Before & After Photos

Overview

Rosacea affects an estimated one million Australians. Since publishing the article "Rosacea: Enigma or Cure" in Australian Cosmetic Surgery Magazine (Issue 20), there was overwhelming interest by many patients from all over the country. After treating hundreds of patients over the past 5 6 years and listening very carefully to what they had to say, 1 have leant so much about Rosacea that is not written in the textbooks. The striking feature is the psychological suffering the Rosacea patient is going through, the intensity of the emotional turmoil and above all the extent of the social implications. This can range from social event avoidance, resignation from work and even total house confinement.

Rosacea is a progressive inflammatory disorder of the skin of unknown aetiology. Rosacea affects the upper part of the body (i.e. sun exposed parts), predominantly the facial skin and the eyes. However the neck and upper chest are frequently involved including the nucheal area and the upper arms. Initial vascular symptoms that present with mild flush and come and go rosy colour across the nose, cheeks and chin, may be misinterpreted as a healthy looking skin. The physician should be on the lookout for pre rosacea symptoms because these are early warning signs.

Facial Redness Facial redness is the commonest symptom.

• Facial telangiectasia (broken capillaries): they are tiny pathological new blood vessels as a fine red lines coursing through the surface of the facial skin.
• Hyper reactive facial skin is believed to be caused by severely inflamed blood vessels near the surface of the skin.
• Uneven skin texture may be present with skin dryness, enlarged pores, papules (in fact they are not acne), pustules, nodules (large lumps) and skin swelling.
• Skin sensation can present as an occasional or constant burning sensation; fluctuating constant pain triggered by it, blowing wind or even by the collar of the shirt. Facial pain and burning sensations may be severe in some sufferers, causing debilitation. At present I am treating a 45 year old gentleman who used to take 4 5 Nurontin tablets every day and now after PhotoLaser therapy he takes 1 2 tablets occasionally.
• Rhinophyma is a form of rosacea characterized by increased tissue growth of the nose.

The Rosacea Society Medical Committee has recently developed a “Rosacea Classification System” that was published in the journal of the American Academy of Dermatology in 2002. Below is the summary:

Rosacea Subtypes (Dr Georghy classification)
• Vascular (erythemato-telangiectatic) Rosacea
• Acneiform Rosacea
• Phymatous Rosacea
• Ocular Rosacea
• Neuropathic Rosacea
• Complex (3 or more)

Rosacea Symptoms
• Facial Redness with or without swelling
• Papules, Pustules, Nodules & Ulcers
• Facial Skin Growth/Thickening
• Eye Symptoms
• Pruritis (itch)
• Facial Pain
• All of the Above (my experience)

I administer PhotoLaser therapy from a distance, applying no gel to the skin or any cooling device. This therapy not only treats the symptoms of rosacea but also treats the root of the problem. The biological effects delivered by this therapy are numerous: it stimulates cell growth and regeneration, repairs and stimulates DNA and provides an anti inflammatory reaction, which is immediate. "Blood vessels that feed the skin are very tiny and if they are not functioning properly the skin reacts by becoming inflamed with pathological blood vessels that do not provide the same nutritional effects as normal blood vessels," explains Dr Georghy. "Using PhotoLaser energy with certain frequency applied gently and from a distance, it stimulates the formation of new healthy blood vessels while shutting down the abnormal pathological ones. This delivers more oxygen and provides better nutritional support to the skin at a cellular level. This, coupled with the immediate anti-inflammatory reaction is the key issue in PhotoLaser therapy. ”

Molecular biology (altering protein production that predisposes an individual to a certain disorder such as rosacea) is the cornerstone of cures (without avoiding the triggers). Topical Antisense technologies can now target and block hyperangiogenesis via VEW (vascular endothelial growth factor). It can also block inflammatory proteins such as cellular adhesions molecules, which are key regulators of rosacea inflammation. It is worth mentioning Human Epidermal Growth Factor. These are being trailed on rosacea patients but it is too early to make any conclusions. They are very expensive and contain ingredients that may aggravate the rosacea. The patient should not purchase these treatments without prior consultation with the treating doctor. Dr Georghy comment: “It is my believe that UV light, various skin care products including certain type of food may be responsible for altered protein production. The above factors are an initial trigger factor in establishment of the disease in predisposed individuals. This is similarly to asthma or Trigeminal Neuralgia but totally different pathology”.