Written By: Erin Storm, PA-C
The Skinny
Rosacea is a relatively common skin condition, but that doesn’t make it less of a hassle for those experiencing daily facial redness and flushing. There’s no definitive cause of rosacea, but there are strong correlations to family history, diet (like spicy foods and hot drinks), alcohol use, smoking, hot baths, mediations, and cosmetics. Most cases of rosacea are seen in middle aged women with fair skin (learn more in our complete guide to Rosacea Concerns). For those who have tried lifestyle modifications and home remedies, and are still frustrated by persistent facial redness, a professional procedure can help get you closer to clearer skin.
The Specifics
Who needs treatment for rosacea?
Rosacea can be temporary or permanent, and typically follows a waxing and waning pattern with flare ups. The redness is caused by dilated blood vessels under the skin surface. Some forms of rosacea have accompanying sebaceous (oil) gland dysfunction that causes pustule formation.Less common causes of rosacea include, an immune system reaction to the bacteria bacillus oleronius, an intestinal infection caused by h. pylori bacteria, and demodex mites (which we actually all have living on our skin).
When the flushed red skin of rosacea is accompanied by changes in skin texture, like bumpiness and roughness, a more severe form of rosacea may be present. The American Academy of Dermatology has categorized four types of rosacea:
- Erythematotelangiectatic Rosacea: The most basic form of rosacea, characterized by redness, flushing, and visible blood vessels.
- Papulopustular Rosacea: Facial redness plus pustules. Often confused with acne.
- Phymatous Rosacea: A variant of rosacea causing thickened, bumpy skin texture.
- Ocular Rosacea: A more severe form of rosacea which causes red and irritated eyes along with swollen eyelids. In some cases, if left untreated this can cause permanent eye problems.
Those with symptoms consistent with papulopustular or phymatous rosacea will most likely need professional interventions in addition to home care to manage their skin condition. Ocular rosacea, which causes eye inflammation may require prescription medication, such as an antibiotic.
What can you expect from treatment for rosacea?
The first step in rosacea treatment is determining what triggers flare-ups. Rosacea typically worsens when exposed to the sun, after eating spicy foods or drinking hot drinks, under stressful or emotional situations that raise your blood pressure, taking hot baths, and certain medications or cosmetics. Knowing what causes your rosacea flare ups can help with mitigating the severity. General skincare advice, like limiting sun exposure, applying sunscreen, and using products specially formulated for rosacea patients will also help.When at home care isn’t cutting it, a professional cosmetic procedure can provide significant benefit. Laser Skin Resurfacing is a versatile option for treating different forms of rosacea. Gels and creams can help clear the pustules seen in papulopustular rosacea. Isotretinoin is a daily oral medication to treat cases of papulopustular and phymatous rosacea. Of note, in some severe cases the thick skin caused by phymatous rosacea may require surgical intervention.
In the case of ocular rosacea it is important to consult a medical provider when taking prescribed medication and eye drops to ensure appropriate treatment, and avoid future eye problems.
When should you seek treatment for rosacea?
The decision to pursue treatment is usually dependent on individual patient preferences, and the severity of their symptoms. For some men and women, home care and lifestyle changes are sufficient to control their rosacea.In more stubborn or severe cases, professional interventions may be necessary to reduce facial redness, prevent pustules, and limit changes to skin texture. For any concerns related to the eye, always consult with a medical provider to ensure you are receiving appropriate treatment.
Why should you seek treatment for rosacea?
The decision to pursue treatment for rosacea is unique to each individual. For those desiring a clearer, more uniform facial skin aesthetic, professional treatments can provide a significant and lasting result. For cases of severe rosacea, the impact on quality of life can be frustrating and upsetting, which may be a motivating factor in pursuing a treatment. Regardless of your motivation, pursuing professional rosacea interventions can significantly reduce your symptoms.Cosmetic Procedures to Treat Rosacea
These procedures are typically performed under the guidance and/or care of a plastic surgeon, dermatologist, or other medical provider. They are designed to reduce the redness, thick skin, pustules, and bumps caused by rosacea.Laser Therapy
- Non-Ablative Non-Fractional Laser Skin Resurfacing
- Overview: Similar process to ablative skin resurfacing, but less aggressive.
- Cost: $1,000 - $1,150
- Recovery & Results: Less side effects and recovery time than an ablative procedure. Multiple sessions will be needed and the results are temporary.
- Non-Ablative Fractional Laser Skin Resurfacing
- Overview: Same as non-fractional, however, fractional means therapy is targeted to specific areas.
- Cost: $1,000 - $1,150
- Recovery & Results: Skin will feel raw, red, and irritated for about two weeks. The results are temporary and require multiple treatments.
- Ablative Non-Fractional Laser Skin Resurfacing
- Overview: The most intense laser therapy that is used over a wide area of skin. Microdamage stimulates the body’s healing processes.
- Cost: $2,000 - $2,500
- Recovery & Results: Redness, flaking, and irritation for a few days. The results are temporary.
- Ablative Fractional Laser Skin Resurfacing
- Overview: The fractional aspect means the therapy is targeted to a specific area.
- Cost: $2,000 - $2,500
- Recovery & Results: Skin will be raw and flaky for a week or two. The results are temporary.
- Intense Pulsed Light (IPL)
- Overview: This laser treatment uses heat therapy to collapse the visible, small blood vessels that cause redness.
- Cost: From $500
- Recovery & Results: Some mild irritation, stinging, and redness for a few days. The results can last for years.
Chemical Peels
- Superficial Chemical Peels
- Overview: This gentle peel stays at the top most skin layers.
- Cost: $3,000 - $6,000
- Recovery & Results: Slight redness and irritation for a day. The results are temporary.
- Glycolic Peel
- Overview: A peel utilizing tha alpha hydroxy acid (AHA), glycolic acid, as its base.
- Cost: $200 - $600
- Recovery & Results: Some mild irritation. The results are temporary.
- Salicylic Acid Peel
- Overview: A common peel that can vary in intensity depending on the concentrations of the beta hydroxy acid (BHA), salicylic acid.
- Cost: $100 - $300
- Recovery & Results: Minor irritation for about two days. Multiple treatments and maintenance are required.
- Medium Depth Chemical Peel
- Overview: Unlike superficial chemical peels, medium peels provide a deeper exfoliation.
- Cost: $200 - $2,000
- Recovery & Results: Skin begins to shed and flake off for around three to 10 days after treatment, and additional treatments may be needed in the future to maintain results.
- Jessner's Peel
- Overview: Salicylic acid, lactic acid, and resorcinol combine for a medium depth chemical exfoliation.
- Cost: $300 - $1,000
- Recovery & Results: Irritation, flaking, and redness for up to two weeks. The results are temporary.
- Antibiotics
- Overview: Typically prescribed by a dermatologist for semi regular use to control severe forms or flares. Not for consistent use.
- Cost: dependent on insurance
- Recovery & Results: Temporary solution that will need to be augmented by treatments that can be utilized regularly.
Facials
- Hydrafacial
- Overview: Cleansing, extracting, and skincare are combined for an effective exfoliating treatment that also nourishes and hydrates the complexion.
- Cost: $150 - $300
- Recovery & Results: Results are immediate, but consistent treatments are required for maintenance.
- SilkPeel Facial
- Overview: A custom serum is applied to the skin while a gentle vacuum is used for light exfoliation to open the pores.
- Cost: $100 - $450
- Recovery & Results: Minimal redness and irritation. Multiple treatments may be needed.
Light Therapy
- LED Light Therapy
- Overview: LED Lights at different colors, depths, and wavelengths penetrate skin layers to clear blemishes and lesions.
- Cost: $25 -$250
- Recovery & Results: Little to no side effects. Results maintained with consistent use.
The Takeaway
The facial redness, sensitive skin, and constant flare ups of rosacea can be frustrating If you’ve attempted to determine your triggers, have changed up your skincare routine, and still find yourself dealing with rosacea, a professional treatment can provide the next steps in management and get you closer to clearer skin.
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