CDA Expert Series | ACD Chronique des experts – Dr. Julia Carroll on Rosacea


(uplifting music) – I’m Dr. Julia Carroll
from Toronto, Ontario and I’m a Board Certified Dermatologist. Rosacea is a chronic
inflammatory condition. There are four different types of rosacea. The first one is erythematotelangiectatic, and this is the type of rosacea that’s mostly redness
and flushing of the face or broken blood vessels on the face. The second type is papulopustular rosacea, and in that type of rosacea
we tend to see bumps and whiteheads on the face, known as papules and pustules. The third type of rosacea is phymatous, and that’s the thickening of the skin that you can see on the
forehead, the nose, and the chin, most commonly on the nose. And the fourth type is ocular rosacea. So, that’s rosacea of the eye
where you may see some redness of the skin around the eyes. The eyes may feel a little bit gritty, sensitive to light, and sore. Even though there are
four types of rosacea, one person may have one, two, three, or even all four types of
rosacea at the same time. And you may have one type at one time and then another type at another, but that doesn’t mean
if you have the redness and the flushing that you
will necessarily progress through all the types of rosacea. People suffer from different combinations of the subtypes of rosacea. Over three million people
in Canada have rosacea. We usually see rosacea appearing between the ages of 30 and 50. You see it in both men and
women but for some reason we do tend to see it more in women. Rosacea tends to affect
people who are fair and often people who
have a Celtic background, but it can affect people
from any skin type. In terms of what causes rosacea, the short answer is we don’t know. However, as dermatologists we do know that environmental factors,
as well as genetics, who your family is, do play
into the presence of rosacea. Some of the things that trigger rosacea would include sun exposure. We also see when people go
from extremes of hot or cold that their rosacea can become worse. Exercise can also worsen rosacea. We also know that eating spicy foods or even eating or drinking products that are hot can flare rosacea. And for some patients they
find that mental stress can really be a big
trigger for their rosacea. For people who suffer with rosacea, one of the problems is
that it often feels worse than it actually looks. So, their skin may be sensitive and sore and that may be difficult
with them day-to-day. Also, they’re very sensitive
to different products so they find it hard to purchase things, to use products on their skin. And they just generally feel embarrassed because their skin is red, and they have what appear to
be breakouts on their skin, even though they’re adults aged
between 30 and 50 years old. So, some of the patients find that they’ll actually
forgo social activities or withdraw at work when
they’re having flares of their rosacea, so that can
be very stressful for people. There are a number of ways
that we treat rosacea. One of the most important
things is to remember that daily sunscreen use
can be very protective for rosacea prone skin. The second thing is
that as dermatologists, we prescribe topical creams for rosacea. So these might be antibiotic creams or they could be anti-inflammatory creams. And we also have topical
products that we put on that will temporarily reduce redness. If your rosacea is more severe, then as a dermatologist we
may offer oral, or a pill, so that may be antibiotics or it could be a product known as isotretinoin. And then in terms of the cosmetic or the very visible aspects of rosacea, people often are concerned about broken blood vessels on the face. So, for that we have various
lasers that we can use that will reduce the blood vessels and the background redness in the face. And then finally, I think
it’s always important to discuss the use of
camouflaging cosmetics, because sometimes we haven’t got the rosacea fully under control, or somebody’s having a flare, so it’s nice for them to
have options to be able to temporarily cover up
a flare so that they feel more confident going about their day. You may find that the
sensation of your skin, the tenderness, or the dryness, may improve quite quickly
within one or two weeks. But it sometimes takes a longer time, four, even six weeks to see
improvement in the breakouts or the bumps on the skin. So it is important when
you start an initial course of treatment that you really
give it six weeks or more to see the full benefits
of that treatment. (uplifting music)

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