This video provides an updated guide to treating rosacea, building upon a previous video from four years prior. The dermatologists discuss the different types of rosacea, their causes, and various treatment options, including over-the-counter and prescription products, as well as laser treatments. The video aims to help viewers understand and manage their rosacea effectively.
Rosacea Types and Appearance: Rosacea manifests in various ways, including acne-like breakouts, facial flushing, enlarged noses (rhinophyma), and ocular rosacea (eye involvement). Four main types are discussed: erythmatotelangiectatic, papulopustular, phymatous, and ocular.
Underlying Cause of Rosacea: Rosacea stems from increased inflammation and inflammatory signaling in the skin. This can lead to increased oil production, vascular dilation, and sensitive skin.
Treatment Approaches for Erythmatotelangiectatic Rosacea: Treatment focuses on soothing, constricting blood vessels, and masking redness. Over-the-counter options include neurosensine, panthenol, azelaic acid, niacinamide, and green tea extract. Prescription options include metronidazole, brimonidine, and oxymetazoline. Green-tinted makeup can help mask redness.
Treatment Approaches for Papulopustular Rosacea: This form often resembles acne. Treatments include topical ivermectin (Sulantra), azelaic acid, sulfur, sulfacetamide, and oral tetracyclines (like doxycycline). A combined prescription treatment from ScriptDerm is highlighted.
Treatment for Phymatous Rosacea: This disfiguring form involves enlarged oil glands and thickened skin. Topical treatments are less effective; oral doxycycline or isotretinoin (Accutane) may be necessary. Surgical procedures may be required in advanced cases.
Treatment for Ocular Rosacea: This involves redness and irritation of the eyelids and eyes. Treatments include topical eye drops prescribed by an ophthalmologist, oral doxycycline, and potentially IPL.
To answer your question about the over-the-counter and prescription topical treatments for erythmatotelangiectatic rosacea and how their mechanisms of action differ, let's examine the information from the transcript:
Over-the-Counter Treatments: These primarily aim to soothe and calm the skin's irritation. Ingredients mentioned include neurosensine (soothing), panthenol (soothing), azelaic acid (soothing and potentially reducing inflammation), niacinamide (soothing), and green tea extract (soothing). They work by reducing inflammation and irritation, but don't directly address the underlying vascular issues.
Prescription Treatments: These are categorized into those that soothe/reduce inflammation and those that constrict blood vessels:
Metronidazole: This topical antimicrobial has been shown to help with redness, though the effect is slight. It works by reducing inflammation and bacterial activity.
Brimonidine (Mirvaso): An alpha-2 agonist, it constricts blood vessels, resulting in a reduction of redness. The effect is temporary and can lead to rebound flushing.
Oxymetazoline (Rozex): Another vasoconstrictor, it's similar to brimonidine in its action but with a less pronounced rebound effect. It temporarily constricts blood vessels to reduce redness.
The key difference is that over-the-counter treatments mainly focus on soothing and reducing inflammation, while prescription treatments offer more targeted approaches by either reducing inflammation more effectively (metronidazole) or directly constricting blood vessels (brimonidine, oxymetazoline). The prescription options offer more noticeable, albeit often temporary, reduction in redness compared to the over-the-counter options.
