• acne
• acne scarring
• birthmarks - brown
• birthmarks - port wine stains (red)
• facial volume loss
• fat deposit reduction
• gynaecomastia / man boobs
• hand rejuvenation
• injectable lip enhancement
• keloid / hypertrophic scarring
• laser hair removal
• laser tattoo removal
• leg veins / spider veins
• neck rejuvenation
• non surgical facial shaping
• rosacea and facial capillaries/redness
• skin analysis
• skin pigmentation
• sweating - excessive
• wrinkles

• anaesthesia/analgesia for procedures
• anti-wrinkle injections
• chemical peels
• dermal fillers
• laser - apogee
• laser - gemini
• laser - medlite
• laser - ruby
• lipodissolve
• make-up - dermacolour
• make-up - glo minerals
• microdermabrasion
• photodynamic therapy
• plasma skin regeneration
• retinoids - topical
• sclerotherapy
• skin care - asap
• skin care - cosmedix
• skin care - rationale
• skin needling

Rosacea, Facial Capillaries, & Redness

What is rosacea?

Rosacea is a condition that is characterised by facial redness - especially around the nose, cheeks, chin and in between the brow. People with this condition are consistently red or flush easily. Broken facial capillaries and acne-like pustules on the face are also a common consequence of having rosacea. Other signs of rosacea include; bloodshot or watery eyes, burning/stinging sensations on the face, and sensitive skin. It is a common condition that affects approximately 1 in 20 people.

What causes rosacea?

The exact cause of rosacea is unknown. Exposure to certain climates, radiation (including UV radiation) resulting in vessel wall abnormalities may play a role in the development of the disease.  Previously, it was believed that Helicobacter pylori, the bacteria that causes stomach ulcers, was involved, however more recent studies show that it may be caused by a mite called Demodex folliculorum.

How is rosacea treated?

The first step in the treatment of rosacea is to avoid any triggers that may exacerbate the condition. Common triggers of rosacea include; certain foods including liver, yogurt, cheese, and spicy/chilli foods, direct sunlight, extremes of weather, alcohol, hot drinks, stress, heavy physical exercise, and hot flushes/menopause.

Particular skin care regimes may also exacerbate rosacea, especially those containing alcohol (e.g. in toners), topical steroids (can help initially, but in the long-term will exacerbate rosacea), and any skin care that irritates the skin. Changing your skin care or avoidance of certain skin care chemicals may be advisable.

The use of non-irritating sunscreens is important. Physical sunscreens with titanium dioxide or zinc oxide tend to irritate skin less than chemical sunscreens. Titanium dioxide and zinc oxide do not enter the skin and are not absorbed by the body, as opposed to chemical sunscreens that are absorbed by the body and skin and increasing the potential for skin irritation and exacerbation of rosacea.

Using skin care with anti-inflammatory ingredients is appropriate in the treatment of rosacea. These include; aloe vera, arnica, calendula, chamomile, cucumber, provitamin B5, feverfew, green tea, licochalone, perilla leaf extract, red algae, red clover, thyme, willow herb, and zinc. Mineral make-up, such as Glo-minerals that contain these anti-inflammatory agents can also help. In addition, they do not tend to enter the skin and exacerbate rosacea.

The aforementioned treatments are the mainstay of topical rosacea treatment. Other topical treatments that are less commonly used, but have found to be effective in some resistant cases are; topical retinoids, and anti-parasitic agents. Studies have shown a significant reduction in inflammatory lesions when compared to topical metronidazole, but none of the improvement in redness and broken capillaries that is seen with topical metronidazole. The main concern with the use of topical retinoids in rosacea is that they can irritate the skin. Thus, they need to be started at low concentrations and commenced slowly. Some rosacea patients may not be able to tolerate topical retinoids, and the suggestion of the author is to firstly control the symptoms and signs of rosacea with other agents before commencing topical retinoids. Topical retinoids come in prescription form e.g. Retin-A, and are also available in the Cosmedix range. Another option in topical retinoids is retinaldehyde. Retinaldehyde is a less irritating form of retinoid and is better tolerated by those with sensitive skin. It is available in the Rationale skin care range.

Anti-parasitic agents such as permethrin 5% cream, ivermectin, and crotamiton lotion have all reported in case reports to help reduce the redness and papules of rosacea. They are also purported to decreased the parasite Demodex folliculorum that has been implicated as a cause of rosacea.

Oral antibiotics have also been used in the treatment of rosacea. Generally, they are used for inflammatory lesions i.e. papules and pustules (or acne-like lesions), rather than for background redness or capillaries. Tetracyclines are the main antibiotic used in rosacea and include minomycin and doxycycline. Macrolides are also used and examples of this group of antibiotics include clarithromycin and azithromycin, and tend to be more expensive than the tetracyclines. All antibiotics require a prescription from a doctor.

Oral isotretinoin can be used for severe forms of rosacea with large numbers of papules and pustules. Isotretinoin, also known as Roaccutane, it is commonly used in the treatment of severe acne. As it can have a lot of side effects e.g. dry skin, dry eyes, abnormal liver function, and hair loss, it is usually reserved for more severe cases of rosacea.

The treatment of redness and capillaries due to rosacea is often more rapidly corrected with laser treatments. In many cases, broken facial capillaries can only be properly treated by laser. Lasers for the treatment of rosacea include the Gemini Laser that has two wavelengths, 532nm and 1064nm. The 532nm is attracted in particular to oxyhaemoglobin (in blood) and is very effective in shutting down broken facial capillaries and reducing facial redness. The 1064nm has a deeper penetration, and although it is not attracted to oxyhaemoglobin as much as the 532nm it has the ability to shut down deeper vessels that may feed the facial capillaries.

For more information on the Gemini laser, click here.

Photodynamic therapy is also a relatively new treatment that has been used in rosacea. By reducing inflammation and sebaceous activity, photodynamic therapy can help control rosacea that is not amenable to laser or conventional therapies.

For more information on Photodynamic therapy, click here.

What are the consequences of rosacea?

Rosacea is a problem that is uncommonly ëcuredí. Generally, people will be able to, with the appropriate therapies, reduce the effects of rosacea. Recurrence is common, and ongoing maintenance treatments may be necessary.

Why choose The Victorian Cosmetic Institute as my provider of rosacea treatments?

Our doctors specialise in skin treatments and rosacea and are able to provide you with a treatment plan for your condition. Also we specialise in laser treatments for the treatment of rosacea and have the latest laser machines available.

The first step is simply contacting us for your initial consultation, where we will discuss with you a diagnosis of the problem and what is a realistic and achievable outcome from treatment.

Making that first phone call can be a confronting task - many of our patients have preferred filling out our online enquiry form. We can then contact you with an understanding of the results you are hopeful of achieving and ensure the treatment is appropriate.