Rosacea

Rosacea is a chronic and recurrent skin condition that causes a red rash on the face and may also affect the eyes. There may be small red multiple pus filled pimples or bumps. The exact cause for rosacea is not known. Fair skinned people between 30 and 60 years of age are most affected. It mostly occurs in women.

People who blush a lot are more prone to get rosacea. A large number of hereditary and environmental factors are said to be causative. Rosacea may run in families and may affect many members in the same family. Some factors that may increase the blood flow to the skin can worsen rosacea. These include exposure to sunlight and extremes of temperature, hot baths and sauna, consumption of alcohol, hot foods or beverages, and spicy foods, stress and strenuous exercise, emotional reactions like anger, and medicines that may affect the skin or blood vessels like corticosteroids and blood pressure lowering medicines.

These are all precipitating and not causative factors for rosacea. The skin in rosacea is said to be over-reactive to some germs. People with rosacea have been known to carry larger numbers of a bacteria called Helicobacter pylori in the stomach and hair follicle mites called Demodex folliculorum. The role of these organisms in causation of rosacea is not clear.

Symptoms

Rosacea symptoms are red patches on the face and there may be tiny red pimples on nose, cheeks, forehead, and chin.

Tiny red threadlike blood vessels may be visible on nose and cheeks. This is called telangiectesia.

The nose may become large, bulbous, and ruddy. This is called rhinophyma.

Ocular rosacea that affects the eyes may lead to a burning and gritty sensation in the eyes. Rosacea may occur in phases.

The florid symptoms of rosacea may be preceded by a tendency to flushing in the central face. This is called pre-rosacea and may occur due to tendency of the blood vessels to dilate. This is followed by vascular rosacea, when telangiectasia or small dilated blood vessels near the skin, appears on the nose and cheeks. In the last phase of inflammatory rosacea, pimples appear in the affected skin.

Treatment

Rosacea cannot be completely cured, however, proper and timely treatment for rosacea may arrest or slow its progression. Rosacea is a chronic condition that shows remissions and relapses. The triggers that may worsen symptoms may include over-the counter skin creams, oils, medicines like corticosteroids, alcohol, and spicy hot food. These should be avoided to slow or arrest progression of the disease.

Early rosacea treatment is important. Topical medicines are applied locally on the red inflamed areas. These include antibiotics such as metronidazole, vitamin A preparations like tretinoin, and others like benzoyl peroxide and azelaic acid. These applicants may be used once or twice in a day depending upon the severity of symptoms.

Oral medicines may be co-prescribed with these topical medicines. These include oral antibiotics include tetracycline, minocycline and erythromycin. Oral isotretinoin may be given for the severe cases. If there are eye symptoms, eye drops containing corticosteroids may be prescribed.

Long term treatment is often necessary in rosacea. Surgery is reserved for the persistent cases. Laser or electrosurgery may be used for telangiectasia and rhinophyma may need surgical reduction.

Self help

Rosacea needs medical attention and appropriate treatment.

  • The face should be protected from extremes of temperature.
  • Sunscreens should be applied before going out in the sun and in winters face should be protected by a scarf or mask.
  • The skin should not be touched or rubbed.
  • Any friction with clothing should be avoided.
  • Only clean water and gentle cleansers should be used on the face.
  • Facial creams with alcohol should be avoided. If the face feels dry after application of topical medicines, a gentle moisturizer can be used.
  • Women should be careful in wearing makeup. Anything that causes irritation should be avoided.
  • One should refrain from alcohol.

Outlook

Rosacea cannot be prevented. It is important to begin early treatment and continue proper treatment as advised by the healthcare professional. Gentle care of the skin and protecting it from triggers that worsen the disease can benefit rosacea. Rosacea needs long term care and attention. You should take proper precaution to avoid anything that can irritate the skin and worsen the disease.