Rosacea is a skin condition in which your face tends to appear red and inflamed with periods of worsening and improvement over months to years. Individuals with rosacea may flush easily or develop what looks like acne breakouts. It can occur in all ages or ethnicities but tends to be most common in white, middle-aged adults.
Rosacea is extremely common with an estimated 14 million Americans suffering from the condition. Some notable sufferers include former President Bill Clinton, J.P. Morgan, W.C. Fields, Rembrandt and Rosie O’Donnell — not to mention Santa Claus and, most likely, Rudolph!
Dermatologists are trained to recognize and treat patients with rosacea. There are four recognized types of rosacea that have different clinical features. These include:
acne rosacea (breakouts, pimples, redness)
vascular rosacea (enlarged facial blood vessels)
ocular rosacea (dry eyes, red eyes, eyelid swelling, multiple styes)
rhinophyma (thickening of the skin, especially the nose, enlarged pores)
You may have just one or several types of rosacea concurrently. If you believe you may have symptoms of rosacea, you should make an appointment to see a dermatologist.
Massive research efforts have identified several abnormalities in inflammatory pathways in the skin that are linked to the development of rosacea. It is now believed that patients with rosacea have an exuberant inflammatory response to environmental stimuli leading to rosacea. Essentially, rosacea skin overreacts to normal stimuli leading to redness, flushing and inflammatory bumps. A mite that lives on everyone’s skin, demodex, may play a role in increasing inflammation in the skin and is more numerous in patients with rosacea. Rosacea tends to run in families and therefore patients often have affected family members.
No. In fact, many over-the-counter acne medications will worsen rosacea. The diagnosis of rosacea is best made by a dermatologist.
No. For centuries a bulbous, enlarged and red nose was interpreted as a sign of alcoholism. We now know that rhinophyma, gross enlargement of the oil glands in the nose, is a common feature of rosacea. Patients with rosacea are no more likely than the general public to suffer from alcoholism. While alcohol may lead to flushing directly following consumption, this is because alcohol can trigger rosacea in an individual who is already susceptible to the development of rosacea. Alcohol itself is never the sole cause of rosacea.
There is no cure for rosacea. Medical and surgical therapies are available for patients in order to suppress rosacea flares. Treatments most commonly include topical and sometimes oral antibiotics. Patients with enlarged blood vessels, or telangiectasias, typically respond very well to laser treatments. Rhinophyma, thickening of the nasal skin, may be amendable to surgical correction. Treatment by a dermatologist is best initiated early since once rosacea progresses it can be difficult to control.
The most important factor in preventing a flare in rosacea is sun protection. Patients with rosacea have sensitive skin that most commonly flares following sun exposure. Following exposure the skin tends to stay red much longer than would be expected from a typical sunburn. The use of zinc oxide containing sunscreen with a minimum of SPF 30 must be used 365 days a year. Regular use will limit flares and disease progression in all types of rosacea.
Other common triggers include stress and certain foods and beverages. Patients should learn what precipitates their rosacea and avoid the known triggers.
While there is no cure, several steps can be taken at home to reduce the frequency and severity of rosacea flares such as identifying triggers and regular sunscreen use.