Rosacea & Rhinophyma

Rosacea is a chronic inflammatory facial skin condition that may cause flushing, persistent redness, visible blood vessels and acne-like bumps. Treatment is individualised according to symptoms, subtype, triggers and medical history.

Types of Rosacea

Type 1: Flushing and persistent redness with visibly enlarged capillaries (telangiectasia). This type of rosacea is usually the least severe and may be accompanied by enlarged sweat glands, oiliness and/or dry and flaky skin. The skin may become sensitive with a burning and stinging effect when it comes into contact with make-up or facial creams, or with sun exposure and/or consumption of spicy food.

Type 2: Persistent redness with transient bumps and pimples is papular rosacea. Papular rosacea is usually seen on a background of flushing and persistent redness and is characterised by the formation of lumps, pimples and pustules.

Type 3: Eye irritation (ocular rosacea). Ocular rosacea is the term used to describe rosacea when it involves the eyes, typically causing redness and grittiness in the eyes. The eyelids may show redness and scaling.

Type 4: Skin thickening, often resulting in enlargement of the nose (rhinophyma). This sub-type of rosacea presents as overgrowth of the oil glands, usually on the nose and sometimes is associated with significant disfigurement.

Treating Rosacea

Treatment is tailored to symptoms and rosacea subtype. Identifying and reducing personal triggers may help lessen flushing and flare-ups.

Rosacea is also provoked by excessive sun exposure, which must be avoided with the use of a broad-spectrum sunscreen (SPF 50) and by wearing a wide-brimmed hat or generally remaining sheltered and avoiding extreme temperatures. (Exercise in a cool environment. Do not overheat and protect your skin from the cold and the wind).

Additionally, rosacea can worsen when exposed to abrasive scrubs. Because of skin sensitivity, topical skincare treatments should include soap-free cleansers, gentle emollients and light foundations. Mineral based make-up can be used and products to avoid are cosmetics and skincare products with toners, alcohol or irritating ingredients. Heavy foundations and cosmetics that are hard to remove, such as oil-based facial creams, are also not recommended. Under no circumstances should topical steroids be used to treat rosacea.

Flushing and persistent facial redness can be treated with laser or intense light based treatment. At the Skin Specialist Centre we have several different laser and light systems, each with its own specific benefits. Treatment is based on the individual requirements and our equipment includes Candela VBeam Perfecta pulse dye laser, Cutera Excel V+, Laser Genesis, Excel V+ vascular laser and Sciton BBL HERO light device. For papular rosacea the firstline treatment for this is systemic antibiotics, which are usually prescribed daily, often in conjunction with creams and gels. For ocular rosacea oral antibiotics can be useful and where they are not successful, referral to an ophthalmologist (eye specialist) is required.

Treating Rhinophyma

Rhinophyma is a form of severe rosacea, relatively common in the New Zealand male population. In most cases it develops in the late forties and worsens with time. Mild cases present as uneven lumps and bumps of tissue on the nose and in more severe cases, the nose and adjacent areas of the face show a thickened over-growth of tissue. Depending on the severity of the rhinophyma, we use a variety of methods to correct the deformity. Moderate deformity is treated with the fractional laser. This laser, aided by the skill of the specialist dermatologic surgeon, also re-shapes the nose, removing excess tissue with each pass.

Rhinophyma treatment aims to reduce excess tissue and improve nasal contour. The number of treatments and degree of improvement vary.

Rhinophyma can have physical and emotional effects. Recovery and time away from work vary. Insurance cover should be confirmed with your insurer.