Dr Christopher Ross explains how to manage rosacea in primary care. Learn more in the HealthCert Professional Diploma of General Dermatology program, fully online, at www.healthcert.com/dtl
So with rosacea there’s obviously a few different subtypes of rosacea so some patients can present with sort of erythropologic categorization which is more of redness or vessel change on the skin and treatment or management of that can be quite different to say papillopushula rosacea and then there’s ocularization granular militarization and neurogenic rosacea as
Well where they get burning and stinging so depending on how the patient presents and the types of rosacea they have is really about where we go from management of that for popular pasteurization which is one of the more common presenting complaints with rosacea is we typically do good gentle skin care that’s very important because if we use any products that are
A little bit harsh on the skin particularly things like retinoids or ahas it can really trigger off the rosacea for a lot of patients sunlight is a trigger and also spicy foods and alcohol as well if we want to manage popular pasteurization they’ve tried to get rid of all the potential triggers we’ll typically use some topical products starting off with something
Like topical metronidazole gel or cream and if that fails we can use things like azelaic acid or topical either mechan in a addition to this we can use oral agents so the first line oral agent if it’s safe to use is doxycycline or then minocycline however you have to be careful with that because if the patient is female and potentially pregnant we don’t want to be
Using it or if they’re breastfeeding we don’t need to use it as well then we have options of doing things like erythromycin orally with treatment resistant rosacea in terms of other systemic therapies we can use low-dose iso tretinoin as well if we’re looking more at the erythroat atlantic categorization that’s a little bit harder to manage because there’s limited
Options so there is a topical product out there called remonidine gel or movasso that can be used to constrict the vessels and reduce redness however it’s only transient and lasts for about 10 to 12 hours and some patients if they use it too frequently can experience a rebound effect so typically i would only get patients to use that for more special occasions rather
Than on a daily basis obviously for some people camouflage can be used so we can use tinted uh you know foundations moisturizers sunscreens to help cover up redness and the green based makeups are good to counteract redness as well further to that we can use vascular laser that’s the most commonly formed treatment for erythraxolactic categorization so any vascular
Laser can be used we use an nda glazer with lots of different vascular lasers that can be used and that usually requires anywhere between two to five treatments to get good results you can also pick up background erythema or redness with certain laser devices as well as well as track the vessels along if patients are experiencing flushing with the rosacea there are
A number of oral medications we can try for that as well including oral propranolol and oral carvedilol when patients have ocular rosacea that’s quite tricky to manage we can use oral doxycycline but sometimes referral to ophthalmology may be more interested in that setting so in terms of the general sort of measures general genital skin care is very important so
Obviously there’s a lot of product ranges out there but some product ranges are specifically designed for rosacea prone skin we often recommend products like avine la roche passe and bioderma specifically the rosacea prone range products there’s a number of additive things that can be used as well to calm down the skin so some antioxidant slags then can be three
From a product like the ordinary can be used as well and then general good skin care in terms of not using anything harsh on the skin so we don’t want to use any physical or chemical exfoliators and we want to not have too hot water because if the water is too hot it doesn’t make the condition worse but it makes it look worse so people get out of the showers up
And say oh the showers may be worse but actually the hot water has caused the vessels to dilate and make it look transiently more red which will often settle down about half an hour in terms of gps managing rosacea they can use or manage most of the changes in rosacea but i think if they’re treatment resistant or flaring or not responding to say topical and oral
Medication then that would be one reason to refer for potential use of something like oral isotretinoin as a low dose and also if they have that erythroat talented change because if they don’t have access to a vascular laser then that would be a good reason to refer on for such treatment
Transcribed from video
How to manage rosacea | Dr Christopher Ross By HealthCert Education
