Rosacea is a common, chronic, disorder of facial skin that causes redness in the face, often with small, red, puss-filled papules, characterized by flares and remissions. It begins after age 30, as redness on the cheeks, nose, chin or forehead, which waxes and wanes. In some cases, rosacea may also occur on the neck, chest, scalp, or ears. Over time, the redness becomes more persistent, and ruddier. Visible blood vessels may appear. Left untreated, bumps and pimples often develop. In some severe cases, the nose may grow swollen and bumpy from excess tissue. This condition is called rhinophyma. In many patients, the eyes are also affected, feeling irritated and appearing watery or bloodshot.
Rosacea can affect anyone, but individuals who are fair-skinned, and tend to flush and blush easily, are at greatest risk. It affects women more than men, often starting in middle age, but the most severe signs and symptoms are found in men, possibly because they delay treatment until the disease is advanced.
There is no cure for rosacea and the cause is unknown, but your cosmetic dermatologist can recommend medical therapy control or reverse the signs and symptoms. Individuals who suspect they may have rosacea are urged to see a cosmetic dermatologist for diagnosis and appropriate treatment.
Signs and Symptoms
Signs and symptoms of rosacea may include:
- Facial redness. Rosacea usually causes a persistent redness in the central portion of the face. Small blood vessels on the nose and cheeks often swell and become visible.
- Swollen red bumps. Many people with rosacea develop bumps on their face that resemble acne. They sometimes contain pus. The skin may feel tender, and hot.
- Eye problems. About half of the people who have rosacea also experience eye dryness, irritation, and swollen, reddened eyelids. In some people, eye symptoms precede the skin symptoms.
- Enlarged nose. Rarely, rosacea can thicken the skin on the nose, causing the nose to appear bulbous (rhinophyma). That occurs more often in men than in women.
Causes and Triggers
The cause of rosacea is unknown, but it is thought to be a combination of hereditary and environmental factors. There are some factors that can trigger or aggravate rosacea by increasing blood flow to the surface of your skin. Some of the factors include:
- Hot foods or beverages
- Spicy foods
- Alcohol
- Temperature extremes
- Sunlight
- Stress, anger or embarrassment
- Strenuous exercise
- Hot baths or saunas
- Corticosteroids, such as prednisone
- Drugs that dilate blood vessels, including some blood pressure medicines
- Cool, dry wind
Diagnosis for Rosacea
Diagnosis is made by examination of the skin by a cosmetic dermatologist, with consideration given to symptoms, and fluctuation of signs and symptoms over time. There is no specific test for rosacea.
Treatment for Rosacea
Although there’s no cure for rosacea, cosmetic dermatology treatments can control and reduce the signs and symptoms. For best results, your cosmetic dermatologists will usually recommend a combination of prescription treatments and/or procedures, along with lifestyle changes. Surgical and other procedures, as well as prescription drugs used for rosacea may include:
Rosacea Medications
Antibiotics. The antibiotics used for rosacea have anti-inflammatory effects. There are various methods of delivery, including creams, gels, or lotions to apply topically, and oral pills. Antibiotic pills are usually more effective for short-term consumption, but may have more side effects.
Acne drugs. If antibiotics are not effective, isotretinoin (Accutane, Claravis, others) may give a better result. It’s a powerful drug, taken orally, which is usually reserved for severe cystic acne. It’s tightly regulated, especially for treatment of women in their child-bearing years. It is known to cause severe birth defects.
Procedures to Remove Signs & Symptoms of Rosacea
Intense Pulsed Light (IPL), the medical name is selective photothermolysis. IPL emits a broad spectrum of high intensity light that destroys the unsightly blood vessels. Eventually, the treated blood vessels are replaced by scar tissue, which does not promote the signs and symptoms of rosacea.
Vbeam Perfecta Pulsed Dye Laser. This treatment is similar to IPL. It’s very effective, eliminating treated blood vessels, reducing the bright redness, and is used for wrinkles around the eyes. It also stimulates collagen, hydrating and firming the skin. Patients may see results after just 3 to 4 sessions. It’s easy, painless, and requires no patient care. After treatment, the individual can return to usual activity immediately.
Photodynamic Therapy (PDT). This treatment uses particular wavelengths of light, along with a substance which is activated by the light, to enhance the effect of the light on target vessels and quickly destroys their function. Patients will experience remarkable improvement in skin texture and tone. Discoloration and acne-like pustules decrease steadily. Mayoral Dermatology patients will see 80 to 90 percent improvement in their rosacea after several treatments.
Blue Light Therapy. This particular wavelength of light destroys the bacteria known to cause acne (Propionibacterium acnes). It is not effective for everyone. Potential side effects are redness and mild swelling.
Prevention and Lifestyle Management
Once treatment achieves remission, it can be maintained by identifying and avoiding lifestyle and environmental factors that trigger flare-ups or aggravate an individual’s condition. Refer to the section listing triggers for what you may need to avoid. Suggestions to prevent flare-ups include:
- Wear broad-spectrum sunscreen with an SPF of 30 or higher
- Protect your face in cold weather – use a scarf or ski mask
- Avoid irritating your facial skin by rubbing or touching it too much.
- Wash problem areas with a gentle cleanser (Dove, Cetaphil)
- Avoid facial products that contain alcohol or other skin irritants.
More information on Rosacea may be found at:
- National Rosacea Society, 196 James Street, Barrington, IL 60010, [email protected], http://rosacea.org, 888-NO-BLUSH
- American Academy of Family Physicians: http://familydoctor.org/familydoctor/en/diseases-conditions/rosacea.html
- National Rosacea Society: http://www.rosacea.org
- U.S. Department of Health and Human Services, Office on Women’s Health: http://www.womenshealth.gov/news/healthday/en/2013/jul/17/677977.html
- Mayo Clinic: http://www.mayoclinic.org/diseases-conditions/rosacea/basics
- National Library of Medicine: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0004971
- National Institutes of Health: http://www.nlm.nih.gov/medlineplus/rosacea.html
