Guest guest Posted July 5, 2002 Report Share Posted July 5, 2002 Helen, an alternative is that aggressive exfoliative treatment causes an irritative contact dermatitis, and interruption of the epithelial protective barrier perpetuates the underlying dermatitis. Not everything that is acneiform is rosacea, even in rosaceans. So the key may not be easy flushing/blushing, but skin sensitivity (that is a frequent rosacean feature from pre-condition onwards, but also affects non-rosaceans) upon which aggressive treatment causes an inflammatory reaction more common in rosaceans but unrelated to rosacea itself. I don't know. To gain more information, I performed a quick Medline search on various related terms and came up with: -=-=-= Dermatol Surg 1998 Mar;24(3):337-41 The etiology of prolonged erythema after chemical peel. Maloney BP, Millman B, Monheit G, McCollough EG. Georgia Facial Plastic Surgery, Atlanta, USA. BACKGROUND: As the number and methods of skin resurfacing procedures are increasing, there is a small number of patients that develop a prolonged inflammation during the postoperative period. OBJECTIVE: We attempted to correlate risk factors for the development of prolonged postpeel erythema (PPPE) and inflammation. A treatment regimen will be described to eliminate permanent skin changes. METHODS: A retrospective chart review is presented to define and correlate risk factors for the development of PPPE and a treatment protocol is described. The setting is a large multisurgeon aesthetic center. Two- hundred and thirty-six consecutive chemical phenol peels on 196 patients over a 2-year period were reviewed. RESULTS: Eleven percent of patients developed PPPE. Allergy to tape was the only factor significantly correlated with PPPE. All patients had complete resolution of skin changes with appropriate treatment. CONCLUSION: A small population of patients undergoing skin resurfacing procedures will develop prolonged erythema. No major risk factor could be correlated with its development. A treatment plan was devised and was successful in all cases. PMID: 9537008 [PubMed - indexed for MEDLINE] -=-=-= I can't tell what's going on. Does anyone have access to the full- text article? I see that the first author has moved on to a new practice: http://www.advancedsurgerycenter.com/specialties/cosmetic.htm A second article looks more objective and may have some answers. (Unfortunately, I don't have full-text access to this journal either): -=-=-= J Oral Maxillofac Surg 1999 Jul;57(7):837-41 Diagnosis and treatment of postoperative complications after skin resurfacing. Demas PN, Bridenstine JB. Department of Oral and Maxillofacial Surgery, University of Pittsburgh Medical Center, PA 15261, USA. Chemical peel, dermabrasion, and laser skin resurfacing are alternative methods to achieve skin resurfacing for reconstructive or cosmetic applications. The potential postoperative complications are similar with all of these techniques. These postoperative complications and their therapy are reviewed. Publication Types: Review Review, Tutorial PMID: 10416632 [PubMed - indexed for MEDLINE] -=-=-= Marjorie Marjorie Lazoff, MD > Iwish more people would be aware that a chemical peel or laser skin > resurfacing (which I had) can bring a tendency to blushing into full > rosacea. That is what happened to me. I never was bothered by any > kind of acne or papules before. > It is too bad that doctors will not even mention this to their > patients as one of the possible side effects of the procedure. > Helen Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 5, 2002 Report Share Posted July 5, 2002 Helen, an alternative is that aggressive exfoliative treatment causes an irritative contact dermatitis, and interruption of the epithelial protective barrier perpetuates the underlying dermatitis. Not everything that is acneiform is rosacea, even in rosaceans. So the key may not be easy flushing/blushing, but skin sensitivity (that is a frequent rosacean feature from pre-condition onwards, but also affects non-rosaceans) upon which aggressive treatment causes an inflammatory reaction more common in rosaceans but unrelated to rosacea itself. I don't know. To gain more information, I performed a quick Medline search on various related terms and came up with: -=-=-= Dermatol Surg 1998 Mar;24(3):337-41 The etiology of prolonged erythema after chemical peel. Maloney BP, Millman B, Monheit G, McCollough EG. Georgia Facial Plastic Surgery, Atlanta, USA. BACKGROUND: As the number and methods of skin resurfacing procedures are increasing, there is a small number of patients that develop a prolonged inflammation during the postoperative period. OBJECTIVE: We attempted to correlate risk factors for the development of prolonged postpeel erythema (PPPE) and inflammation. A treatment regimen will be described to eliminate permanent skin changes. METHODS: A retrospective chart review is presented to define and correlate risk factors for the development of PPPE and a treatment protocol is described. The setting is a large multisurgeon aesthetic center. Two- hundred and thirty-six consecutive chemical phenol peels on 196 patients over a 2-year period were reviewed. RESULTS: Eleven percent of patients developed PPPE. Allergy to tape was the only factor significantly correlated with PPPE. All patients had complete resolution of skin changes with appropriate treatment. CONCLUSION: A small population of patients undergoing skin resurfacing procedures will develop prolonged erythema. No major risk factor could be correlated with its development. A treatment plan was devised and was successful in all cases. PMID: 9537008 [PubMed - indexed for MEDLINE] -=-=-= I can't tell what's going on. Does anyone have access to the full- text article? I see that the first author has moved on to a new practice: http://www.advancedsurgerycenter.com/specialties/cosmetic.htm A second article looks more objective and may have some answers. (Unfortunately, I don't have full-text access to this journal either): -=-=-= J Oral Maxillofac Surg 1999 Jul;57(7):837-41 Diagnosis and treatment of postoperative complications after skin resurfacing. Demas PN, Bridenstine JB. Department of Oral and Maxillofacial Surgery, University of Pittsburgh Medical Center, PA 15261, USA. Chemical peel, dermabrasion, and laser skin resurfacing are alternative methods to achieve skin resurfacing for reconstructive or cosmetic applications. The potential postoperative complications are similar with all of these techniques. These postoperative complications and their therapy are reviewed. Publication Types: Review Review, Tutorial PMID: 10416632 [PubMed - indexed for MEDLINE] -=-=-= Marjorie Marjorie Lazoff, MD > Iwish more people would be aware that a chemical peel or laser skin > resurfacing (which I had) can bring a tendency to blushing into full > rosacea. That is what happened to me. I never was bothered by any > kind of acne or papules before. > It is too bad that doctors will not even mention this to their > patients as one of the possible side effects of the procedure. > Helen Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 5, 2002 Report Share Posted July 5, 2002 : " emarjency " writes in reply to Helen regarding peels: > aggressive exfoliative treatment causes > an irritative contact dermatitis, and interruption of the >epithelial protective barrier perpetuates the underlying >dermatitis. I have never had a peel, but would consider cosmetic surgery to correct a few aging concerns ( I am 51 ) but all this talk has made me a little apprehensive. I don't have pimples, or a bit problem with redness or flushing/flaring so I don't want to make a mild case into a full blown one. If I can get a appointment with a derm in " our one derm town " then I will discuss this with him as well as the plastic surgeon who will perform the face lift ( I presume ) but while I am waiting ( probably October/ NOvember ) then I would love to know your opinions, experiences and/or medical expertise. I have tried to do a web search but came up with nothing. So perhaps those of you who are more well versed in computer searching could help me with some appropriate descriptors or whatver they are called in computer language. Thanks Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 5, 2002 Report Share Posted July 5, 2002 : " emarjency " writes in reply to Helen regarding peels: > aggressive exfoliative treatment causes > an irritative contact dermatitis, and interruption of the >epithelial protective barrier perpetuates the underlying >dermatitis. I have never had a peel, but would consider cosmetic surgery to correct a few aging concerns ( I am 51 ) but all this talk has made me a little apprehensive. I don't have pimples, or a bit problem with redness or flushing/flaring so I don't want to make a mild case into a full blown one. If I can get a appointment with a derm in " our one derm town " then I will discuss this with him as well as the plastic surgeon who will perform the face lift ( I presume ) but while I am waiting ( probably October/ NOvember ) then I would love to know your opinions, experiences and/or medical expertise. I have tried to do a web search but came up with nothing. So perhaps those of you who are more well versed in computer searching could help me with some appropriate descriptors or whatver they are called in computer language. Thanks Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 5, 2002 Report Share Posted July 5, 2002 Hi Marjorie, In your opinion, how long should " post-operative inflammation " last? my chemical peel was last august (symptoms began 3 months later, exactly as dr nase predicted!) it has now been almost a year, with things looking worse not better. since helen's case is rather similar to mine, i was wondering whether inflammation could have affected cell renewal ? hence the almost consistent flakiness of certain parts of the skin? (i think i read somewhere that typically it takes a month to rejuvenate new layer of skin, dr nase said damaged skin could take up to 3 months?)maybe ours is even longer? > > Iwish more people would be aware that a chemical peel or laser skin > > resurfacing (which I had) can bring a tendency to blushing into > full > > rosacea. That is what happened to me. I never was bothered by any > > kind of acne or papules before. > > It is too bad that doctors will not even mention this to their > > patients as one of the possible side effects of the procedure. > > Helen Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 5, 2002 Report Share Posted July 5, 2002 Hi Marjorie, In your opinion, how long should " post-operative inflammation " last? my chemical peel was last august (symptoms began 3 months later, exactly as dr nase predicted!) it has now been almost a year, with things looking worse not better. since helen's case is rather similar to mine, i was wondering whether inflammation could have affected cell renewal ? hence the almost consistent flakiness of certain parts of the skin? (i think i read somewhere that typically it takes a month to rejuvenate new layer of skin, dr nase said damaged skin could take up to 3 months?)maybe ours is even longer? > > Iwish more people would be aware that a chemical peel or laser skin > > resurfacing (which I had) can bring a tendency to blushing into > full > > rosacea. That is what happened to me. I never was bothered by any > > kind of acne or papules before. > > It is too bad that doctors will not even mention this to their > > patients as one of the possible side effects of the procedure. > > Helen Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 6, 2002 Report Share Posted July 6, 2002 > In your opinion, how long should " post-operative inflammation " > last? I don't know, , but I would think it is self-limiting -- assuming it is managed appropriatly and there's no further exposure to irritants so the skin to heal. Otherwise it could go on indefinitely. I don't see how a single beta chemical peel can cause permanent skin damage, but dermatology isn't my specialty -- just my affliction. <g> > i was wondering whether inflammation could have affected cell > renewal ? hence the almost consistent flakiness of certain parts of > the skin? The cell renewel occurs at (in other words, cell turnover is controlled by) the basal layer of the epithelium, and responds to increase or decrease in cells at the uppermost corneum layer. This process is normal in rosaceans (though it is affected in seborrheic dermatitis, as those of you familiar with that condition know about). I don't believe there's a direct relationship between inflammation and cell turnover. Inflammation wouldn't directly cause gain or loss of corneum -- but it could indirectly, through treatments for inflammation that exfoliate. I may well be wrong, but I would think a more likely explanation for continued flakiness is a chronically impaired epithelial protective barrier resulting in dry and overly sensitive skin. (this has nothing to do with cell renewel, but with ongoing irritation/inflammation, even at very low levels). Marjorie Marjorie Lazoff, MD Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 6, 2002 Report Share Posted July 6, 2002 > In your opinion, how long should " post-operative inflammation " > last? I don't know, , but I would think it is self-limiting -- assuming it is managed appropriatly and there's no further exposure to irritants so the skin to heal. Otherwise it could go on indefinitely. I don't see how a single beta chemical peel can cause permanent skin damage, but dermatology isn't my specialty -- just my affliction. <g> > i was wondering whether inflammation could have affected cell > renewal ? hence the almost consistent flakiness of certain parts of > the skin? The cell renewel occurs at (in other words, cell turnover is controlled by) the basal layer of the epithelium, and responds to increase or decrease in cells at the uppermost corneum layer. This process is normal in rosaceans (though it is affected in seborrheic dermatitis, as those of you familiar with that condition know about). I don't believe there's a direct relationship between inflammation and cell turnover. Inflammation wouldn't directly cause gain or loss of corneum -- but it could indirectly, through treatments for inflammation that exfoliate. I may well be wrong, but I would think a more likely explanation for continued flakiness is a chronically impaired epithelial protective barrier resulting in dry and overly sensitive skin. (this has nothing to do with cell renewel, but with ongoing irritation/inflammation, even at very low levels). Marjorie Marjorie Lazoff, MD Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 10, 2002 Report Share Posted July 10, 2002 Hi , I had a facelift and the telangetasia became 100 fold. I don't think the ps new this would happen to my skin. I didn't either but I have read that this can be a side effect for those of us that have rosecea. Patty Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 10, 2002 Report Share Posted July 10, 2002 Hi , I had a facelift and the telangetasia became 100 fold. I don't think the ps new this would happen to my skin. I didn't either but I have read that this can be a side effect for those of us that have rosecea. Patty Quote Link to comment Share on other sites More sharing options...
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