Rosacea Skin Disease is a condition that has become chronic. It’s characteristics are facial redness, superficial, small dilated blood vessels on the face, pustules, papules and swelling. It affects all ages, having 4 subtypes of which 3 affect the skin and one affects the eye (called ‘ocular rosacea’).
Rosacea usually begins with red spots on the face, going across the cheeks and nose, even the forehead; yet, it can also affect the neck, ears, chest and scalp. Sometimes, the patient may develop semi-permanent redness, red papules or pustules, red eyes, a stinging or burning sensation. Those less fortunate can experience rhinophyma (a lumpy bulbous nose) and telangiectasia (spider veins).
Although the exact cause of Rosacea skin disease is still up for conjecture, it affects both sexes, being three times more common in women, people between 30 and 50 years old and those of Caucasian (Northwestern European) descent. In fact, is has even been called “the curse of the Celts” by some people.
There are some triggers that play a part in developing Rosacea Skin Disease (blushing episodes, Rosacea flares):
- exposure to extreme temperatures, strenuous exercise, sunlight, sunburn, severe stress and anxiety, cold winds
- moving from heated shops or offices to a cold environment
- consuming alcohol and beverages containing caffeine such as coffee, as well as spicy foods ( a journal should be kept in order to identify and help reduce food and beverage triggers.)
- medication and topical irritants
- some wrinkle (and acne) treatments (microdermabrasion, chemical peels) have been reported to cause Rosacea Skin Disease
While avoiding such triggers may reduce the onset of Rosacea Skin Disease, it will not lead to full remission except in some particularly mild cases.
Rosacea Skin Disease – Prevention and Causes
Some patients with Rosacea may benefit from the daily use of sunscreens while others prefer to wear hats with broad brims. It is extremely important for people with eyelids infection to practice constant eyelid hygiene.
Studies have revealed that some people affected by Rosacea have increased numbers of the Demodex mite living in the pores of their skin, which may be a trigger along with the ones mentioned above.
Also, Rosacea patients with SIBO (Small Intestinal Bacterial Overgrowth) experienced significant skin lesion improvement while undergoing antibiotic therapy in order to erradicate SIBO.
There are no specific tests for Rosacea Skin Disease, so most people are never formally diagnosed and treated accordingly.
Types of Rosacea
As we mentioned earlier, there are four Rosacea subtypes but a patient may present more than one subtype:
1. Erythematotelangiectatic Rosacea characterised by permanent redness (a tendency to flush/blush easily); also common – having small, visible blood vessels near the skin surface (telangiectasias) and sometimes experiencing an intense burning/stinging/itching sensation; dry, flaky skin on the face, ears, neck, chest, forehead and scalp.
2. Papulopustular Rosacea consists of permanent redness with red papules (bumps) and even pustules (filled with pus); this subtype is easily confused with acne.
3. Phymatous Rosacea: a subtype most commonly associated with the enlargement of the nose (rhinophyma); other signs such as thickened skin, irregular surface nodularities along with enlargement are also present. Phymatous Rosacea may sometimes affect the chin, forehead, cheeks, eyelids and ears.
4. Ocular Rosacea: in this instance, the eyes and eyelids affected by Ocular Rosacea may appear red and inflammed or may feel dry, gritty and irritated; other symptoms may include a foreign body sensation, stinging, itching, burning and light sensitivity; eyes are more susceptible to infection and almost half of the patients with 1-3 subtypes also develop eye symptoms. If the cornea is affected, blurry vision or loss of vision can occur.
Treatments for Rosacea Skin Disease
How to treat Rosacea will vary depending on severity and subtypes. Dermatologists recommend a subtype-directed approach, with some mild cases often not being treated at all (simply covering up with make-up or other cosmetics).
Since the current therapy for Rosacea is not curative, the best measurement is in terms of reduction of facial redness, inflammatory lesions, decreasing the number and intensity of flares, itching and burning.
Two primary treatment approaches consist of topical and oral antibiotics.
While medications usually tend to induce a temporary redness remission (within several weeks), it will return shortly after suspending the treatment. However, following a long-term treatment (1 to 2 years) may help some patients maintain permanent control of the condition. Even if lifelong treatment is often required, some patients do go into a permanent remission.
Several medications with very good results include Invermectin and Azelaic acid creams and Brimonidine (deal with the typical flushing and blushing that accompany Rosacea Skin Disease). Doxycycline and Isotretinoin taken orally are believed to reduce papulopustular lesions more due to anti-inflammatory actions than to their antibacterial capabilities.
There is less evidence supporting the use of Metronidazole creams (containing anti-inflammatory mechanisms) and oral Tetracycline.
The use of Alpha-hydroxy acid peels may relieve erythema caused by irritation and also reduce papules and pustules specific to Rosacea Skin Disease. Some oral antibiotics help with relieving Ocular Rosacea symptoms.
Another form of treatment is laser therapy using different dermatological vascular lasers or intense pulsed light machines. These offer some of the best treatments for Rosacea Skin Disease, especially for the erythema of the skin (see above for what this means). Given a sufficient session of treatments, the method may eliminate redness altogether but additional treatments from time to time will be necessary in order to remove the new capillaries.
Using photorejuvenation to improve the appearance of the skin and reduce associated redness is another method of treatment.
If left untreated, this condition will worsen over time but topical steroids treatment can also aggravate it.
If you feel unhappy about your “reddish” looks every now and then, it may comfort you to know that some pretty famous people developed Rosacea Skin Disease. You might recognize the following names:
Mariah Carey, Bill Clinton, Sir Alex Ferguson, W. C. Fields, Diane Kruger, J. P. Morgan, Cynthia Nixon, Rosie O’Donnell, Dita Von Teese