Acne Treatment Induced Rosacea

Rosacea can result from abuse to the skin caused by products and treatments that have been applied to the skin the treatment of other skin conditions such as acne.

As adults, when we get a pimple we tend to treat it the same way we did as teenagers – our old acne zit cream or lotion packed with high concentrations of benzoyl peroxide, salicylic acid and sometimes even topical vitamin A products.

The problem is that adult skin doesn't respond the same way to these products as teenage skin does. The result is red blotchy areas, more break outs and increased skin sensitivity. In trying to control this, we apply even more and stronger treatments to our skin, but instead of seeing an improvement; we actually see more damage and skin-related issues as the skin creates more oil to protect it from the damage and abuse of these harsh chemicals. Thus creating a vicious cycle of over-medicating the skin causing increased facial redness, clogged pores and skin irritation.

To examine each of these traditional acne treatments more closely, we need to first examine what it is that we are actually applying to our skin.

What exactly is benzoyl peroxide? Benzoyl peroxide is an oxygen-releasing chemical that causes drying, peeling and antibacterial action on the skin. It is the #1 topical treatment for acne lesions. The release of oxygen is important to combat the anaerobic bacteria present in the acne-affected follicles. The peeling and drying effects peel the acne pustules (vesicles filled with pus) and open up the comedones (non-inflammatory acne lesions, such as black heads or white heads). Benzoyl peroxide is absorbed in the skin where it is metabolized to benzoic acid and then excreted as benzoate in the urine. Side effects consist mainly of skin irritation including burning, blistering, crusting, itching, severe redness, and skin rash.

Use of benzoyl peroxide for adult acne can often lead to a more serious skin condition called rosacea. Rosacea is defined as a hereditary; chronic (long term) skin disorder that most often affects the nose, forehead, cheek bones, and chin (Dr. Berasques). Groups of tiny micro vessels (arterioles, capillaries, and venules) close to the surface of the skin become dilated, resulting in blotchy red areas with small papules (a small, red solid elevated inflammatory skin lesion without pus, that is minor when the size is of a small measles lesion, moderate when about the size of a pencil eraser, and severe when the papule is the size of a small currency coin or the tip of the little finger) and pustules (pus-filled inflammatory bumps). The redness can come and go, but eventually it may become permanent.

Benzoyl peroxide based products seem to flood the market in acne treatment options. But how safe is benzoyl peroxide? The International Rosacea Foundation mentions these precautions when using benzoyl peroxide based products:

• Do not use this medicine in or around the eyes or lips, or inside the nose, or on sensitive areas of the neck. Spread the medicine away from these areas when applying. If the medicine gets on these areas, wash with water at once.
• Do not apply this medicine to wind burned or sunburned skin or on open wounds, unless otherwise directed by your doctor.
• To avoid further damage to your skin, it is especially important to avoid using the following skin products on the same area as benzoyl peroxide:
• Any other topical acne product or skin product containing a peeling agent (such as resorcinol, salicylic acid, sulfur, or tretinoin);
• Hair products that are irritating, such as permanents or hair removal products;
• Skin products that cause sensitivity to the sun, such as those containing lime or spices;
• Skin products containing a large amount of alcohol, such as astringents, shaving creams, or after-shave lotions;
• Skin products that are too drying or abrasive, such as some cosmetics, soaps, or skin cleansers.

Salicylic Acid is another common ingredient in many acne products. Commonly known as aspirin, salicylic acid is also used for wart removal. Salicylic acid removes the outer layer of skin and is toxic in large amounts.

Salicylic acid can irritate or damage healthy skin surrounding the application site. On rare occasions, salicylic acid treatment causes scarring.

Retinols or Vitamin A based products act as a chemical peeling agent, which helps the skin to renew itself more rapidly. By increasing the rate of turnover of the skin, it reduces pimple and black head formation. It is commonly used to treat acne as well as to treat fine wrinkling.

Topical vitamin A has a number of common side effects--such as burning, redness, itching, peeling, and stinging; but it is very effective at increasing the shedding of coenocytes, the cells of the topmost layer of the epidermis, contributing to smoother-feeling skin. It also reduces pigmentation and more evenly distributes pigment in the epidermis, resulting in the improvement of mottled hyper pigmentation. This really limits your ability to use these products as part of your daily skin care regimen.

Is there a better way to treat pimples without the resulting dryness, redness, flaking and irritation to the skin? Many have found the use of zinc to be effective for acne. Topically applied zinc has been used for decades by various medical physicians for the treatment of inflammatory acne. They have used zinc either as the primary ingredient or in conjunction with other anti-acne medications. Currently, zinc is found in several different active forms in hundreds of over-the-counter skin care products and anti-acne medications. Topically applied zinc has been shown to have a potent anti-septic effect (Drs. Provost and Farmer). More specifically, evidence suggests that zinc has anti-bacterial and anti-fungal actions, as well as mild anti-inflammatory actions (Drs. Rock, Wilkinson, and Ebling).