Rosacea

Medical Dermatology

Skin Conditions

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Rosacea is a common skin disease that causes redness and swelling on the face. Often referred to as "adult acne," rosacea may begin as a tendency to flush easily, but may progress to become a persistent redness in the center of the face that may gradually involve the cheeks, forehead, chin, and nose. As the disease progresses, small blood vessels and tiny pimples begin to appear on and around the red area. When it first develops, rosacea may come and go on its own. When the skin doesn't return to its normal color and when other symptoms, such as pimples and enlarged blood vessels, become visible, it's best to seek advice from a dermatologist. The condition rarely reverses itself and may last for years. It can become worse without treatment.

In more advanced cases of rosacea, a condition called rhinophyma may develop. The oil glands enlarge causing an enlarged red nose and puffy cheeks. Thick bumps can develop on the lower half of the nose and nearby cheeks. Rhinophyma occurs less commonly in women.

About 50% of people with rosacea have eye involvement. Some rosacea patients experience burning and grittiness of the eyes. If this condition is not treated, it can lead to more serious complications for the eyes. Those most likely to develop rosacea are fair-skinned adults, especially women, between the ages of 30 and 50, although it may affect men or women of any age and even children. For some unknown reason, women get rosacea more often than men, and some cases of this disorder have been associated with menopause. Rosacea usually develops over a long period of time.

The exact cause of rosacea is still unknown. The best prevention may be to avoid things that make the face red or flushed.


Prevention

  • Avoid hot drinks, spicy foods, caffeine and alcoholic beverages. Although alcohol may worsen a case of rosacea, symptoms may be just as severe in someone who doesn't drink at all. This condition has been unfairly linked to alcoholism.
  • Practice good sun protection. This includes limiting exposure to sunlight, wearing hats and using broad spectrum sunscreens with SPF of 15 or higher and avoiding extreme hot and cold temperatures.
  • Avoid rubbing, scrubbing or massaging the face. Rubbing will tend to irritate the reddened skin.
  • Exercise in a cool environment. Don't overheat.
  • Avoid irritating cosmetics and facial products. Use hair sprays properly.
  • Keep a diary of flushing episodes and note associated foods, products, activities, medications or other trigger factors.


Identifying the disease is the first step to controlling it. Self-diagnosis and treatment are not recommended, as some over-the-counter skin applications may make the problem worse.

Dermatologists often recommend a combination of treatments tailored to the individual patient. Together, these treatments can stop the progress of rosacea and sometimes reverse it.

Gels or creams may be prescribed by a dermatologist. A slight improvement can be seen in the first three to four weeks of use. Greater improvement is usually noticed in two months. Oral antibiotics tend to produce faster results than topical medications.

The persistent redness may be treated with a small electric needle or by laser surgery to close off the dilated blood vessels. Cosmetics may offer an alternative to the more specific treatment and green tinted makeup may mask the redness.

Your dermatologist may help you select a skin care regimen that will not irritate your skin further.

The key to successful management of rosacea is early diagnosis and treatment. It is also important to follow all of your dermatologist's instructions. Rosacea can be treated and controlled if medical advice is sought in the early stages. When left untreated, rosacea will get worse and may be more difficult to treat.