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General dermatology posts
Rosacea (pronounced roh-ZAY-sha) is a common disorder of the facial skin that afflicts an estimated 14 million Americans, many of whom do not know they have it. It affects mostly adults, usually people with fair skin, between the ages of 30 and 60. Rosacea is an inflammatory condition characterized most typically by facial redness and/or acne-like eruptions of the nose, cheeks, chin and forehead. Rosacea can also manifest as watery, irritated eyes or as small visible blood vessels on the face. Although rosacea is not harmful in and of itself, it is often progressive, and if left untreated can significantly impact one’s personal appearance. Surveys indicate that nearly 70 percent of rosacea patients report lowered self-esteem and difficulties with social and professional interactions.
The cause of rosacea is unknown, and there is no cure. However, medical intervention can control the signs and symptoms of this potentially life-disruptive disorder. Doctors often prescribe topical and/or oral antibiotics to treat rosacea, more for their anti-inflammatory properties than to kill bacteria. Azelaic acid, which reduces redness and inflammation, is another commonly prescribed topical medication. Because symptoms may recur when medications are discontinued, long-term treatment is often necessary.
With long-standing rosacea, the characteristic enlarged blood vessels and facial redness can become permanent. In these cases, laser surgery may be a more suitable treatment. Treatment with a vascular laser can significantly reduce the visibility of blood vessels, decrease redness and improve overall appearance.
By Robyn E. Glaesser, M.D.
One of the most common reasons for seeking dermatologic care is for the evaluation and management of acne. Although primarily a disease of adolescence, acne can afflict infants, young adults and people in their forties and fifties. In simple terms, acne results from the action of hormones and other substances on the sebaceous (oil) glands and hair follicles. The sebaceous glands make an oily material called sebum that normally empties onto the surface of the skin via openings in the hair follicles (pores). Oil and cells that line the follicle (keratinocytes) can plug the opening. This, in turn, allows bacteria that live on the skin surface to grow and produce chemicals that attract inflammatory cells. The wall of the hair follicle can then rupture, spilling sebum, keratinocytes and bacteria into the surrounding skin. This results in the formation of “pimples”.
There are several types of acne. Comedones are plugged follicles without associated inflammation. Papules are small inflamed acne lesions that are red and tender. Nodules and cysts are deeper, painful inflammatory lesions that can lead to scarring.
The cause of acne is unknown and probably multifactorial; nevertheless, there are many myths on the subject. Chocolate and greasy foods do not cause acne, nor does dirt on the skin. However, there are things that can exacerbate acne in those with the disease: changing hormones (in adolescence or before menstrual periods), stress, oil in skin products, pressure from sports helmets, squeezing acne lesions and scrubbing of the skin.
Just as there are multiple types of acne, many treatments exist. There are over-the-counter and prescription medications that are very effective in treating acne. Depending on the type and severity of the condition, your doctor may recommend topical therapies, oral medications or both. The mainstays of therapy are topical retinoids (vitamin A derivatives) to unclog pores and topical or oral anti-inflammatory medications and antibiotics. For girls and women with acne, oral contraceptives and other medications that regulate hormones are used. The treatment of choice for scarring acne is isotretinoin (Accutane), and use of this very effective medication must be monitored closely by a dermatologist.
In addition to medications, there are cosmetic procedures which can improve acne. Chemical peels with exfoliating substances such as glycolic acid can be quite beneficial as an adjuvant to traditional acne therapy. Some relatively new, innovative treatments for acne using certain wavelengths of light and lasers are becoming more popular.
About the author
Doctor Robyn E. Glaesser is a practicing Dermatologist at Ironwood Dermatology located at 1735 E. Skyline Drive • Tucson, AZ 85718 • 520-618-1630 • Fax: 520-618-1636
Help your skin survive the desert winters
I am often asked by my patients “My skin gets so dry in this desert climate during the winter months. How can I keep it moisturized and healthy?” Here’s what I tell my patients who ask me this question.
The Sonoran Desert climate can be tough on your skin, especially in the winter months. The combination of dry air and lots of sunny days creates a challenge to keeping your skin looking and feeling good. Minimize the number of baths and/or showers you take daily and use a mild, moisturizing cleanser. Use warm to cool water only as very hot water can aggravate dry skin. Afterwards, lightly pat your skin dry and immediately apply a thin moisturizing CREAM to your skin. Reapply the cream several times daily as needed and before going to bed. Also remember to keep yourself hydrated with fluids throughout the day – your body, including your skin, will thank you!
Sun protection is another way to keep your skin in top form. Winter sun exposure can still cause significant damage and can lead to skin cancers in the future. Sun avoidance between about ten o’clock and two o’clock is ideal. Other sun protective measures include protective clothing (wide brimmed hat, long sleeves and long pants) and sunblock. Your sunblock should be at least SPF 30, contain zinc oxide or titanium dioxide, and should be applied every three to four hours for optimum results. Moisturizing and oil-free sunblocks are available, depending on your skin type. The lips are especially sensitive to the sun and to dry climates so use a moisturizing lip sunblock often. Finally, annual skin checks by a dermatologist are important for skin cancer screening.
The winter season is a wonderful time in the desert. These simple tips will keep you and your skin healthy for many desert winters to come!
About the author…
Doctor Fiona D. Behr is a practicing Dermatologist at Ironwood Dermatology located at
1735 E. Skyline Drive • Tucson, AZ 85718 • 520-618-1630 • Fax: 520-618-1636