CONDITIONS

Rosacea

What Is Rosacea

Rosacea is a chronic disease of the skin that causes inflammation, redness, bumps, pimples, and skin thickening. The characteristic skin inflammation of rosacea most often occurs on the face, though it can also occur on other parts of the upper body.

According to the National Rosacea Society, rosacea affects more than 16 million Americans and typically develops between the ages of 30 and 50. With successful treatment, rosacea symptoms can be significantly reduced. If left untreated, the disease can cause lasting damage to the skin.

What Causes Rosacea

The exact cause of rosacea is still unknown. According to the American Academy of Dermatology, the following are some of the leading theories on the causes of rosacea:

  • Genetics, because rosacea is known to run in families
  • Bacteria. Some scientists believe that rosacea is caused by an immune overreaction to the bacterium bacillus oleronius. Bacillus oleronius is found in almost all patients with Rosacea, though it is not apparent what causes the overreaction.Heliobacter pylori, a bacterium found in the stomachs of some rosacea patients, is also suspected to be linked to the disease.
  • DemodexDemodex is a common mite that lives on the skin. People with rosacea have been found to have larger numbers of this mite on their skin, though high numbers of the mite have also been found on people without the disease.
  • CathelicidinCathelicidin is a protein that protects the skin from infection. Some scientists believe that people with rosacea use this protein differently, causing the characteristic skin inflammation.

Risk Factors For Rosacea

The following factors can affect your risk of developing rosacea:

  • Age. Rosacea is most likely to develop between the ages of 30 and 50.
  • Skin type. Rosacea is more likely to occur in people with fair skin, especially in combination with blonde hair and/or blue eyes.
  • Location. The New England region reports the highest incidence rates of rosacea in the United States while Hawaii reports the lowest.
  • Sex. Women are more likely to get Rosacea, though men are more likely to experience severe rosacea symptoms.
  • Family history. A family history of rosacea or cystic acne increases the risk of developing rosacea

Diagnosing Rosacea

Rosacea is diagnosed with a simple examination by a dermatologist. During this examination, the dermatologist will examine all areas of the skin as well as ask for a personal and family medical history to help rule out other causes of the symptoms.

Symptoms of Rosacea

Symptoms of rosacea include:

  •  Persistent facial redness resembling a blush/sunburn
  • Burning sensations of the skin
  • Swollen red bumps, sometimes pus-filled
  • Eye irritation
  • Visible blood vessels beneath the skin

Prognosis

Though rosacea cannot be cured, most cases of the disease can be controlled with proper treatment. Early detection and treatment is crucial to properly controlling the symptoms, which can worsen overtime and cause permanent damage to the skin if left untreated.

Living With Rosacea

The skin irritation caused by rosacea can be disruptive to daily life. The following tips can help you control your symptoms and make life with rosacea easier:

  • Educate yourself about all things rosacea. Understanding your condition can help you better cope with and adapt to life with rosacea.
  • Find your triggers. There are many factors that can trigger a rosacea flare-up, including sun exposure, stress, heat, alcohol consumption, and humidity. Learn what triggers your rosacea flare-ups and do your best to minimize your exposure to those elements.
  • Be gentle with your skin. Harsh scrubs and heavy moisturizers can add to the inflammation. Avoid skincare products with potential irritants like alcohol and fragrances.
  • Keep makeup simple. It can be tempting to cake on layers of foundation or heavy concealers to get rid of the redness, but heavy makeup can irritate the skin more in the long run. Consider using sensitive-skin formulas and lighter makeup options such as mineral powder. 

Screening

Rosacea is not a disease that is regularly screened for. If you experience any of the symptoms of rosacea, contact your doctor. He or she will be able to determine the cause of your symptoms.

Prevention

In many cases, rosacea is not entirely avoidable. However, there are a number of factors that can trigger or worsen rosacea symptoms. If you already suffer from rosacea, limiting your exposure to the following factors can help prevent flare-ups.

According to the National Rosacea Society, the following are the most common rosacea triggers:

  • Sun exposure
  • Stress
  • Heat
  • Heavy exercise
  • Alcohol consumption
  • Cold weather
  • Spicy foods
  • Indoor heat
  • Skincare products

Medication And Treatment

Rosacea symptoms are most often treated with topical or oral medications, or a combination of both. Your doctor can help you find the right treatment based on the type and severity of your symptoms.


Treatment for facial redness includes:

  • Brimonidine tartrate, a gel applied to the skin once daily, which works by limiting the width of the blood vessels in the face.
  • Clonidine, and many other anxiety medications, which work by relaxing the blood vessels
  • Beta-blockers, which work by decreasing the activity level of the heart. Because of their effect on the heart, beta-blockers are a less commonly prescribed form of treatment for rosacea.
  • Oral antibiotics, including tetracycline, oxytetracycline, and erythromycin. Antibiotics work by decreasing overall skin inflammation and redness.
  • Pulsed dye laser (PDL) treatment.  During this treatment, lasers are used to decrease blood vessel dilation and overall redness. PDL treatment is done over the course of several sessions and can have impressive results, with many patients reporting a 40-60% decrease in overall rosacea symptoms.
  • Treatment for bumps and/or pustules includes:
  • Oral antibiotics, including tetracycline, oxytetracycline, and erythromycin. Antibiotics work by decreasing overall skin inflammation and redness.
  • Oral isotretinoin, which works by decreasing facial oil production. Isotretinoin is most often used only when rosacea symptoms do not respond to antibiotic treatment, due to its potentially severe side effects including dry and cracking skin, headaches, muscle/joint pain, and bloody urine.
  • Metronidazole, applied topically in cream or gel form.
  • Azelaic acid, applied topically in cream or gel form.
  • Treatment for eye irritation includes:
  • Lubricating eye drops
  • Oral antibiotics, incases of eyelid inflammation (blepharitis)

Treatment for skin thickening includes:

  • Laser resurfacing. During this treatment, excess layers of skin are removed using a laser. Technological advancements have allowed for the development of extremely precise lasers, making the treatment arguably safer than many more invasive procedures such as dermabrasions.
  • Dermabrasions. Dermabrasions involve the manual scraping off of excess skin layers. This was frequently used as treatment for rosacea in the past, however its effects are still a topic of debate. Some argue that though it may temporarily improve rosacea symptoms, it worsens them in the long run by damaging the skin’s surface blood vessels.

Complementary and Alternative Treatment

The following are alternative and complementary treatments for rosacea symptoms. Talk to your doctor before trying any of these methods, as they lack clinical study data and are not FDA approved treatment methods for rosacea.

  • Vinegar. Washing the face with diluted white vinegar wash (1 part white vinegar, 6 parts water) can help to decrease rosacea symptoms. Vinegar is a natural disinfectant and helps to decrease the skin’s level of surface bacteria. Test the wash on a small portion of skin before applying to the entire affected area, as it may be too harsh for some.
  • Green Tea has anti-inflammatory properties that are thought to decrease the inflammation of the skin when applied in a compress.
  • Tea tree oil is a powerful disinfectant that can help rid the skin of surface bacteria. Use only a few drops of the oil in 2 cups of water and apply the mixture to the face. As with the vinegar mixture, test the mixture on a small portion of skin before applying to the entire face.
  • Aloe Vera can help to soothe irritated skin and reduce redness.
  • Oatmeal. Cooked oatmeal with added water can be applied directly to the skin for a soothing topical treatment. Oatmeal is known to reduce redness, itching, and overall irritation.
  • Red Clover tea, once or twice daily, can be helpful in reducing skin redness and irritation.
  • Zinc is an essential mineral for skin maintenance and repair. It can be taken in supplement form or found naturally in foods such as whole grains, nuts, seeds, shellfish, and dairy.

When To Contact A Doctor

If you think you are experiencing any of the symptoms of rosacea, schedule an appointment with your doctor or dermatologist.

If you are currently being treated for rosacea and experience any of the following symptoms, call your doctor:

  • Extreme burning sensation of the skin
  • Rapidly worsening symptoms
  • Eye irritation
  • Fever, rapid heart rate, surface bleeding, or any other possible treatment side effects. 

Questions For A Doctor

You may want to ask your doctor the following questions about your condition:

  •  What is causing my rosacea?
  • How severe are my symptoms?
  • Are my symptoms likely to worsen?
  • What treatment options are available?
  • Are there any side effects to the treatments?
  • Which treatment option is most suited for my condition?
  • What can I do personally to lessen my symptoms?
  • Will rosacea medications interfere with any of my current medications?
  • Should I consider laser treatment?
  • How often do I need to come in for checkups?