Facial flushing, redness, spots, broken capillaries and pustules – rosacea is affecting more and more people in the UAE, and the chronic skin condition is all too easily misdiagnosed, says Dr Hossein Yavari, a dermatologist at Emirates Hospital in Abu Dhabi.
With the UAE’s soaring temperatures in the summer months, the common skin condition – which mostly affects fair-skinned women – is often mistaken for acne or eczema. Sometimes, patients incorrectly put their rosy cheeks down to prickly heat or a change in their skincare products, which can worsen without appropriate treatment. According to the US-based National Rosacea Society, the world’s largest organisation dedicated to the condition, more than 40 million people worldwide are affected it.
“Every day, at least twice a day, I am seeing patients with rosacea,” says Yavari. “The causes are multiple and the precise aetiology is unknown. However, many factors are known to trigger it including: extremes of temperature, the sun, saunas, spicy foods, caffeine, alcohol, excessive exercise, stress, hormones and an element of genetics. As there’s not just one specific cause, there’s no cure.”
The absence of a cure is cold comfort for those who experience regular “flare-ups” of inflamed, tingling, itchy skin, which is not easily disguised or soothed by over-the-counter products. Successfully managing the non-contagious condition, says Yavari, depends on how early a diagnosis is made.
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“Treatment depends on the stage of a patient’s rosacea, of which there are four. The first is just redness; the second stage is the appearances of red and yellowish spots; the third is phymatous rosacea which makes the skin very thick and coarse; and finally there is rosacea that also affects the eyes.”
The daily use of mineral or full-spectrum sunscreens that contain blockers of zinc or titanium oxide – normally prescribed – is essential, says Yavari. Laser treatments can also go some way to reducing red patches and concealing broken blood vessels. The rest is down to the patient, and normally involves lifestyle changes and a healthier diet.
“It’s a very hard condition to manage in this region, mainly because of the climate,” says Yavari. “On top of full sun protection, patients must also wear hats, sunglasses – anything that shades them. They also must avoid exercising outdoors in summer, and have check-ups every two to three months.”
“The sun is the enemy, and I recommend that all patients use non-comedogenic high-factor sunscreens that won’t block pores,” says Dr Missan Hamoudeh of the ZO Skin Centre in Dubai. “The newest generation of sunscreens also contain melanin, and they protect the skin a lot more than the highest SPFs. Don’t think either that you’re protected from UVA rays when you’re indoors. People should be wearing a UVA-fractionated melanin sunscreen at all times.”
In the pursuit of a peachy complexion, a rigorous skincare routine is essential. “I firmly believe that by controlling the skin’s sebum – or oil – the inflammation and sensitivity associated with rosacea can also be controlled,” says Hamoudeh.
“Steps towards achieving this involve the proper cleaning of the skin twice daily with a sensitive cleanser for oily skin. Then a gentle scrub should be massaged into the skin to remove dead cells. Then, I’d advise using special cleansing pads to remove any remaining oil and normalise pore size.” Once a new regimen is embarked upon, patients in the first flush of rosacea should expect to see results within four to six weeks in line with the skin’s natural regeneration cycle.
Ignoring early indicators of the skin condition or attempting to self-treat it, however, can have serious consequences, says Hamoudeh. “If left untreated for five or 10 years, for example, creams, peels and even lasers will have no effect. That’s why education is so important, and people must be advised how to avoid the exacerbating factors of rosacea.”