Salicylic acid peeling in the treatment of rosacea

[prryjones]

Salicylic acid peeling in the treatment of rosacea1 , *1

Antonella Tosti MDa, Maria Pia de Padova MDa, Nicola Venturo MDa and Colombina Vincenzi MDa

a Department of Dermatology, University of Bologna, Bologna, Italy

Available online 10 March 2004.




Rosacea is a very common disease that may be classified in 4 stages:

1. Flushing stage or transitory congestive redness
2. Erythrosis stage or persistent teleangiectatic redness
3. Papulopustular or granulomatous stage
4. Phyma stage
The etiology and pathogenesis of rosacea remain poorly understood. Improvements in our understanding of the etiology would probably facilitate a more rational approach to treatment, which has developed along largely empiric lines.

We report here the results of a study performed on 10 patients (9 females and 1 male, aged between 30 and 45 years) affected by papulo-pustular rosacea. All patiens were treated with topical 0.75% metronidazole and with systemic tetracyclines or clarithromycin until complete or almost complete resolution of the papulopustular lesions. Patients were then treated with a series of 3–4 peelings with a 25% salicylic acid solution performed at 3–4 weeks intervals.

Complete resolution of the remaining inflammatory lesions and improvement of erythrosis was obtained in all the patiens. Salicylic acid penetrated more deeply in the areas of inflammation which showed decreased erythema; papule and pustules were rapidly dried at 1 or 2 days after the peeling. These beneficial aspects of salicylic acid peeling are probably determined by the antimmicrobic activity of salicylic acid which also stimulates fibroblasts inducing an improvement of the vascular component of rosacea.


Journal of the American Academy of Dermatology
Volume 50, Issue 3, Supplement 1 , March 2004, Page P72
Supplement to the American Academy of Dermatology: Poster Abstracts

[Tricia]

Yikes! I don't think my skin could handle one peel of 2% salycic acid let alone 4.

Tricia

[Bradley]

I really can't believe that SA can improve red cheeks in rosacea in the long term. In the short term, sure it will probably even out skin texture reasonably enough however the underlying damage in the long term on the vascular level is likely to be unprecedented!

I have had an 80% - buffered SA solution peel on my face before...it didn't do a thing but worsen the condition.

[IowaDavid]

Yeah, seriously. Take care of the p&p's but...at what cost?

[JR]

Actually, SA helped me a little a while ago. I had rough skin texture and 2% SA evened it out qite nicely, but my skin flaked and neither papules, pustules nor background redness improved. If anything the peeling made my skin more sensitive and red. I would say that SA is not favorable for most rosacea sufferers.

/JR

PS: I'm so busy at the moment I just can't keep up with all the post but I'm still alive ;)

[claudia]

I've read that some people with rosacea seem to benefit from much much milder versions of salicyclic acid...NOT the peels but from products that have just a little bit of salicyclic acid in them...i.e. 1% or less.

I don't think many people realize that the popular rosacea cream, "Z" cream, has salycylic acid listed in its ingredients but it comes after a long list of other calming ingredients.

I'm actually into my 4th day with no irritation of trying Oil of Olay Beta Hydroxy Complex SPF 15 lotion that has a teeny amount of salicyclic acid in it (...the "beta hydroxy"). It lists it at the very end, with calming ingredients in higher amounts preceding it. I'm doing this because I have P&P rosacea that has almost cleared but I have lots of visible plugged up pores, uneven skin, and skin colored bumps (milia). I think I must have a combination of mild rosacea and acne like skin...less redness flares and more blemish flares.

I know that Dr Nase and others discourage use of salicyclic acid but I'm wondering if in a really mild dose and "buffered" by a host of calming ingredients that it would not be too damaging. Also I've done a ton of reading on it and salicyclic acid is in the same family as aspirin and is considered an anti-inflammatory...besides being a very mild exfoliating agent that deep cleans the pores and moisturizes.

From what I've read, I think it works best if used with a "disinfectant" such as metrogel that kills the bacteria. I've already noted less redness in the areas that have plugged pores because I think the metrogel is getting into that area better after using the Olay lotion. I also have really really oily skin (...nice for looking younger but...) and the Olay lotion seems to be helping with that too but not in a drying way...hard to explain.

[nikkitn]

Dr. Nase did say in a post that he was using a clearasil face wash with SA in it. He said that they have formulated it so that the SA is not damaging to the skin. Here it is:

Hi Group,

A new salicylic acid cleanser just came out by Clearasil. As many
of you know my face cannot tolerate any form or concentration of
salicylic acid. It reacts within 7 to 10 days…..always. But, I
like to be a guinea pig. I stumbled across this cleanser when it
was released and have been using it for 41 days straight (one time
at night). I am simply speechless. It is fantastic on my skin. It
is also a great moisturizer. and pore cleanser. In addition, my
face has become non-reactive to the harsh winter elements and indoor
heating ever since I started using the cleanser.

If you read the ingredient list below most of the ingredients look
like rosacea death bullets. I did not expect anything but
irritation. But it has been wonderful surprise and its
inexpensive.

I believe that these companies now have the technology to put
salicylic acid in a non-irritating, soothing base. I am only one
person and I have not received any other reports yet, but based on
my strong reactions to salicylic acid in the past, I believe that
some rosacea sufferers that have acne, clogged pores, or
papulopustular rosacea may want to put this on their list to try.
If you are Subtype I with just facial redness I would probably still
stay away from anything with salicylic acid. This is just an
anecdotal report. I hope some find relief. Below is a brief
description of the product and its ingredients.

Regards,

Geoffrey

[claudia]

Well...there you go! I'd agree with Dr Nase that maybe companies are doing something different now than they did years ago. I remember trying salicyclic acid in my 20's and peeling terribly!

When I talked with Oil of Olay customer service this week they said that they specially formulated this lotion to be very gentle and that they've heard from rosacea patients that like it. This lotion (Oil of Olay SPF 15 "Protective Renewal" Beta Hydroxy Complex) also has a really mild fragrance that I was initially concerned about but they said that they've heard it's well tolerated and I'd have to agree that my skin has not reacted at all.

Reason I went with this lotion is partly to clear up plugged pores but also because I'm lazy and keep trying to streamline my routine...ie the less to put on my face the better! So finding something that unplugs pores and works as a sunscreen is very appealing