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Rosacea: Cause, Triggers and Treatment

Contact Author Mindy Goldstein, PhD, Estee Lauder and Eric Bernstein, MD, University of Pennsylvania
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From the column editor: Rosacea is a common but little-known disorder of the facial skin that affects an estimated 14 million Americans. In fact, rosacea is becoming increasingly widespread as the baby boomer generation enters the most susceptible ages for its development. Typically, the condition begins any time after the age of 30 and is expressed as redness that may come and go on the cheeks, nose, chin or forehead. The disease is more frequently diagnosed in women; however, more severe symptoms tend to be seen in men that could result from a delay in seeking medical attention until the disorder reaches advanced stages. While the cause of rosacea is unknown and there is no known cure, medical treatments are available to help control the signs and symptoms of this potentially life-disruptive disorder. For example, oral and topical medications may be prescribed to treat the bumps, pimples and redness often associated with the disorder. Dermatologists usually prescribe an initial treatment with oral antibiotics and topical therapy to control the condition more immediately, followed by long-term use of the topical therapy alone to maintain remission. When appropriate, treatments with lasers, intense pulsed light sources or other medical and surgical devices may be used to remove visible blood vessels, reduce extensive redness or correct disfigurement of the nose. Cosmetic dermatology is a growing area and many companies are formulating creams to be used with the medical treatments that patients receive. In addition, the industry is moving toward the development of home devices for personal use. This month, “Tech Edge” welcomes Eric F. Bernstein, MD, who currently serves as clinical associate professor of dermatology at the University of Pennsylvania, to present an overview of rosacea and how it can be treated through laser therapy. Bernstein is a distinguished practitioner, researcher and innovator in the fields of dermatology and laser surgery. He earned his bachelor of science degree from Duke University, medical degree from the Yale University School of Medicine, and materials science and engineering degree in management of technology from the engineering school at the University of Pennsylvania, co-administered by the Wharton School. After fellowships with the National Cancer Institute at the National Institutes of Health and Drexel University, Bernstein joined Jefferson Medical College, where he directed a photobiology laboratory and served as the first director of the laser surgery center. His research on a molecular model of skin photoaging led to the development of his own firm, DakDak LLC, which performs in vitro phototoxicology testing for large pharmaceutical companies and pursues the discovery of novel antiaging and pharmaceutical compounds. Bernstein also sits on the boards of, and consults with, numerous biotechnology and cosmetic firms.

—Mindy Goldstein, PhD

Rosacea is a skin condition characterized by broken (extra) blood vessels on the face, flushing and blushing of facial skin, and by acne-like bumps that occur on the cheeks, nose and chin.These bumps are primarily located around the mouth. In addition, rosacea can affect the eyes, causing irritation that is sometimes severe.

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In searching for the causes of rosacea, experts have identified one hint: rosacea affects predominantly sun-exposed sites.4 Beyond distribution on the face where the sun typically shines, rosacea has been identified as occurring predominantly on the side of an individual’s face nearest the window of their vehicle. For example, in the United States, drivers tend to have more veins on the left side of their face, while passengers have more veins on the right side. Although the glass blocks UVB radiation, it allows 71% of UVA to transmit through. Thus, many patients challenged by rosacea exhibit a significant asymmetry of veins on their faces.

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