Ocular Rosacea – And How Rosacea Differs From Acne
Learn about the two types of rosacea, and why rosacea sufferers are often misdiagnosed. Learn the common treatment options for ocular rosacea.
Rosacea (pronounced Rose Ay sha) sufferers must be very frustrated people. They have to live with an extremely uncomfortable, embarrassing and disfiguring condition. Worst of all, when they visit a doctor for help, they are often given inappropriate medication which in many cases makes things much worse.
How Does This Happen?
Before we look at how many doctors get it so wrong, let’s examine rosacea itself. There are two types of rosacea. Acne rosacea (which is an erroneous term as we shall see), and ocular rosacea. Sufferers of rosacea have red, flushed skin. Papules break out on their nose, forehead and cheeks. If they drink alcohol, eat hot or spicy food or increase their body temperature, they suffer severe flushing of the face. Their facial skin is usually dry and flaking.
What Is Ocular Rosacea?
60% of people who have rosacea develop similar problems affecting their eyes. This is called ocular rosacea. These people have dry, burning, red, sore eyes, and irritated eyelids, with frequent styes. They constantly feel as if there is something in their eye.
In severe cases there may be ulceration of the cornea – the clear layer of the eye, covering the iris and pupil. This is extremely painful, and if left untreated, may lead to perforation of the eye and blindness.
Treatment for ocular rosacea should involve daily cleansing of the eyelid with cotton buds, paying particular attention to the base of the lashes. It is there that debris and oily secretions gather. An antibiotic ointment can be used with caution, and continued if it is successful. The best treatment for ocular rosacea is tetracyclic antibiotics.
Ocular rosacea often includes dry eye syndrome. This can be helped with the insertion of artificial tears at least four times a day. If the dry eye is severe, the tear ducts may be closed with tiny silicone plugs. This is reversible. The other option is punctual cautery, which is a burning of the tear duct to close it. This is usually permanent.
Why Do Rosacea Sufferers Get The Wrong Treatment?
The common misconception is that rosacea of any kind is caused by abnormalities in the sebaceous glands and micro-organisms of the skin. The confusion arises because rosacea sufferers often have papules but they are not caused by the same things that cause acne papules. Rosacea papules arise as a result of repeated flushing of the skin. Acne can occur at the same time as rosacea, but the two are different conditions.
General physicians who believe that rosacea is a skin disease caused by bacteria often give their patients harsh medications (commonly benzyl peroxide) to clear facial micro-organisms, sebaceous glands and pores. This treatment would be suitable for true acne – but rosacea is not acne. It’s a disorder of the blood vessels of the face. In most rosacea sufferers, facial micro-organisms and sebaceous glands are completely normal, and that is where the danger lies. In giving these people harsh, skin ‘stripping’ medications, their skin can become extremely sore and irritated.
Topical steroid creams that are indicated in the treatment of acne are often given to rosacea sufferers. These must not be used as they can make the skin very sensitive. Once the steroids are stopped, the skin may become even worse for a while as it is ‘withdrawing’ from the steroids.