Yes. Although rosacea has a variable course and is not predictable in everyone, it gradually worsens with age, especially if untreated. In small studies, many rosacea sufferers have reported that without treatment their condition had advanced from early to middle stage within a year. With good therapy, it is possible to prevent progression of rosacea.
Since there is some overlap between acne and rosacea, some of the medications may be similar. Acne and rosacea have in common several possible treatments, including (but not limited to) oral antibiotics, topical antibiotics, sulfa-based face washes, isotretinoin, and many others. It is important to seek a physician's advice before using random over-the-counter acne medications since they can actually irritate skin that is prone to rosacea. Overall, rosacea skin tends to be more sensitive and easily irritated than that of common acne.
Severe acne. Severe acne consists of deep cysts, redness, swelling, extreme damage to the skin and scarring. You should see a dermatologist to care for this type of acne. Scarring can be prevented with appropriate treatments. Your dermatologist can prescribe oral antibiotics and oral contraceptives. Large inflamed cysts can be treated with an injection of a drug that lessens the redness, swelling, and irritation, and promotes healing.
Your dermatologist may prescribe Accutane®, if other treatments have not worked. This is a strong medicine that can help prevent scarring and treat active disease. But, Accutane also can cause birth defects. It is important that you are not pregnant and do not plan to get pregnant while taking this medicine. You must use two methods of birth control at the same time. This is done for one month before treatment begins, during treatment, and for a full month after stopping the drug. Talk with your dermatologist about when it's safe to get pregnant. Other side effects of this drug may include dry eyes, itching, mood changes, and changes in the blood and liver. You and your dermatologist can decide whether this medicine is right for you based on the pros and cons. Use any prescribed medicine exactly as you are advised. Taking more medicine than you are supposed to take may make acne or your general health worse. Ask your doctor what to do if you miss a dose.
Laser treatment may cause some discomfort. While most patients are able to endure the procedure, ice packs and topical anesthetic cream can help alleviate the discomfort. Multiple treatments are typically necessary, and most insurances do not cover the procedure. Doctors recommend treatments in three- to six-week intervals; during this time, sun avoidance is necessary. Review risk, benefits, and alternatives with a physician prior to treatment. Combine laser treatments with photodynamic therapy (light-activated chemical using Levulan) for more noticeable results.
Medications prescribed for mental illnesses can have the unfortunate side effect of causing acne. Some antidepressants have been purported to trigger acne breakouts, including brands like Wellbutrin and Lexapro. Those diagnosed with bipolar disorder are often prescribed lithium to help handle their condition. Unfortunately, lithium can cause acne breakouts. Often the benefits of these types of drugs outweigh the negative onset of acne, but it’s important to look into various options to determine what might have the minimal amount of side effects.
Treating acne requires patience and perseverance. Any of the treatments listed above may take two or three months to start working (even isotretinoin). Unless there are side effects such as excessive dryness or allergy, it is important to give each regimen or drug enough time to work before giving up on it and moving on to other methods. Using modern methods, doctors can help clear up the skin of just about everyone.
Rosacea may affect the eyes. Not everyone with rosacea has eye problems. A complication of advanced rosacea, known as ocular rosacea, affects the eyes. About half of all people with rosacea report feeling burning, dryness, and irritation of the tissue lining of the eyes (conjunctivitis). These individuals may also experience redness of the eyelids and light sensitivity. Often the eye symptoms may go completely unnoticed and not be a major concern for the individual. Many times, the physician or ophthalmologist may be the first one to notice the eye symptoms. Untreated, ocular rosacea may cause a serious complication that can damage the cornea permanently damaging vision, called rosacea keratitis. An ophthalmologist can assist in a proper eye evaluation and prescribe rosacea eyedrops. Oral antibiotics may be useful to treat skin and eye rosacea.
"Acne scars are very challenging to treat and are even more challenging to treat once they've been given time to age," says Joel Schlessinger, M.D., a board-certified dermatologist in Omaha, Nebraska. Although he says the best option is prevention (but if you just can't resist popping your pimples, do it the doctor-approved way!), there are ways to treat acne scars to drastically reduce their appearance.
Not for those with moderate to severe acne: Facials are effective in removing comedones (whiteheads and blackheads), but aren’t for those with many pimples, or inflammatory acne. Exfoliants help reduce comedones, but they frequently irritate pimples — causing them to become more inflamed and noticeable. Also, extracting inflammatory acne, like nodules and cysts, can be very challenging and when done improperly, can lead to scarring or further inflammation.
Exfoliating cleansers and masks: A variety of mild scrubs, exfoliants, and masks can be used. These products may contain salicylic acid in a concentration that makes it a very mild peeling agent. These products remove the outer layer of the skin and thus open pores. Products containing glycolic or alpha hydroxy acids are also gentle skin exfoliants.