Treatment of Rosacea in Indianapolis

Rosacea is an incredibly common skin condition, affecting an extimated 14 million Americans. It affects women about three times as often as men and appears most commonly as flushing and red blotches on the cheeks and nose as well as the chin and forehead. In more advanced cases, tiny pimple-like bumps and small discrete blood vessels appear as well. Eventually if the condition progresses, the skin will thicken and raise creating a coarse texture. Not every patient actually moves beyond the red discoloration or 'slap face' appearance and there is no predicting whether rosacea will become progressive in any patient. In fact, no one knows what causes rosacea or how to prevent it. And there is no single theory of causation that is universally agreed on. ( inflammatory proteins vs. microscopic mites in the hair follicles) While rosacea can appear in anyone, it is more common in fair-skinned middle-aged (30 to 50) individuals.
Prevention of flaring in rosacea is important. There are some established triggers to rosacea and include sun exposure, emotional stress, hot weather, excessive exercise, alcohol and spicy foods which top the list. To those afflicted, avoidance of these situations when possible requires simple behavior modification.
Actual treatment of rosacea includes a variety of topical and oral medications as well as light and laser therapies. At Ology, we see a fair number of rosacea patients. Many have been on topical creams and oral antibiotics as a first-line approach with their dermatologist. When these fail, our approach has been to use pulsed light for generalized redness and the 1064nm wavelength laser for specific telangectasias or spider veins. Our version of pulsed light is broad band light (BBL) using either 560 or 590nm filters. This requires a series of treatments using different energy levels and depth of light penentration. Usually it takes a series of trials varying the fluence and milliseconds to find a good combination for each specific patient. That is why it takes multiple treatments and good patience on both sides for a BBL treatment program that may work. In some cases we will combine BBL treatments with athome topical niacin cream. (NIA 24) It would seem contradictory that a topical agent that causes flushing would be helpful, but it seems to work in some cases.
While not every patient seen can get great results, our experience with light and laser therapies for the problematic and very symptomatic rosacea patient offers hope for a skin condition that frequently defies standard medical treatments.
Dr. Barry Eppley
http://www.eppleyplasticsurgery.com
http://www/ologymd.com
Clarian North Medical Center, Carmel, Indiana
Clarian West Medical Center, Avon, Indiana
Indianapolis