What is rosacea?

Rosacea is a skin disease that affects the middle third of the face, causing persistent redness over the areas of the face and nose that normally blush -- mainly the forehead, the chin and the lower half of the nose. The tiny blood vessels in these areas enlarge (dilate) and become more visible through the skin, appearing like tiny red lines (called telangiectasias). Pimples can occur in rosacea that resemble teenage acne. In fact, rosacea is frequently mistaken for acne and is also referred to as acne rosacea.
Is rosacea like acne?

Rosacea is basically different than acne. Unlike common acne, rosacea is not primarily a plague of teenagers, but occurs most often in adults (ages 30 to 50), especially those with fair skin. Different than acne, there are no blackheads or whiteheads in rosacea.
Rosacea strikes both sexes. It tends to be more frequent in women but more severe in men.
What causes rosacea?

The cause of rosacea is unknown. Rosacea is more common in people who blush easily. Furthermore, rosacea tends to affect the "blush" areas of the face. Emotional factors (stress, fear, anxiety, embarrassment, etc.) may trigger blushing and aggravate rosacea. A flare-up can be caused by changes in the weather like strong winds or a change in the humidity. Sun exposure generally aggravates rosacea.
A mite sometimes found in hair follicles may play a role in the development of rosacea. The bacteria Heliobacter pylori (that is associated with stomach ulcers) and medications like vasodilators (that cause blood vessels to widen) have also been thought possibly to bring out rosacea.
What are the signs and symptoms of rosacea?

Rosacea typically causes inflammation of the skin of the face, particularly the forehead, cheeks, nose, and chin. When rosacea first develops, it may appear, then disappear, and then reappear. However, in time the skin fails to return to its normal color and the enlarged blood vessels and pimples arrive. Rosacea rarely reverses itself. It lasts for years and, if untreated, it will worsen. Rosacea does not cause the blackheads and whiteheads that are in common acne.
What happens to the nose?

Untreated rosacea can cause a disfiguring nose condition called rhinophyma (ryno- fee-ma), literally growth of the nose, characterized by a bulbous, enlarged red nose and puffy cheeks (like the old comedian W.C. Fields). There may also be thick bumps on the lower half of the nose and the nearby cheek areas. Rhinophyma occurs mainly in men. Severe rhinophyma can require surgical repair.
What happens to the eyes?

Another complication of advanced rosacea affects the eyes. About half of all people with rosacea feel burning and grittiness of the eyes (conjunctivitis). If this is not treated, a serious complication that can damage the cornea, called rosacea keratitis, may impair vision.
How is rosacea cured?

Rosacea cannot be cured but it can usually be controlled with the proper, regular treatment.
What about using acne medicine?

Over-the-counter medications for acne can be a hazard; they can irritate the skin of rosacea.
What is used for rosacea?

Treatment involves both oral and topical medicines. Oral antibiotics (such as tetracycline) are commonly prescribed; the dose may be initially high and then be tapered to maintenance levels.
A topical (skin) antibiotic cream such as metronidazole (Metrocream) is useful to reduces the inflammation and the redness. Other topical antibiotic creams include erythomycin and clindamycin (Cleocin).
Short-term topical cortisone (steroid) preparations of the right strength may also be used to reduce local inflammation. Some doctors are trying tretinoin (Retin-A) or isotretoin (Accutane), prescription medications also used for acne, or permethrin (Elimite) cream, which is used for the mites that cause scabies.
What should be avoided?

Smoking, food (such as spicy food) and drink (such as hot beverages and alcoholic drinks) that can cause flushing should be avoided.
Exposure to sunlight and to extreme hot and cold temperatures should be limited. That will also help relieve symptoms of rosacea.
Potent cortisone medications on the face should be avoided because they can promote widening of the tiny blood vessels of the face.
How should I care for the skin of my face?

Rubbing the face tends to irritate the reddened skin. Some cosmetics and hair sprays may also aggravate redness and swelling.
Facial products such as soap, moisturizers and sunscreens should be free of alcohol or other irritating ingredients. Moisturizers should be applied very gently after any topical medication has dried. When going outdoors, sunscreens with an SPF of 15 or higher are needed.


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