About
Rosacea is a chronic inflammatory skin condition that is characterized by redness and inflammation of the face, along with visible blood vessels, bumps, and pimples. It most commonly affects people with light-colored skin and typically appears in four stages: pre-rosacea (when simply mild redness is present), early rosacea (when redness is more pronounced and bumps and pimples may appear), moderate rosacea (when blood vessels appear on the face and there may be an enlargement of the nose), and severe rosacea (when there are large bumps and swelling on the face and an appearance of “papules”). Common treatments for rosacea include topical medications and antibiotics, laser treatments, and lifestyle modifications.
Symptoms
The most common symptoms of rosacea include redness and flushing of the face, visible blood vessels, small bumps and pimples on the face (sometimes mistaken for acne) and burning, stinging and/or itching sensations. Some people also experience dry, scaly skin and eye irritation, including styes and red, watery eyes. In severe cases, some people may also experience swelling of the nose, a condition known as rhinophyma.
Causes
The exact cause of Rosacea is unknown, but it is thought to be due to a combination of triggers such as genetics, environmental factors, and microscopic mites that live on the skin. Other potential causes include weather, stress, inflammation, sun exposure, alcohol consumption, and some medications.
Risk factors
The exact causes of rosacea remain unknown, however there are some risk factors associated with developing the condition. These include:
- Having fair skin – people with a lighter skin complexion are more likely to develop rosacea
- Being a female – women are more likely to experience rosacea
- Being between the ages of 30-60 – although rosacea can affect any age, it is most common among adults in their 30s to 50s
- Being of Northern or Eastern European descent
- Having a family history of rosacea
- Suffering from acne in the past
- Exposure to ultraviolet (UV) light
- Exposure to extreme temperatures
- Consuming hot drinks and spicy food
- Exposure to certain substances, e.g. alcohol, caffeine, and certain skin care products
- Having certain skin mites – Demodex folliculorum mites have been linked with rosacea, although the exact connection is not yet known
Diagnosis
Rosacea is typically diagnosed based on a physical exam and the patient’s medical history. A doctor will examine the individual’s skin and ask about their symptoms. The doctor may also ask about any family history of rosacea and/or any prior treatments the patient may have tried. In some cases, a biopsy may be done to rule out other skin conditions.
Sub-types
The American Academy of Dermatology recognizes four distinct types of Rosacea:
- Erythematotelangiectatic Rosacea: Characterized by redness, flushing, visible blood vessels, and inflammation of the skin.
- Papulopustular Rosacea: Characterized by redness, inflammation, and acne-like bumps.
- Phymatous Rosacea: Characterized by thickening of the skin, especially around the nose, and the development of a bumpy texture.
- Ocular Rosacea: Characterized by red, swollen, and irritated eyes and eyelids.
Treatments
The main treatment options for Rosacea are as follows:
- Topical medications such as antibiotics, azelaic acid and metronidazole.
- Oral antibiotics such as tetracycline, doxycycline and minocycline.
- Surgery for those with particularly severe symptoms.
- Laser and light therapies including intense pulsed light or pulsed dye laser.
- Anti-inflammatory lotions or creams to reduce redness.
- Proper skin care regime to reduce irritation and inflammation.
- Medicated facial cleansers.
- Oral medications such as isotretinoin ormethoxydose to reduce inflammation.
- Avoid triggers by avoiding hot foods and drinks as well as alcohol, spicy foods and sun exposure.
- 0. Photodynamic therapy.
Prevention
There are several steps that can be taken to reduce the risk of Rosacea:
- Protect your skin from the sun. Wear a wide-brimmed hat, use a high SPF sunscreen, and seek shade when possible.
- Avoid triggers that can cause flushing such as spicy food, hot drinks, alcohol, physical activity, and hot weather.
- Avoid facial products that contain alcohol, fragrances, and other irritating ingredients.
- Consider using a mild facial cleanser or moisturizer to clean your face.
- Use a gentle moisturizer with sunscreen regularly to protect your skin and reduce irritation.
- Avoid using skin care products that contain abrasive ingredients such as glycolic acid, salicylic acid, or retinoids.
- Use a humidifier in your home or office to keep your skin hydrated.
- Talk to your doctor if you have persistent redness, flushing, or pimples that aren’t responding to self-care measures.
Gender differences?
Yes, there are gender-specific differences in the presentation and management of Rosacea. While both men and women can be affected by Rosacea, women are more likely to experience it before the age of 50 and are more likely to have a type of Rosacea that involves papules and pustules, known as papulopustular Rosacea. Men are more likely to experience redness and flushing in the center of their face, which is known as erythematotelangiectatic Rosacea. Additionally, the treatments prescribed for Rosacea may differ for men and women. Generally, women will receive topical antibiotics such as metronidazole, azelaic acid and ivermectin, while men may receive antibiotics by mouth in addition to topical antibiotics. In addition, women may be administered laser treatments or a light-based therapy to help reduce the redness and bumps associated with Rosacea, while men may be prescribed medication to reduce skin sensitivity or an anti-inflammatory oral medication.
Nutrition
Nutrition plays an important role in the management of Rosacea. Eating a well-balanced diet that is rich in whole grains, lean proteins, fruits and vegetables, and reducing the intake of spicy, fried, processed, and high-sugar foods can help to reduce inflammation in the body. Proper nutrition also helps to ensure that our bodies have enough of the vitamins, minerals, and antioxidants needed to be healthy and to reduce the risk of other health issues that can make Rosacea worse, such as diabetes and obesity. Additionally, avoiding caffeine and alcohol can lessen the severity of Rosacea symptoms. Finally, staying hydrated and consuming foods that are high in water, such as cucumbers and melons, can help to keep skin healthy and reduce irritation.
Physical Activity
Physical activity can have a positive effect on Rosacea, in that regular exercise can help to increase overall blood circulation and reduce skin redness. Additionally, physical activity can help to reduce stress, which is known to be a common cause of flare-ups. However, it is important to be mindful of the type and intensity of physical activity when addressing Rosacea. High intensity activities such as running, or activities that may cause excessive sweating can lead to increased skin redness and irritation. Furthermore, activities that involve sun exposure can aggravate symptoms. Therefore, it is recommended to opt for activities that are low intensity, sweat-free, and avoid direct sun exposure.