sensitive dry and flaky skin, sebum and sebaceous glands

From:  “Linda Sy MD” 
Date:  Mon Jan 4, 1999  4:35 am

Matija,

It has always been my (previous) belief that the “dryness, flaking and sensitivity” in rosacea patients are associated with and initiated by genetically hyperactive sebaceous glands that secrete more sebum than non-rosacea individuals. The oil (sebum) dries on the skin forming a thin flaky film much like what we see in cradle cap in babies (we call this seborrheic dermatitis). For some reason, the normal resident microorganisms on the skin, flourish in this oil-rich milieu and probably produce some end-products(free fatty acids?) that cause inflammation.

This in return causes redness and irritation. The skin’s immune system tries to control this inflammation by vasodilatation, sending more blood supply to the area thus causing telangiectases (broken blood vessels). The rosacea patient perceives this “rash” as allergy or dry sensitive skin and is reluctant to use moisturizers or sunscreens or soaps on his/her skin because all these products seem to cause burning and stinging. These sensations, BTW, are real. What happens next is that the skin does become drier, unprotected and more inflamed- perpetuating the vicious cycle. At the same time, sebum plus dry flaky dead cells clog pores causing pimples (acne/peri-oral dermatitis). This is a theory.

In conclusion, 3 factors are involved: sebaceous gland activity, inflammation and vascular reactivity. To make things more confusing, are the various triggers. Which is the horse and which is the cart? Are less severe individuals less sensitive and perceive their skin as oily/combination while the more severe perceive their skin as dry and sensitive? Can careful selection of cleansing products, sunscreen, moisturizers, topical anti-microbial etc.  prevent mild rosacea from becoming severe and even maintain control? Anyway, I hope that when we conclude the test, (which incidentally, involves a good mix -males, females, diff. ages, diff skin types) we’ll be able to shed some light!

Linda Sy M.D.
Linda Sy Skin Care
http://www.lindasy.com

—–Original Message—–

From: David RuizdelVizo
To: rosacea-support@_.com>
Date: Saturday, January 02, 1999 2:26 PM
Subject: [rosacea] Re: rosacea and wrinkles

Dr Sy:

I notice that some with Rosacea can use body lotions and moisturizers with much success. However, I have never been able to use those products because they consistently produce severe reactions — red, burning skin with lots of pimples and bumps. Even if I use body lotion that’s non-comeodegenic (sp?), and use separate towels for my face and body, my face reacts horribly. My derm doesn’t take this concern seriously. I have been diagnosed with atopic dermatitis, acne and rosacea. Anyway, I hope these new products that you’re testing can work for people like me. Good luck to you, and thank you for taking our concerns seriously.

Matija Mosunic

—Linda Sy MD  wrote:

Mary,

I have not heard of any data about rosacea causing wrinkles. As a matter of fact, many of my patients w/ rosacea have less wrinkles because of the amount of sebum they have on their skin. A couple of theories why some rosacea sufferers may look older than their chronological age could be: 1) they have very fair skin that burns easily and they were afraid to use any or adequate sunscreen, thus getting sun-damaged and wrinkled. 2) They have inflamed easily irritated skin like some of you and because of this, did not use lubrication. This causes severe dryness, inflammation and flaking that give the skin a dull wrinkled appearance. The skin is akin to a piece of hide. If dehydrated and not oiled properly, while being exposed to water, wind, chemicals, sun etc - it shrivels up, cracks, becomes brittle and easily irritated- in other words, burns and stings like crazy.

How to manage this or prevent this? The answer is to find the proper products that will lubricate and protect yet not cause problems or interfere w/ the treatment medications. It may not be easy but that is the point of my project. With the help of 12 volunteers, I hope to conclude w/ some basic answers to some puzzling questions.

Linda Sy M.D.
http://www.lindasy.com

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