Rosacea

Rosacea is a common skin condition, usually occurring on the face, which predominantly affects fair-skinned but may affect all skin types in people aged 40 to 60 years old. It is more common in women, but when affecting men, it may be more severe.

It is a chronic condition and can persist for a long time, and, in any individual, the severity tends to fluctuate. Rosacea tends to affect the cheeks, forehead, chin, and nose and is characterized by persistent redness caused by dilated blood vessels, small bumps, and pus-filled spots similar to acne.

There may also be uncomfortable inflammation of the surface of the eyes and eyelids.

The cause of rosacea is not fully understood. Your genetics, immune system factors, and environmental factors may all play a part. Factors that trigger rosacea can cause the blood vessels in the skin of the face to enlarge (dilate). The theory that rosacea is due to bacteria on the skin or in the gut has not been proven. However, antibiotics have proven helpful in treating rosacea. This treatment is because of its anti-inflammatory effect. 

Rosacea is not contagious. There are a variety of triggers that may make rosacea worse. These include alcohol, exercise, high and low temperatures, hot drinks, spicy foods, and stress. Rosacea can be sun sensitive.

Rosacea does seem to run in some families, but there is no clear genetic link.

The rash and the blushing associated with rosacea can lead to embarrassment, lowered self-esteem, self-confidence, anxiety, and even depression. Furthermore, the skin of the face is often sensitive, and the affected area can feel very hot or sting.

Some people with rosacea have eye symptoms. A few patients with rosacea may develop more severe eye problems, such as painful inflammation involving the front part of the eye (rosacea keratitis), causing blurred vision. It is essential that you consult a dermatologist or an optician if you develop symptoms affecting the eyes.

Rosacea usually starts with a tendency to blush easily. After a while, the central areas of the face become a permanent deeper shade of red, with small dilated blood vessels, bumps, and pus-filled spots. Occasionally, there may be some swelling of the facial skin (lymphoedema), especially around the eyes.

Occasionally, an overgrowth of the oil-secreting glands on the nose may cause the nose to become enlarged, bulbous, and red (called rhinophyma). Rhinophyma is more common in men than in women. 

Its appearance can diagnose rosacea. Specific tests are not usually required. Can rosacea be cured? No, but long-term treatments can be helpful.

The inflammation that accompanies rosacea can be treated with preparations applied to the skin or taken by mouth; however, not all these will help the redness or blushing associated with rosacea.

The inflammatory element of rosacea may be controlled with a medication applied to the affected areas. It takes at least eight weeks for their effect to become evident, and some applications work specifically to reduce the redness associated with rosacea 

These are helpful for the inflammatory element of moderate or severe rosacea. The most commonly used antibiotics belong to the tetracycline group.

• An eye specialist should manage the severe types of eye involvement
• A bulbous nose affected by rhinophyma can be reduced by a dermatologist or a plastic surgeon.
• Redness and dilated blood vessels can be treated with laser therapy by a dermatologist.
• The dermatologist may prescribe a beta-blocker tablet or clonidine. It may help if blushing is a significant problem.
• A dermatologist sometimes prescribes isotretinoin tablets for severe rosacea.

• Protect your skin from the sun by using a sunblock (with a sun protection factor of at least 30) on your face every day, and it needs to be frequently reapplying if outdoors.
• Do not rub or scrub your face when cleansing as this can make rosacea worse.
• Do not use perfumed soap as this can make rosacea worse.
• Use a soap substitute (emollient) to cleanse your face.
• Use an unperfumed moisturizer regularly if your skin is dry or sensitive. 
• Consider the lifestyle factors that can worsen rosacea and avoid them; a written record of your flare-ups may help.
• Unless they are specifically recommended to you by your dermatologist, it may be best to avoid some acne treatments, as they can irritate skin prone to rosacea.
• Do not use topical preparations containing corticosteroids unless specifically recommended by your dermatologist, as these may make rosacea worse in the long run. 
• If your eyes are affected, do not ignore them – consult your dermatologist or an eye specialist doctor.
• Some drugs can aggravate blushing, and your doctor or dermatologist may make appropriate changes to your medication.