rosacea
ROSACEA
Treatment Guideline Chart
Rosacea is a chronic inflammatory cutaneous disease of the convexities of the central face (cheeks, chin, nose and central forehead) and eyes with periorbital and perioral skin sparing. This condition is attributed to chronic vasodilation.
Remissions and exacerbations are common.
It typically begins after 30 years of age but may occur at any age.  It commonly affects fair-skinned individuals.
The common presenting symptoms are facial flushing, stinging/burning erythema, telangiectasia, edema, papules, pustules, ocular lesions, and hypertrophy of the sebaceous glands of the nose with fibrosis (rhinophyma).
A history of episodic flushing often heralds onset of rosacea.

Rosacea Patient Education

Patient Education

  • Patient should be informed that there is no cure for rosacea and that the available treatment options can only delay the progression of symptoms
    • The most important steps are to maintain skin integrity and to avoid precipitating and aggravating factors
  • Advise patient that instead of completely eradicating facial coloration, the goal is to normalize the skin tone and color to prevent a sallow appearance 
  • Educate on the regular use of sunscreens, proper skin care, and importance of follow-up for ocular symptoms
    • Patients with ocular features should use ultraviolet-coated sunglasses and practice lid/eyelash hygiene which includes warm compresses and dilute baby shampoo scrubs twice daily, application of lubricating eyedrops and meibomian gland expression
  • Consider a referral to:
    • A dermatologist if symptoms are more severe and acne are refractory to treatment
    • An ophthalmologist if patients with ocular rosacea have persistent or serious ocular symptoms, eg red eye, corneal ulceration, inflammation
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