Living with Rosacea - Denise, aesthetician

Tuesday, April 30th, 2019

Hi, my name is Denise Hand.  I am a Licensed Aesthetician and a Licensed Assistant Laser Practitioner.  This is my first week at Dermatology Affiliates.  I'm very excited to be a part of Dr. Forney's team.  This is a second career for me.  My journey into the world of Aesthetics and Dermatology started in my forties.  Prior to becoming an Aesthetician, I was a Licensed Clinical Social Worker and a Licensed Marriage and Family Therapist.  I'm sure your next question is why?  It was time for a change, but I knew I still needed to be in a profession in which I could give patients the tools, support, education, and empathy they needed to address a problem or improve their self esteem.  

In addition to my desire to help people, skin diseases and disorders had always intrigued me, probably because growing up I battled acne, redness, and sensitivity.  While the acne improved some with age, I noticed that the redness and flushing was more prominent in my 30s.   When I would work out, people in the gym would approach me and ask if I was "ok" because my face would be extremely red during my entire workout.  My face was always red in the summer, especially if I was outside in direct sun.  When I turned 40, I began experiencing stinging and burning with the flushing.  My skin was finely textured with some scaling on the central face, and I began noticing dilated capillaries on my cheeks and chin.  Needless to say, I became increasingly frustrated.  

Just like so many of my new patients, rather than seeing a Dermatologist, I sought help at the cosmetics counter.  Most of the time I was given a green makeup primer to conceal the redness or skin care that only exacerbated my redness and caused more capillary damage.  At one time, I was using a granular scrub daily, an alcohol based toner, and a scented moisturizer.  My skin had never looked so bad. 

I finally sought the help of a Dermatologist.  Smart idea!  I could have saved myself hundreds of dollars by doing this first.  Fortunately, I was blessed with a very knowledgeable and compassionate Dermatologist who diagnosed me with rosacea.  I learned that rosacea was common.  More than 16 million Americans have rosacea - and most don't know it.  

Fast forward to today.  I have learned so much since the day I decided to have a professional analyze and diagnose my problem.  I am passionate about helping those who have this condition.  I have familiarized myself with the different subtypes of rosacea.  Rosacea is an inflammatory condition, and typically what determines the subtype is the location and pattern of the inflammation.  The types of Rosacea often overlap, and it's possible to have more than one type.  While rosacea is more common in fairer skinned individuals, it can occur in skin of all colors.  

The type of rosacea that I have is called 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 subtle.  Like myself, people with this type of Rosacea tend to be sensitive.  Other individuals may have Papulopustular Rosacea, which is usually considered the classic rosacea subtype, with inflammation heavily centered around the pore, causing pimple like redness and swelling, sometimes with pustules and papules.  There may or may not be a history of sensitive skin.  The skin may be sebaceous and oily, red, thick, and swollen.  

I hope by sharing my own story, it will encourage those of you who are struggling with similar symptoms to reach out to a Dermatologist or PA who specializes in Dermatology here at Dermatology Affiliates to diagnose your condition, and if necessary, prescribe the appropriate medication.  One of the most appealing things about working at Dermatology Affiliates, is Dr. Forney's collaborative approach to treatment of various skin disorders.  She realizes the vital role a well-trained and well-educated Aesthetician/Associate Laser Practiioner can play in the treatment of a skin disorder like rosacea.  

In addition to providing laser services that address diffuse redness and eliminate the damaged capillaries, I believe it is equally important to educate patients on common rosacea triggers.  This may require keeping a rosacea diary checklist.  My main trigger is emotional stress.  Someone else may be more triggered by spicy food or alcohol consumption.  Over the years, I have put together a list of simple things you can do to help cope with your triggers.  I look forward to sharing those with you.  

Of particular importance to me is taking a detailed history that includes what products and procedures the patient is using or has used.  What has he or she tolerated? I use this history as a guide.  Most of the time, people with rosacea tolerate nonirritating products better.  I like to start with the basics, including: cleanser, treatment, hydration, and protection.  The advantage to seeing an Esthetician like myself who is part of a Dermatology practice is I am aware of what your physician or PA has prescribed or recommended.  If you have a prescription topical, I can help you understand how to incorporate that into a safe, nonirritating home skin care routine.  

When formulating a safe, nonirritating home skin care routine and a plan for in office treatments, I strongly believe it is important to address the role your skin's barrier function plays.  I will determine if my patient is suffering from the exquisitely sensitive skin of the erythematotelangiectatic type of rosacea like myself, or the tougher skin of papulopustular rosacea - or if they fall somewhere in between.  In general, the facial skin barrier strength in rosacea is compromised, making any irritating products or treatments, such as those for anti-aging, much more aggravating to rosacea-prone skin.  Yet another reason to to see myself or one of the other Estheticians who are more knowledgeable about skincare ingredients and skilled in skin analysis.

I welcome the opportunity to look at your current skin care and analyze the ingredients.  Feel free to bring your products to your appointment or write them down.  The most common mistake I see with rosacea is over-exfoliation, which further compromises the skin's barrier function and contributes to more redness or using too many products.  It is always best to start with a simple, nonirritating routine that strengthens your skin's barrier function.  With my help, I can recommend anti-aging products that are less likely to be irritating.  For example, vitamin C is a powerful antioxidant and should be an essential part of any woman's anti-aging routine.  However, some of the more popular vitamin Cs on the market are in a form that is too acidic for someone with rosacea.  

Moisturizers are important to heal a compromised skin barrier that often accompanies rosacea.  I can assist you in making the appropriate selection.  While it is imperative to consider the rosacea, it is also important to analyze the skin and take into account the history I mentioned earlier.  Is a heavier moisturizer more appropriate or does the patient have oily, papulopustular rosacea?  In the case of the latter, non-oil ingredients like hyaluronic acid and glycerin may help increase skin moisture without leaving a heavy product feel on patient's skin.  

Finally, the number one most important product in your battle against rosacea is a great sunscreen.  Sunscreen is not just for the beach or the pool, it should be worn daily.  Prior to becoming an Esthetician, I loathed sunscreen.  Either it burned my skin right after application or once I started sweating, my cheeks were on fire.  Guess what?  No one ever educated me on the difference between chemical and physical blockers in sunscreens.  Physical blockers like zinc oxide and titanium dioxide are preferred for people with rosacea.  I learned that chemical sunscreens could sting and irritate sensitive skin rosacea-skin, and they also generate a slight amount of heat as they deflect the UV rays.  Three of my favorite sunscreens are EltaMD UV Clear, which is formulated with Niacinamide (good for inflammation), TruPhysical by Revision for a tinted anti-aging moisturizer with spf 46, and Eryfotona by ISDIN. 

I am thrilled to be a part of the Dermatology Affiliates family.  If you can relate to my story or have been battling rosacea or sensitivity for a while, let's work as a team, in conjunction with your physician or PA to come up with a comprehensive plan to treat your rosacea.  Let me guide you through the process.  I'm here to help with all your skin care needs.  We will work together as a team to formulate short and long term goals to get your skin healthy and less inflamed.