rosacea
ROSACEA
Rosacea is a chronic cutaneous disease of the convexities of the central face (cheeks, chin, nose and central forehead) w/ periorbital and perioral skin sparing. This condition is attributed to chronic vasodilation.
Remissions and exacerbations are common.
It typically appears 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.
A history of episodic flushing often heralds onset of rosacea.

Surgical Intervention

Surgical/Laser and Light Therapy

  • Telangiectasias are best treated with light-based and laser therapies
  • Laser and light-based therapies are also used to manage facial erythema secondary to rosacea
  • Indicated in patients with clinically noninflamed phyma
  • Some reports show that moderate to severe rhinophyma respond well initially to surgical excision, electrocautery, cryosurgery or carbon dioxide-laser therapy
  • Side effects: Temporary bruising, redness, swelling, darker or lighter spots on the skin and scarring
  • Pulsed Dye Laser (PDL)
    • Targets the visible blood vessels and reduces flushing and erythema
    • Considered as one of the first-line modalities in patients with persistent erythema
    • Indicated in patients with telangiectasia
    • Improvement is not permanent and may cause some temporary bruising
  • Intense Pulsed Light Therapy (IPL)
    • Preferred for larger areas of diffuse redness and may improve flushing
    • Considered as one of the first-line modalities in patients with persistent erythema
    • Indicated in patients with telangiectasia
  • Potassium-titanyl Phosphate Laser (KTP)
    • Ideally used for linear, arborizing and discrete telangiectasia
  • Neodymium:Yttrium-Aluminum-Garnet (Nd:YAG) Laser
    • Efficacy found in the treatment of large deep vessels with blue tones
    • Used in the treatment of facial telangiectasia
  • Erbium Laser and Fractional Photothermolysis
    • Used to smoothen the nose in rhinophyma without significant removal of the top layer of skin
  • Dermabrasion
    • Surgical resurfacing technique to remove thickened skin 
  • Electrocautery
    • The top layers of excess skin are scraped off using the hot tip of an electrode
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