Rosacea

Rosacea is a common skin disease that causes redness, papules, and swelling on the face. Often referred to as "adult acne," rosacea frequently begins as a tendency to flush or blush easily. It may progress to persistent redness in the center of the face that may gradually involve the cheeks, forehead, chin, and nose. The eyes, ears, chest, and back may also be involved. With time, small blood vessels and tiny pimples begin to appear on and around the reddened area; however, unlike acne, there are no blackheads.

When rosacea first develops, the redness may come and go. Some people may flush or blush and never form pustules or papules. Small dilated vessels may also be present. However, 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 may last for years, rarely reverse itself, and can become worse without treatment.

How to Recognize Rosacea

Small red bumps, some of which may contain pus, appear on the face. These may be accompanied by persistent redness and the development of many tiny blood vessels on the surface of the skin.

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

Who is at RiSk for Rosacea?

Fair skinned adults between the ages of 30 and 50 may develop Rosacea. It affects men and women of any age, and even children. Since it may be associated with menopause, women are affected more often than men and may notice an extreme sensitivity to cosmetics. An occasional embarrassment or a tense moment also may trigger flushing.

Tips for Rosacea Patients

  • Avoid triggers, including hot drinks, spicy foods, caffeine and alcoholic beverages that make the face red or flushed. It's important to note that although alcohol may worsen rosacea, the condition may be just as severe in someone who doesn't drink at all; thus rosacea has been unfairly linked to alcoholism.
  • Practice good sun protection. Seek shade when possible and limit exposure to sunlight, wear hats and use broad spectrum sunscreens with SPF of 15 or higher; reapply every 2 hours.
  • Avoid extreme hot and cold temperatures which may exacerbate the symptoms of Rosacea. Exercise in a cool environment. Do not overheat.
  • Avoid rubbing, scrubbing or massaging the face.
  • Avoid cosmetics and facial products that contain alcohol. Use hair sprays properly, avoiding contact with facial skin.
  • Keep a diary of flushing episodes and note associated foods, products, activities, medications or other triggering factors.

Treatment

Many people with Rosacea are unfamiliar with it and do not recognize it in its early stages. Identifying the disease is the first step to controlling it. Self-diagnosis and treatment are not recommended since some over-the-counter skin products may make the problem worse.

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

Creams, lotions, foams, washes, gels, and pads that contain various topical antibiotics, metronidazole, sulfcetimide, benzoyl peroxide, and retinoids may be prescribed. 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. Cortisone creams may reduce the redness of rosacea; however, they should not be used for longer than two weeks since they can cause thinning of the skin and flare-ups upon discontinuation. It is best to use these creams only under the direction of a dermatologist.

The persistent redness may be treated with laser surgery.  This melts the dilated (broken) capillaries that cause most of the redness. Cosmetics may be helpful. Green tinted makeup may mask the redness.

Special Treatments

Rhinophyma is usually treated with surgery. The excess tissue can be carefully removed with a scalpel, laser or through electrosurgery. 

The key to successful management of Rosacea is early diagnosis and treatment. It is important to follow all of Dr. Robinson'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.