Rosacea

Rosacea is a chronic inflammatory skin condition causing facial redness that looks like a blush or sunburn, and doesn’t go away. It affects the tiny blood vessels and connective tissues of the face and is known for flare-ups and remission periods. Rosacea mostly affects the cheeks but over time the area of redness can spread to the nose, chin, forehead, ears, neck, chest and scalp. Bumps and pimples that look like acne can occur and more severe rosacea can cause the skin of the nose to get swollen and lumpy. Affected skin can feel swollen and hot. Eyes can also be involved and feel gritty and irritated while looking watery and bloodshot. Styes are common and the eyelids can become swollen and red. Other symptoms include sun and light sensitivity, and sensitivity to hot, spicy food or drinks and also to certain cosmetics and sunscreens.

Rosacea is more common in people with fair skin, blue eyes or of Celtic or Northern European heritage. It tends to start between the ages of 30 and 60. People who flush or blush easily are also more predisposed to developing rosacea. It is diagnosed more often in women, but affects men more severely.

It is still unknown what causes rosacea, but it is thought that some cases can be genetic. Other suggested causes are stress, autoimmune disorders, H. Pylori infection (the bacteria known to cause stomach ulcers), as well as an overgrowth of the hair follicle mite Demodex folliculorum.

Rosacea cannot be cured but it can be managed effectively and controlled with lifestyle measures, skin care, medicines and procedures such as laser. The treatment used depends on the severity of the condition. First line treatment for mild rosacea is usually a topical antibiotic (metronidazole) in a cream or gel form. This is applied on the affected areas twice daily and can take several weeks before any improvement is seen. If the rosacea is more severe with pimples and eye symptoms, oral antibiotics are used in low doses as they have an anti-inflammatory effect. Vascular laser can decrease redness and flushing. Surgery or carbon dioxide laser can treat an enlarged nose.

Knowing your rosacea triggers can be helpful. For some people exposure to wind, too much sun or cold weather can set off their rosacea. For others, minimizing their alcohol, caffeine and spicy food intake can keep flare-ups at bay. Stress seems to be a common factor in rosacea, and anything to minimise this can be of huge benefit.

Other tips for prevention can include:

• avoiding oil-based face creams, use water-based creams instead
• using hats and high SPF sunscreens to limit sun exposure
• decreasing exposure to temperature extremes
• avoiding hot showers, baths, saunas and spas -lukewarm temperature is best
• avoiding the use of steroid creams on the face
• limiting hot drinks
• exercising at cooler times of the day, for shorter and more frequent periods, and avoiding high intensity workouts. Exercise can worsen rosacea as it raises body temperature and increases the blood supply to the surface of the skin
• keeping eyelids clean with warm soaks, and using a diluted baby shampoo to remove any crusted areas.

Avoiding triggers can help to decrease flare-ups, prevent rosacea from worsening and enable you to get better results from any treatment.

Without treatment, not only can rosacea worsen but it can also affect the self-esteem and quality of life of the person with the condition, including causing embarrassment, social anxiety and depression. If you think that you have rosacea, talk to your GP about what treatment is best for you. It is best to see a skin specialist (dermatologist) for more severe cases, and you may also need to see an ophthalmologist if your eyes are involved.

This blog provides general information and discussion about medicine, health and related subjects. The information contained in the blog and in any linked mate­ri­als, are not intended nor implied to be a substitute for professional medical advice.