There was a really interesting LinkedIn Aesthetics & Beauty Group thread recently about how best to deal with clients with rosacea.

We thought this discussion could be of benefit to our delegates at Cosmetic Courses as it is a relatively common ailment presented in clinic and quite tricky to deal with. As a potential contraindication, rosacea impacts upon many skincare / medical aesthetic treatments which you are offering.

Interestingly, one LinkedIn user opened the discussion by wondering how often “Rosacea” is actually misdiagnosed. True rosacea is estimated to effect about 1 in 10 people. It is characterised by:

• episodes of flushing
• outbreaks of spots
• persistent redness of the skin
• Visibility of small blood vessels
•  Thickening and enlarging (especially around the nose area), but this is in more severe cases

It is counted as a chronic, long-term condition which is made worse by a number of trigger factors including extreme weather exposure, stress, certain food/drink.

Because there are so many different aspects to these symptoms, Broken Capillaries on the face are often wrongly diagnosed as Rosacea…so are papular / pustular acne break outs with a large degree of redness and even tendencies to flushing may be labelled Rosacea too! On the other extreme, some patients may have been given an official rosacea diagnosis by their GP but hide telling you for fear you won’t treat them or due to the connotations with stress / alcohol consumption.

It is good practise (as agreed on the LinkedIn thread) that, when dealing with rosacea only a doctor or dermatologist should make an official diagnosis. If you do have suspicions that your patient is suffering from this condition, you could gently try and persuade them to make an appointment. However, you should never share your own diagnosis with the patient.

Where does that leave you, with treating a potential Rosacea patient?

Lovely as it would be to “fix” every patient’s skin problems, as one LinkedIn thread user admits, it just isn’t possible. Rosacea is a long-term problem without a known cure and certain treatments are actually proven to aggravate and make the condition worse.

If the rosacea presents with active acne, for example, then you should react as with any other active acne case and avoid treatments like Genuine Dermaroller Therapy, botox to the area and microdermabrasion which could spread the acne or cause infection. You will not need to mention rosacea to your patient: you can just cite the active acne as your reason for being unable to pursue this course of treatment and this is an ideal excuse to refer them to their GP who may identify the rosacea at the same time.

For rosacea patients with particularly irritated, red skin and blood vessels very close to the surface, treatments like abrasive peels and microdermabrasion should be avoided.

However, your rosacea patient may still be able to have some treatment. If no active acne is present, use your experience to decide whether a gentle L-absorbic acid type peel might be suitable (for example) and Genuine Dermaroller, too, is fine on non-irritated areas. It is all about really getting to know your patient, doing a very thorough skin history assessment with them and using your professional discretion. If in any doubt, refer to a GP first and remember you are within your right to gently suggest it would be better not to treat – rosacea is a recognised contraindication.

We hope this has been helpful to you. For more advice, please do not hesitate to contact Cosmetic Courses on 0845 230 4110.