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No need to be bashful – try this light therapy for your rosacea!

September 23, 2021 5 min read

 Red and infrared light therapy for rosacea 

 


Rosacea - a condition that appears like permanent embarrassment but, instead, actually causes great embarrassment! Rosacea is a very misunderstood skin state that causes a lot of concern about one's appearance. Rosacea causes tiny bumps that make the skin look red and irritated – the reason for acne being part of the name in some cases. It occurs mainly on the face and is often concentrated over the cheeks and nose. It can also include a network of enlarged capillaries that add to the red damaged appearance [1]. It can be itchy and hot. In advanced stages, it can include skin lesions and a fleshy, bulbous nose that can be seen in older men. This condition is often confused with eczema and the type of acne usually seen in teenagers. It can cause a great deal of distress for the people who suffer from it. 


About 5% of the global population is affected by rosacea. It is considered a long-term skin condition that usually affects European/Caucasian women above the age of 30 [1]. 


Types of Rosacea

All cases are slightly different and have unique symptoms. 

  •  Subtype 1 - referred to as ‘Erythematotelangiectatic Rosacea’ (ETR), this is the typical rosacea with redness, inflammation, surface blood vessels and flushing. Erythema comes from the Greek word erythros, which means red [2].
  • Subtype 2 - acne rosacea is where red skin is combined with persistent or intermittent acne-like breakouts [2]. This shows as pustules and papules but not blackheads. This type can cause a burning or stinging sensation.
  • Subtype 3 -  known as phymatous rosacea or rhinophyma where parts of the face get thicker and larger, especially the nose [2]. It is most common in older men and typically starts off as a different subtype of rosacea.
  • Subtype 4 - rosacea of the eye or ocular rosacea [2]. This form shows as bloodshot, watery eyes with feeling of something in the eye, burning, itching and crusting.

Causes of rosacea


Some of the theories about the cause of rosacea are [3]:

Bacterial infection

Dust mites 

Genetics 

Environmental factors

Caffeine

Spices

Certain foods

Cold/hot weather

Stress

Alcohol

Age and the ageing process

Inflammation

Immune imbalance

Microbiome of the gut imbalance, especially the bacteria called H.pylori that has been implicated in stomach ulcers

Abnormal expression of an antimicrobial peptide called cathelicidins with elevated levels of skin protein enzymes [5]


Treatments:


This skin condition is often misdiagnosed, misunderstood and left untreated. There is no specific treatment for rosacea and the ones which are available are often not very effective in many cases. People often use topical treatments and antibiotics with varying degrees of success, often more short term than long term.


* Identify and avoid trigger foods, depending on the person

* Use sunscreen and avoid too much sun exposure

* Protecting the skin against harsh weather, either hot, cold or windy 

* A skin care routine for sensitive skin

* Using makeup to minimise the appearance


Red Light Therapy for Rosacea


Using red and infrared light can help to reduce inflammation and redness in the area, and also resolve the problem of low oxygen consumption to help normalise capillary blood supply. 


In a small study of 20 people with red facial skin, each person was given red light treatment to one side of their face only. This method allowed the other side of their face to act as the control for the study. This study was done on artificially irritated skin using laser, rather than those who had rosacea. All 20 people experienced less redness within 24 hours on the treated side. This reduced redness on the treated side continued through to the 48 hour point. By the 96 hours mark both sides had returned to normal. This means that red light can decrease the intensity and duration of skin redness [4]. 


Studies have also used infrared and red light on the papules and pustules of the subtype 2 rosacea, seeing very efficient results. It has also been seen that using this same technology can actually improve and normalise the cathelicidins and skin protein enzymes in the skin when examined in a chemical/microscopic manner. A similar study showed that infrared and red light can help to break down the biofilm of Staphylococcus aureus [5]. They found that this bacteria was implicated in rosacea so breaking down the biofilm, the protective layer around it, helped to normalise the bacterial imbalance. 


A variety of strengths of red and infrared light has been used to bring about a significant suppression of skin’s many chemicals which have been linked with rosacea production [6]. This was seen as early as within 24 hours when it was performed with a mixed red and infrared light device. It was recommended in this study to be used three times a day for a beneficial rosacea treatment but other studies used once a day so however often it is used will likely be an effective treatment option.


Studies show that the majority of people who are treated with red and infrared light can stop or significantly reduce other rosacea treatments for a period lasting from about 3 months and up to 2 years [7]. Discontinuing or changing the use of other prescribed medications or treatments should always be discussed with a doctor before doing so. It is likely infrared and red light could be used alongside these other treatments also once the doctor gives the go-ahead.


It’s highly likely that people will see improvement after their first session but consistency is key. This type of light therapy has proven to be very effective in managing rosacea symptoms and minimising redness. With this technology there’s no need to be left red-faced!



References


[1] Better Health Channel, Rosacea, Victorian State Government, Australia, 2020,https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/rosacea


[2] Jonathan Wilkin, MD, et.al, Standard classification of rosacea: Report of the National Rosacea Society Expert Committee on the Classification and Staging of Rosacea, National Rosacea Society, April 2002,https://www.rosacea.org/physicians/classification-of-rosacea/view-online


[3] AAD, Rosacea: Who gets and causes, American Academy of Dermatology Association, 2021,https://www.aad.org/public/diseases/rosacea/what-is/causes


[4] Alster T.S., Wanitphakdeedecha R., Improvement of postfractional laser erythema with light-emitting diode photomodulation. Journal of Dermatology Surgery, May 2009, https://pubmed.ncbi.nlm.nih.gov/19397672/


[5] Sorbellini E., Rucco M., Rinaldi F., Photodynamic and photobiological effects of light-emitting diode (LED) therapy in dermatological disease: an update, Lasers in Medical Science Journal, July, 2018,https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6133043/


[6] Lee J.B., Bae S.H., Moon K.R/, Na E.Y., Yun S.J., Lee S.C., Light-emitting diodes downregulate cathelicidin, kallikrein and toll-like receptor 2 expressions in keratinocytes and rosacea-like mouse skin, Experimental Dermatology Journal, December, 2016, 

https://pubmed.ncbi.nlm.nih.gov/27315464/


[7] Bryld L.E., Jemec G.B., Photodynamic therapy in a series of rosacea patients, Journal of the European Academy of Dermatology Venereology, October, 2007, 

https://pubmed.ncbi.nlm.nih.gov/17894705/