•  Manifests as a redness around the middle of the face, generally the nose and cheeks in a butterfly pattern
•  Has telangiectasia (couperose)
•  Is NOT acne, and does not have comedones
•  Attributed to photo damaged
•  Especially occurring in fair skinned persons

1) Overview

•  Family history/ Ethnic Background ( Celtic )
•  Sun Exposure
•  Male or female
•  Age
•  Demographics

Rosacea has progressive stages, as follows:
Pre-Rosacea
Frequent episodes of flushing and redness that come and go – triggered by foods, stress, environment and lifestyle.
Stage One – Vascular Stage
Telangiectasia, persistent flushing and redness; may be swollen and warm. Many never progress beyond this stage.
Stage Two – Inflammatory Rosacea
Pustules and papules, though no blackheads or white heads; may be misdiagnosed as acne. Telangiectasia is dilated and pores can be enlarged.
Stage Three – Orange Peel Skin Stage
Exacerbation of previous symptoms and tissue hyperplasia (overgrowth). Strikes mostly men and most often on the nose (rhinophymy), the red bulbous nose of W.C. Fields. Patients can experience more than one stage simultaneously, in progression, or only one type, including rhi

2) Topical

(Cosmecutical, Pharmaceutical OTC over the counter)

• OTC ( Over the counter) Department stores/retail outlet
• Cosmecutical sold under  license Esthetic- Cosmetology Boards
• Prescription from MD

3) Ingredients

Cosmecutical

• Antioxidants/Anti Inflammatory:
• Astaxanthin- Soluble Vitamin C-Alpha Lipoic
• Wound healing improve integrity of the skin Copper- Vitamin K –Willow Herb-Co Q10 for stimulating the ATP  ( energy)of the cell

Prescription from MD

4) Ingredients

Cosmecutical

• Antioxidants/Anti Inflammatory: Astaxanthin- Soluble Vitamin C – Alpha Lipoic
• Wound healing improve integrity of the skin Copper- Vitamin K –Willow Herb- – Azeleic  acid
• Co Q10 for stimulating the ATP  ( energy)of the cell

Prescription from MD

• Azeleic  acid (15%)
• Metronidazote ( demodex mite)
• Oral antibiotics ( tetracycline dirivitives)

5) Other information

• Sunscreen non irritating/ physical block/ oil free moisturizing
• Homeopathic Medicine
• Camouflage for coverage quality of minerals /particle size/ amount of fillers
• Things that may trigger it
  - Food
  - Exercise
  - Heat
  - Stress

If you have any questions about how to handle your rosacea-prone skin, Parkway Skin Centre’s staff is always available for consultation. Click here if you would like to purchase Derma MD’s Rosacea Skin Saver Kit.

Winter winds and cold weather are common triggers. If you find that your rosacea flares in winter, here are tips that can help diminish flare-ups:

• Protect your face. Covering your face with a scarf or ski mask helps protect it from the wind and cold. Just make sure that if it touches your face, it is not made of wool or a fabric that feels rough to the touch. Wool and rough-feeling fabrics can irritate the skin.
• Protect your eyes. Wear sunglasses that shield your eyes from both the UVA and UVB rays
• Apply sunscreen. The sun’s reflective powers are great year round — 17% on the sand and 80% on the snow. Applying a broad-spectrum sunscreen with an SPF of 15 or more on exposed skin helps protect your skin.
• Use a barrier-repair product. Protective creams and other topicals that create a barrier on your skin help to shield it. Your dermatologist can help you find a product that does not irritate your skin.
• Wear loose, layered clothing. This allows you to stay warm and remove layers as needed to prevent overheating.
• Reduce indoor heating. Indoor heat can cause a flare-up. When possible set the thermostat to a temperature that does not trigger your rosacea.
• Avoid sitting near a lit fireplace or stove. Becoming overheated often triggers rosacea.
• Prevent heat from blowing on your face. When in a car, set the heat so that it does not blow directly on your face.
• Limit consumption of heated beverages and alcohol. If these are triggers, limiting consumption or avoiding them can help.
• Avoid hot showers, hot baths, saunas, and steam. All of these open blood vessels, which can cause rosacea to flare. Hot water also can irritate rosacea-prone skin. When possible, wash rosacea-prone skin with lukewarm water.

If you have any questions about how to handle your rosacea-prone skin, Parkway Skin Centre’s staff is always available for consultation.

Vanity appears to be trumping frugality in a looks-conscious society.

Despite the dismal economic climate, most women – and men – who undergo appearance-enhancing treatments such as Botox injections are spending hundreds or even thousands of dollars a year to maintain the regimen, aesthetic physicians say. Meanwhile, some older patients who are putting off or forgoing expensive facelifts are instead opting for less-costly injections and laser treatments.

Doctors say a weak economy hasn’t curtailed demand for Botox injections.

Maralyn Burr of Omaha, Neb., in June lost her job as a district sales manager for bookstore chain Borders Group Inc. Ms. Burr, who is $140,000 in debt from her 22-year-old daughter’s musical education, says she has slashed spending and all but stopped eating out. But she hasn’t given up her Restylane and Botox injections. “It’s like comfort food,” she says.

Nearly three out of four plastic surgeons who responded to a survey this fall reported that demand has increased or held steady for minimally invasive procedures, including Allergan Inc.’s Botox antiwrinkle drug, dermal fillers used to plump up lips and smile lines, and skin-smoothing chemical peels, according to the American Society of Plastic Surgeons, a professional group representing 6,700 surgeons. The survey also found a steep drop in demand for plastic surgeries ranging from breast augmentation to nose reshaping.

To be sure, makers of aesthetic medical treatments are bracing for a challenging year ahead. While many established patients are sticking to their beauty regimens, it’s tough to entice new patients in the current economic environment. In late October, Allergan said that dermal-filler sales were up 18% through September, but the company reduced its 2008 Botox sales guidance, citing overall “subdued demand.” Medicis Pharmaceutical Corp. recently has been offering a $100 consumer rebate on its Restylane family of products.

Most of the products used for so-called facial rejuvenation weren’t available in the U.S. when the last downturn hit, so there’s no historical precedent to estimate their sales performance in the current economic environment. While Botox has been on the market for nearly 20 years, it didn’t receive regulatory approval for cosmetic use until 2002, at the tail end of the dotcom-led stock-market bust. Allergan’s dermal filler, Juvéderm, which competes with Restylane, has been on the market for about two years.  Parkway Medical Laser & Skin Centre offers both Restylane and Juvéderm treatments.

Joel Schlessinger, Ms. Burr’s dermatologist in Omaha, says the number of his patients seeking dermal fillers began to increase on a year-over-year basis in the last few months, after posting declines earlier in the year. “Things are so bad [in financial markets] that investments aren’t even worthwhile anymore, so people are investing in themselves,” he suggests.

Moisturizer: For best results, a moisturizer should be applied after bathing and spread on damp skin. Moisturizer forms a protective coating that reduces the amount of water lost through the skin. This, in turn, decreases dryness, itch, and cracking skin. When using a topical medication, be sure to apply the medication first. Then wait one or two minutes before applying the moisturizer so that the medication can penetrate the skin. The same procedure should be done in using a treatment serum.

Sunscreen: Wearing sunscreen every day helps prevent premature aging caused by the sun’s harmful ultraviolet (UV) rays. Dermatologists recommend applying a broad-spectrum (offers UVA and UVB protection) sunscreen with a Sun Protection Factor (SPF) of 15 or higher. To give the sunscreen time to work, be sure to apply it 20 minutes before going outdoors.

While some makeup and moisturizers contain sunscreen, dermatologists recommend applying a separate sunscreen. The sunscreen found in moisturizers, foundations, and other products tends to have a low SPF, and this sunscreen usually wears off quickly.

Foundation: Applying a foundation over other topical products allows the products to work effectively and gives the best cosmetic result.

Makeup including powder and blush: These products look best when applied last. If you are not getting the results you want from your skin care products, be sure to try these recommendations. Hopefully, you will see a visible difference.

Water helps the body work better. It also helps keep the skin moist and fresh. Collagen and other building blocks of the skin are made up of mostly water. Without enough water, the body will re-absorb as much water as possible. Staying hydrated helps avoid this, and keeps all of your body systems working better.

Sun block protects the skin from sun effects, but you have to use it properly. It should be applied every two to three hours and re-applied after swimming. If you use a sun block rated SPF 30, and you don’t apply enough, you have effectively cut the protection in half. So, apply liberally. Many people don’t use sun block because it feels greasy or stings the eyes. Natural powder sun block made from minerals is a good alternative. Sunforgettable by Colorescience goes on dry, lasts a little longer, is waterproof and does not feel greasy. It works well, is relatively inexpensive, and is easily applied to children without a fight!

Finally, wear a wide-brim hat. Because of the extensive blood supply to the scalp, most of our water loss is from our head. A hat will decrease this dramatically, especially if it is ultraviolet rated. Wearing a hat makes us feel cooler and keeps the sun off of our faces and ears. The top of the ear has a high incidence of skin cancer.

Visit Parkway Medical to check out our array of physician-endorsed sun blocks, hats and sunglasses.

First, we recognize(and you should as well) that cosmetic enhancement isn’t a necessity. It is a luxury. Many patients ask, “What do you think I need?” Our answer is always the same. “You don’t need anything. We are not treating a disease. What will make you happy?” Botox, dermal fillers, laser, microdermabrasion and other methods of skin rejuvntaion are for enhancement. They can make you look relaxed and feel better about yourself.

Finally, combination therapy is the ideal solution. There are many modalities and products to try. Each one has its benefits. But, a combination works even better. Laser treatments, combined with dermal fillers(ex: Restylane, Juvederm) and Botox enhance the whole picture and can easily be used in combination to achieve the desired result. Add skin care products and you have a winning combination.

Dr. Blume and Breanna’s high level of professionalism and proficiency make Parkway Medical Laser & Skin Centre a leader in skin care rejuvenation.