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New help for Rosacea sufferers
Untangle the misinformation
CHICAGO, IL May 20, 2009
We can barely pronounce Rosacea without asking the experts (roe-ZAY-sheh), let alone untangle all the misinformation surrounding this chronic, inflammatory skin condition.

So when we heard about Oracea, a new drug that treats one of the three Rosacea symptom types, we called on Dr. Hilary Baldwin, a New York dermatologist and the former President of the American Acne and Rosacea Society.

The three primary symptoms of this inflammatory skin condition, which affects an estimated 14 million people in the U.S., include facial flushing, breakouts and eye problems. You can experience one, two or all of these symptoms, although there’s no evidence that the symptoms are progressive (i.e., that they move from one type of symptom to the second or third). Once your Rosacea type define itself, it can worsen over time without treatment.

"Oracea represents a big treatment success for people with the type of Rosacea that causes breakouts," says Dr. Baldwin. Oracea is not a cure for Rosacea, which will return when you stop taking the pill. But Dr. Baldwin says it works faster and in a more predictable way for a higher percentage of patients than Metro-Gel (metronidazole) and Finacea (azelaic acid). Those topical solutions can be effective, but for those people who don’t achieve desired results from the solutions, Oracea is a welcome addition.

Because Rosacea breakouts look so much like acne--including white bumps (which doctors call papules) and red pimples (or pustules)--this condition was long called “Acne Rosacea.” In the past and today, many people mistakenly think their Rosacea is just a case of adult acne that won't budge.

Doctors don't know the cause of Rosacea--but they suspect it’s a combination of inflammatory proteins and peptides in the skin. In other words, it’s not bacteria. “We know now that acne and Rosacea are two totally different diseases,” says Dr. Baldwin. “And therefore, they need to be treated differently."

Oracea contains a dose of Doxycyclene that has an anti-inflammatory, but not an antimicrobial, effect. Because it doesn’t kill bacteria, it doesn’t create bacterial resistance, as would an antibiotic. Therefore, it can be used safely for long-term treatment. Dr. Baldwin typically prescribes the pill first, plus or minus a topical solution. "If patients decide they don’t want to be on pills, we can try the topical solutions and see how they work. But the oral and topical treatments are equally safe."


A breakdown of Rosacea symptoms:
  • Facial flushing, which can sometimes be traced to certain triggers--like extreme weather, exercise or spicy foods--but can also be unpredictable.
  • Persistent redness in the center of the face.
  • Unpredictable flare-ups of red pimples and/or white bumps.
  • A burning or stinging feeling on the face.
  • Swelling at the center of the face.
  • Eye problems, such as burning, itching and watery eyes, as well as swollen eyelids.
  • Bumps on the nose, which may develop if left untreated

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A word on facial flushing

The facial flushing of Rosacea happens when small, close-to-the-surface blood vessels dilate. It's often unpredictable, although some people can trace their flushing back to spicy foods, extreme weather and even exercise. It starts as transient redness, but can become permanent over time. And many people who experience the facial flushing of Rosacea complain of sensitive skin.

Though there's not much in the way of pharmacotherapy for this type of Rosacea, Dr. Baldwin is optimistic about a "vaso-constrictor" product that's currently in Phase II trials. If it's approved (we'll keep you posted), the prescription solution will help keep disobedient blood vessels in check.

Baldwin also recommends meeting with a doctor to discuss laser treatment options. But "doctor" is the key word. "There are a lot of lasers out there," says Dr. Baldwin. "And a lot of places offering laser therapies. I want to emphasize how important it is that the person who is doing the consultation and the laser treatment be a doctor. This is not the time to decide you're going to try out the cosmetologist down the street."


The truth about Rosacea: Breaking through the myths. This myth-busting list straightens out Rosasea fact from Rosasea falsehood.

False: Rosacea strikes only people with fair skin, like Swedes and Poles.

Fact: While darker skin might mask the symptom type of flushing and therefore make it harder to diagnose, people of color are just as likely to have Rosacea.

False: Rosacea is the result of drinking too much alcohol.

Fact: Rosacea doesn't care what you imbibe. It affects drinkers and teetotalers alike.

False: People who suffered through acne in their teenaged years will suffer through Rosacea as an adult.

Fact:  If that were true, it would be hard to find an adult without Rosacea. There's just no evidence to support a link between teenage acne and Rosacea.

Potentially False: Rosacea is hereditary.

Fact: Actually, the verdict isn't out on that yet. Some studies have pointed to heredity, but, as Dr. Baldwin and others see it, the results are inconclusive.

-TM

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