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Rosacea for the Esthetician: A Comprehensive Guide, Part I

By: Cynthia Bailey, MD
Posted: July 1, 2013, from the July 2013 issue of Skin Inc. magazine.

Rosacea is common, and it’s also complicated to manage. Many more than 16 million Americans have rosacea—and most don’t know it, according to the National Rosacea Society. Identifying classic rosacea is easy, but identifying the more subtle forms is not; yet these will be some of your trickiest and most sensitive skin clients. Give them the wrong treatment or advice, and you can exacerbate their rosacea, potentially causing hyperpigmentation, scarring and a very unhappy client. Give them the right advice, and you have a loyal client and big fan who will help build your business.

As a skin care professional, you need to be familiar with all the types of rosacea. This article will help you better understand rosacea and will teach you how to identify some of the more subtle signs. Guidelines for choosing the right treatments will be provided, as well as tips to help you identify when your client needs to see a dermatologist for prescription treatments.

What is rosacea?

Rosacea is a rash of adulthood. Any adult is at risk, but rosacea is most commonly seen in light-skinned women between the ages of 30–50. It is characterized by persistent redness of the rounded areas of the face, including the cheeks, nose, chin and mid-forehead. It often spares the skin around the eyes. (See Facial Distribution of Rosacea.)

The skin looks red, hot and inflamed, but it is not infected. Rosacea is an inflammatory condition, and the location and pattern of the inflammation determines the type of rosacea it is.

1. Erythematotelangiectatic rosacea. This is the subtype in which inflammation is more diffuse in the skin, and is associated with redness and flushing. It may be dramatic or it may be quite subtle. With this type:

  • There is often a history of flushing episodes lasting more than 10 minutes and occurring due to various stimuli, including emotional stress, hot drinks, alcohol, spicy foods, exercise, cold or hot weather, and hot baths or showers;
  • The skin may sting or burn with flushing; and
  • The skin is often finely textured with scaling and roughness of the central face—this is a big tip-off that your clients’ skin is sensitive. They will probably tell you that their skin is easily irritated, so you need to ask them about past product and treatment sensitivities.

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