Rosacea Treatment

Rosacea is a highly prevalent skin condition and affects many people in the UK. Rosacea is a chronic skin condition which tends to undergo an unpredictable course. Low grade inflammation is responsible for the facial redness, flushing and the often visible blood vessels or facial thread veins. In untreated cases of rosacea, the patient may develop raised papules and pustules on the face. Rosacea undergoes flare-ups which can last a few weeks to many months followed by spontaneous resolution without any active treatment. Rosacea can in many cases mimic the appearance of active acne.

Rosacea commonly develops after the age of 30, and tends to affect people with lighter skin types. Although rosacea is seen more commonly in women, the more severe grades of rosacea tend to occur in men. In many cases, rosacea can be hereditary with the condition running in families. Currently there is no definitive cure for rosacea but fortunately there are many excellent treatments with a proven track record. Our dermatologists are specially trained in the treatment of rosacea and achieve excellent outcomes to improve the quality of life of sufferers of rosacea.

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Based on 135 reviews

Zara Khan

19/11/2021

Amazing from start to finish, the communication was the main thing was fully informed and looked after, on the day of my breast augmentation, the staff were fab and made me feel at ease through out the whole process. Thank you so much.

Mohammed Farid

18/11/2021

I’ve had such a great experience with excellent advice, care and attention and surgical treatment (gynaecomastia) - I can fully endorse the treatment I have received from Centre for Surgery with absolutely no qualms at all. Brilliant in every way - thank you all so much.

Caroline Thorpe

14/11/2021

Very pleased with my whole experience of having a procedure. Was so nervous about getting treatment and i was reassured and felt so comfortable throughout thanks to the amazing nurses. I definitely made the right decision to have breast augmentation at centre for surgery with dr erel.

Melissa Briggs

08/11/2021

So glad I went with centre for surgery, the whole process went very smoothly from the consultations down to the actual day of the procedure. I was so nervous on the day but the whole team put me at ease and I’m happy with my results as I feel a lot more comfortable wearing certain clothes now. My surgeon was Alberto Di Giuseppe who performed a breast Augmentation on me, and I would definitely recommend as he was very clear on what the outcome of the surgery would be and which size would look the best for my frame.

Raphinha kiki

08/11/2021

Couldn’t be happier with Dr Tillo work,i had my breast surgery one week ago and so happy with the results so far,all the staff are extremely nice and very supportive,i would definitely recommend their services,thank so much

Grace Olafemi

15/10/2021

From start to the finish everything was perfect for tummy tuck surgery. All staff is very friendly and the aftercare has been good. The Doctor and the nurse team was fantastic. I'm so happy...result is amazing. Thank you!!!

Ranjit Singh

14/10/2021

This was overall a great experience, all the staff at Centre for Surgery were friendly and put me at ease. It is a nerve wracking thing to go through an op but the staff were so nice. Mr Ertan has got a great team around him. On the day of the operation everything went smoothly to plan, there was no delay or holdups, I had another consultation with Mr Ertan who confirmed what was going to be done and that I was still happy to proceed. I was prepped for the procedure, I met with the anaesthetist who again was really nice and put me at ease explaining his role. After the procedure I woke up with the nurse by my side making sure I was OK and checking on me, I was able to stay in the clinic until I was ready to leave and was not rushed at all. I was well looked after from the start to the point when I was discharged. Post operation I was staying at a local hotel it was so close there was no point in even getting a taxi and I was able to walk back where my partner was waiting for me. I was expecting a lot of bruising to both my eyes but there was very little if any by the time the cast came off after 7 days, I am now at the two week post operation point and it is healing well with no outwardly visible bruising or scaring. The next milestone is a checkup at the 6 week point with my surgeon. If you're thinking of having something like this done I would highly recommend getting in touch with Centre for Surgery.

Layla Karami

13/10/2021

The staff at Centre for Surgery were very kind and accommodating. They answered any questions I had about the procedure and were constantly checking up on me. A special thank you to Christina for all her support throughout.

Gemma Small

08/10/2021

I would just like to state the quality of care received from the nurses at Centre for Surgery was beyond the highest level. Sophie takes her patient care to another level beyond words. She always puts me at ease. She is there for me even at awkward hours just when I mostly needed reassurance and she is one of the most compassionate nurses I have come across and demonstrates her passion naturally for caring for others. She totally deserves recognition at its finest and thank you for always being there for me. 😍

Rosacea remains an incompletely understood condition and the precise causes are therefore unknown. There are however, a number of possible explanations for the appearance of facial redness:

Defects in blood vessels

The facial redness of rosacea may partly be down to an underlying defect in the superficial blood vessels. The blood vessel dysfunction is possibly linked with raised levels of a number of growth factors including vascular endothelial growth factor and certain prostaglandins and pro-inflammatory cytokines. VEGF is responsible for the profliferation of new blood vessels. VEGF also makes the tiny capillaries more leaky which leads to the plasma part of blood being released into surrounding tissues. This results in the formation of a localised inflammatory process which leads to the commonly observed signs of redness. The prostaglandins are responsible for increasing the diameter of the blood vessels and this also contributes to the redness observed.

Inflammatory processes

In more chronic forms of rosacea, the facial flushing and chronic skin changes are often due to the presence of pro-inflmmatory cytokines. The dermodex mite parasite has also been found in more chronic forms of rosacea. The follicle sebaceous shafts are where the mites tend to reside. Research has shown raised levels of the dermodex mite in rosacea sufferers. With increased levels of mite, skin irritation then becomes an added problem.

Everyday common precipitating causes of rosacea

The exact causes of rosacea are unknown although there are known to be a number of triggers which can make rosacea appear. For any rosacea sufferer, it is important to steer clear of these triggers for optimal control.

• Food with a high spice content such as Indian food
• Heavy alcohol intake
• Hot cups of tea or coffee
• Hot showers, saunas or steam rooms

Rosacea has a number of characteristic clinical features and our dermatologists will accurately assess you to determine your particular sub-type of rosacea. The following clinical features are most commonly found in most forms of rosacea:

• Persistent facial flushing and redness – Patients with rosacea often have diffuse facial redness with associated flushing. In many cases, patients often report their faces feeling very warm when the flushing starts
• Inflammatory lesions (red papules and pustules) – small red lesions that are raised along with small pustule lesions. In papulo-pustular forms of rosacea, acne can be mistakenly misdiagnosed as the two conditions can look very similar. The key distinction lies in the stinging and burning sensation which most patients get with papulo-pustular rosacea.
• Facial thread veins (telangiectasias) – facial thread veins are often seen on the cheeks and nose. These blood vessels are also known as facial telangiectasia and often a feature of the blood vessel inflammation that occurs in rosacea.
• Facial warmth, burning, or stinging sensation – patients often find they experience a warming sensation on the face in the early phase of rosacea which progress to burning and stinging sensations when patients experience an exacerbation of rosacea.
• Facial oedema – swelling of the face is a very common feature of rosacea.
• Disfigurement of the nose –  In advanced cases of rosacea and particularly in men, the skin of the nose may begin to thicken and can cause a severe cosmetic disfigurement. This is called rhinophyma and severe cases may even impair breathing.
• Red and watery eyes – ocular rosacea is a distinct subtype of rosacea which often presents as red, watery and irritable eyes. The eyelids can look inflamed mimicking the appearance of a blepharitis. In more advanced cases of ocular rosacea, localised bacterial infections of the eyelids can occur or even visual disturbance in severe cases.

The most important aspect of the management of rosacea is learning how to prevent exacerbations of rosacea. Every individual will have certain triggers which may not the be the same in others. Treatment is always tailored to the individual and the specific type of rosacea. Patient education is important in order to understand the condition as much as possible along with the maintenance of good hygiene.

How to prevent rosacea:

• Avoid spicy foods such as Indian food.
• Avoid alcohol or at least reduce consumption to as little as possible. White wine is known to be better than red wine.
• Learn effective stress coping strategies. Stress is a well known trigger of rosacea.
• Avoid the use of aggressive skincare and hair products. Exfoliating skin care products should be avoided.
• Keep well protected from sunlight exposure. Using sunscreen of at least SPF 30 is highly recommended.
• Reduce intake of hot drinks such as tea and coffee.
• Avoid use of heavy make-up and foundation that is water-repellent.
• Avoid use of hot showers, saunas and steam rooms and other environment which could make your skin get hot.
• Tell your dermatologist what medicines you are taking, both prescribed and over the counter. Many medicines can make rosacea worse.

Currently, there is no single treatment which will eliminate rosacea. Treatment is therefore targeted based on symptoms, severity and the specific type of rosacea. Combination treatment is usually the best treatment strategy.

Topical prescription medications for rosacea

Brimonidine gel available in either 0.33% or 0.5% strengths. Brimonidine is applied one daily resulting in an improvement in redness which can last up to 12 hours. Treatment must be applied daily as the redness will quickly  reappear otherwise. Oxymetalozine have also provided improvements but are not yet routinely available.

Topical metronidazole is used to reduce facial redness and is known to be effective in reducing the pustular component of rosacea. Recurrent of symptoms is uncommon with metronidazole and is generall safe and effective with a small risk of side effects including irritation and dermatitis.

Azelaic acid has antioxidant, antimicrobial and anti inflammatory activities which help to reduce redness and skin thickening. It is applied once daily and is safe to use in pregnancy. Side effects are minor and include irritation, dryness and burning/stinging sensation.

Retinoids such as tretinoin are able to stimulate connective tissue remodelling which helps to repair any sun induced damage. They also have anti-inflammatory actions. In combination with other topicals, tretinoin is able to reduce redness, papules and/or pustules although treatment can take months.

Oral Prescription Medications for rosacea treatment

Tetracycline antibiotics have been for rosacea treatment for over 50 years and are generally safe to use. Doxycycline is used at a 50mg dose for both treatment and prevention of rosacea. Although Doxycycline is an antibiotic, it exerts useful anti-inflammatory effects which help to reduce redness. Other antibiotics such as erythromycin may also be used.

Although topical and oral antibiotic treatments are good for inflammatory aspects of rosacea, they are less effective on improving the diffuse redness and prominent facial blood vessels.

Isotretinoin also known as Roaccutane is usually the last line of treatment for patients who have shown a lack of response to other commonly used treatments. Isotretinoin taken at low doses have resulted in improvement of facial redness, papules and pustules with a lower risk profile. Isotretinoin carries recognised adverse side effects and all patients are placed under close supervision of a dermatologist. It is very important to use adequate contraception while on Isotretinoin as the drug is not safe to use in pregnancy (risk of birth defects).

IPL treatment for rosacea treatment

Rosacea can be very effectively treated with IPL or intense pulsed light, and is commonly used by dermatologists to achieve effective symptom control in relapses of the condition. IPL acts on the small superficial blood vessels located beneath the skin. The pulses of light emitted from the IPL hand piece impart thermal energy to the blood vessels causing them to significantly reduce in size. The appearance of the skin is visibly improved following treatment. Your dermatologist takes special precautions during treatment to prevent injury to other parts of the skin. It is common to experience a degree of mild discomfort during treatment and is often compared to a light flick of an elastic band against the skin. In some cases you may prefer to have a topical anaesthetic applied before treatment. The final results are determined by the number of treatments and how severe the grade of rosacea.

Our specialist dermatology clinic at 106 Crawford Street is a centre of excellence for the treatment of all types of rosacea and facial redness.

Laser treatment for Rosacea

Lasers in the treatment of rosacea are able to reduce both erythema and telangiectasia. The objective is to reduce the density of the blood vessels in the superficial part of the skin which leads to reduction in redness as well as both both flushing symptoms and the burning and stinging sensations. Many types of lasers and light devices have been increasingly used in the treatment of rosacea. Laser can be used for both the two most common subtypes of rosacea – erythemato-telangiectatic (ETR) and papulo-pustular (PPR) forms. The long-pulsed Nd:YAG laser is an excellent laser treatment used by dermatologists at Centre for Surgery. With Nd:YAG treatment, the entire face is treated. There is no requirement for topical anaesthesia although an air cooling device is used to protect the skin and also to reduce discomfort during treatment. Treatment is repeated at 3-4 week intervals.

Patients treated with Nd:YAG laser can become asymptomatic however it cannot be considered a cure as the underlying disease processes are not fully addressed and the patient may get an exacerbation in future. However, in our experience it does lead to long periods of disease remission. Because of lower melanin absorption with Nd:YAG lasers, there is less concern for epidermal damage, and they may be more safely used to treat patients with darker skin. Compared to other lasers, the risk for post-inflammatory hyper-pigmentation is very low. Nd:YAG laser is a very successful treatment in rosacea patients, and the effect among ETR patients was greater than for PPR patients.

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Our specialist dermatologists are experts in the diagnosis, treatment and management of all types of rosacea. We always customise treatment to the individual based on your lifestyle, goals and severity of condition. No two skin types are the same and therefore every case of rosacea is different. Depending on the subtype of rosacea, some patients can get good results with a straightforward topical skincare routine coupled with laser treatments to maintain remission. Other patients will need oral medication early on to control symptoms. Our dermatologists have access to the full range of treatment options using gold standard treatment protocols to ensure your rosacea is kept under control and reduce the risk of potential exacerbations.

You will be booked in to see one of our expert dermatologists at Centre for Surgery on Crawford Street in Marylebone for your rosacea consultation.

Centre for Surgery is located at 106 Crawford Street in Marylebone. Crawford Street is just off Baker Street. We are easily accessible by all major bus routes that pass through Baker Street as well as Baker Street underground station.

From the tube station, we are just a 5 minute walk southwards down Baker Street followed by a right turn onto Crawford Street. The clinic is about 200 yards on the left.

There is ample local pay & display parking in the surrounding area and an NCP car park is located further west along Crawford Street. Our local residential parking zone is the City of Westminster.

Address: 106 Crawford Street, Marylebone, London, W1H 2HY