it is a different entity altogether.Rosacea is a rash commonly found on the central part of the face that tends to appear between the ages of 30-50. In the UK it affects 1 in 10  people, women are more than likely than men to have this condition. It is an uncomfortable skin condition as it causes burning pain and itching. Most people with rosacea find it embarrassing and it can lower a person’s self-esteem. Sometimes people get asked why they are getting acne in their 40s!. When the eyes are affected this can cause problems with vision.

Causes

The exact cause of rosacea is unknown although genetics and a type of mite called demodex have been implicated in Rosacea.There are also a number of triggers that have been identified that might exacerbate the condition:

Sunlight exposure – stress – excessive exercise – extreme weather – drinks that are hot are contain alcohol and caffeine.

Symptoms include a tendency to flush easily ifollowed by persistent redness on the cheeks, chin, forehead and nose, and by crops of small inflamed red bumps and pus spots.

There are four tyoes or substypes of rosacea, these are also known as:

• ETR (erythematotelangiectatic rosacea)- in this type the skin is red or flushed due to multiple small veins/capillaries on the skin.UV light can be a trigger and so is spicy food and alcohol.

• Papulopustular- this is the typical type where red and white spots come and go on the skin in the background of some redness. Sufferers complain of stinging and burning when it flares. Although it can be severe and  very uncomfortable and embarrassing it is the type that responds to treatment the best.

• Rhinophyma- The nose is affected with an overgrowth of skin, vessels and oil glands causing enlargmenent and distortion of the nose.

• Ocular rosacea- It’s the eyes that are affected in this type of rosacea with irritation of the eyelids (blepharitis) or the eyes themselves (conjunctivitis). This causes irritable gritty eyes.

Treatment  

There is no permanent treatment for rosacea but with the right tailored treatment the condition can go away for a period of time or be kept at bay and not affect the person’s quality of life.

The severity and type of rosacea determine the best treatment options. These include:

Rosacea specific creams- containing azelaic acid, topical antibiotics and topical ivermectin

 oral antibiotics - tetracyclines can be very effective when used intermittently 

 oral retinoids- isotretinoin (Roaccutane) is used to treat both acne and rosacea

laser treatment and surgery. 

Finding and avoiding the triggers for rosacea can help also. Having a good skin care regime and using products that are suitable in rosacea also plays its role. We  will cover all aspects of this treatment with you and choose the right one for you.

The skin is the largest organ in the body. It covers every inch of us and is our armour against the world. Unlike many other conditions, those that affect the skin can be very visible. Trying to cover them up often causes more harm than good. The situation for sufferers can sometimes feel hopeless as, for conditions like eczema, there is no cure.

However, no cure doesn’t mean no hope. It is possible to effectively manage conditions through obtaining a clear diagnosis and understanding the factors that might aggravate it. Seeking expert advice and finding the most effective treatment can put the sufferer back in control, giving them the power to manage their own body and appearance. This is essential for maintaining a positive outlook and supporting their mental health.

Through my many years of working with patients I have gained a deep understanding of the problems that eczema causes and seen first-hand the extensive and long-lasting impact it can have on sufferers and their families.  Many of the patients that I meet have endured years of discomfort and often found it difficult to find the right support. Sadly, this is an area that many GPs aren’t specialists in, and they can lack the knowledge and expertise to provide patients with correct treatments. They can also underestimate the impact the condition can have on day-to-day living and the mental wellbeing of patients, failing to refer them on for specialist help. Even if they do make a referral, there are often long waiting lists to see a dermatologist and this delay can be agonising for those that need help.

Although we cannot cure eczema, we can help identify what triggers a flare up in the condition, so patients know what to avoid. There are various effective treatments that can be used that will help keep the condition in check. These treatments are suitable for all types of eczema and they include:

Emollients - these are moisturising creams and are important in repairing the skin barrier and reducing itching. The choice of emollient that is appropriate to the patient will vary depending on the type and severity of their eczema.

Steroid creams and ointments – these are the cornerstone of any treatment regime. Although they have some potential side-effects, careful selection of the type and strength together with appropriate use advised by a dermatologist makes them very safe and effective treatments.

Steroid ointment alternatives - in some case alternatives to steroid creams are more suited for certain patients. These can only be prescribed by doctors who specialise in the treatment of eczema.

Systemic Tablets – these are used when dealing with more severe forms of eczema and normally require monitoring by a specialist to ensure they have the desired effects without causing any complications.

Light therapy – this is offered only by the NHS and can be very effective for some patients.

Antihistamines - These can benefit some but not all patients as eczema is not a histamine-driven problem. 

Patients who have the most common type of eczema, atopic eczema often suffer from allergies too, like hay fever, so controlling these can help them be in a better position to deal with their eczema.

There is something that can be done to make life easier for anyone living with any type of eczema. There is no need for anyone to suffer in silence. If you’re finding it difficult to find the right treatment for your eczema and you’d like some expert advice, I’m here to help.