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Rosacea is an inflammatory skin disease that is predominantly associated with facial redness. It is often mistaken for acne, but the condition is actually quite different. Rosacea affects primarily fair skinned adults, between the ages of 30 and 60. It is a chronic skin condition that affects approximately 14 million Americans, more commonly women but also men. It’s not dangerous but because it affects your appearance, it can be problematic.
Left untreated, rosacea tends to worsen over time. In most people, however, it is cyclic – the symptoms may flare up for a period of weeks to months and then lessen for a while before flaring up again. Rosacea can be mistaken for other skin problems, such as skin allergy, acne or eczema. Once diagnosed, it’s quite treatable.
What are the symptoms of rosacea?
Signs and symptoms of rosacea include:
- Red areas on the face
- Small, red bumps or pustules on the nose, cheeks, forehead and chin
- Red, bulbous nose (rhinophyma)
- Visible small blood vessels on the nose and cheeks
- Burning or gritty sensation in your eyes (ocular rosacea)
- Tendency to flush or blush easily
Also, Rosacea typically appears in phases:
- Pre-rosacea: Rosacea may begin as a simple tendency to flush or blush easily, then progress to a persistent redness in the central portion of your face, particularly your nose. This redness results from the dilation of blood vessels close to your skin’s surface. This phase may sometimes be referred to as pre-rosacea.
- Vascular rosacea: As signs and symptoms worsen, vascular rosacea may develop — small blood vessels on your nose and cheeks swell and become visible (telangiectasia). Your skin may become overly sensitive. Rosacea may also be accompanied by oily skin and dandruff.
- Inflammatory rosacea: Small, red bumps or pustules may appear and persist, spreading across your nose, cheeks, forehead and chin. This is sometimes known as inflammatory rosacea. In severe and rare cases, the oil glands (sebaceous glands) in your nose and sometimes your cheeks become enlarged, resulting in a buildup of tissue on and around your nose (rhinophyma). This complication is much more common in men and develops very slowly over a period of years. In addition, more than half the people with rosacea experience ocular rosacea — a burning and gritty sensation in the eyes. Rosacea may cause the inner skin of the eyelids to become inflamed or appear scaly, a condition known as conjunctivitis, which can be treated with topical antibiotics.
What Causes Rosacea?
The cause of Rosacea remains unknown, but scientists increasingly believe it is due to a combination of hereditary and environmental factors. The environmental factors, called triggers, may vary from one person to another. Common triggers include:
- Hot foods or beverages
- Spicy foods
- Temperature extremes
- Stress, anger or embarrassment
- Strenuous exercise
- Hot baths, saunas
- Drugs that dilate blood vessels, including some blood pressure medications
Treatment for Rosacea
Rosacea rarely clears up on its own and as previously stated, tends to worsen over time if left untreated. Many over-the-counter skin care products contain ingredients such as acids, alcohol and other irritants, that may actually worsen the condition. Because of the progressive nature of Rosacea, an early diagnosis is important. Treatments are more effective if started early. Although there’s no way to eliminate rosacea altogether, signs and symptoms can be relieved and reduced. Most often this requires a combination of prescription treatments and certain self-care measures. Particular moisturizers, cleansers and sunscreens will help improve the health and appearance of your skin.
Doctors often prescribe topical antibiotics to treat rosacea, due to their anti-inflammatory properties which destroy bacteria. A common topical antibiotic prescribed is metronidazole (Metrocream, Metrogel, Noritate). Another prescription medication is azelaic acid (Azelex, Finacea), which reduces redness and inflammation.
Oral antibiotics may also be prescribed in combination to achieve noticeable results faster. In many cases, dermatologists will often prescribe both oral and topical antibiotics for this very reason, followed by long-term use of a topical antibiotic alone to maintain remission. Some of the most common prescription oral antibiotics include tetracycline, minocycline, doxycycline and erythromycin. The duration of your treatment depends on the type and severity of your symptoms, but typically you’ll notice an improvement within weeks. Because symptoms may recur if you stop treatment protocol, regular treatment is often necessary.