Rosacea Explained: Causes, Treatments, and Relief for Your Red Skin
Rosacea can manifest as flushing, redness, and acne-like bumps on the face.
Chronic skin conditions like rosacea continue to be an issue for many patients. In this post, I'll provide some educational information about rosacea and what you can do to manage this frustrating but treatable condition.
What Is Rosacea? Understanding the Basics
Rosacea is a common skin condition that often begins as a tendency to blush or flush more frequently than other people. The central face is most often affected, but as rosacea progresses, it can spread to involve the forehead, ears, chin, and, in some cases, even the chest.
Rosacea is more than just redness. There are multiple signs and symptoms of rosacea, and it is divided into four primary subtypes:
The 4 Types of Rosacea You Should Know
Erythematotelangiectatic Rosacea: This is a mouthful but refers to background redness (erythema) and dilated "broken" blood vessels (telangiectasias). This is the most commonly seen form of rosacea.
Papulopustular Rosacea: Red papules and white pustules are seen in this form. This is the second most commonly seen form of rosacea and can sometimes be difficult to distinguish from acne.
Phymatous Rosacea: This involves thickening of the skin and development of a bumpy texture.
Ocular Rosacea: In this form, the eyes become red and irritated, and the eyelids can become swollen.
Rosacea Triggers: What Makes Your Skin Flare Up?
The natural course of rosacea is to wax and wane, although, with time, some changes can become permanent, such as redness of the mid-face and thickening and bumpy texture of the skin, typically the nose. With careful observation, many people are able to identify triggers that cause flares of their rosacea.
Common Rosacea Triggers to Avoid:
UV light / Sunlight
Stress
Temperature changes, including both heat and cold
Alcohol, especially red wine
Spicy foods
Some skin and hair care products, including makeup
Some medicines
Exercise
What Causes Rosacea? The Science Behind the Redness
The simple truth is that we don't know everything about what causes rosacea.
Based on observational studies, it is clear that the tendency to develop rosacea is heritable, meaning it runs in families. Family members of rosacea patients are more likely to develop the disorder.
Demodex mites may play a role in rosacea. These mites live on everyone's skin and are considered a normal part of the skin flora. However, studies have shown that in patients with severe rosacea, the number of Demodex mites can be significantly increased.
Famous Faces with Rosacea
As with all skin conditions, rosacea can cause significant distress and social discomfort. But take heart! You are not alone. Not only is rosacea common in the general population, but you almost certainly know of several celebrities who are living or have lived with rosacea. The list includes such luminaries as Bill Clinton, Renee Zellweger, Cynthia Nixon, and Diana, Princess of Wales.
Medical Treatments for Different Types of Rosacea
The first step in rosacea treatment is education. Careful avoidance of triggers, including practicing safer sun exposure, is a critical part of improving the overall well-being of patients with rosacea. It's also critical to practice rosacea-friendly skin care. Wash using gentle cleansers, and avoid harsh scrubbing or the use of rough exfoliating washes.
There are multiple medical treatments available for rosacea. Different forms of rosacea respond to different treatment methods.
Topical Treatments: These are applied directly to the skin in cream, ointment, or gel form. They include medications such as metronidazole, azelaic acid, ivermectin, clindamycin, niacinamide, oxymetazoline, and brimonadine. Your doctor may prescribe one or more of these, sometimes in a compounded formulation.
Ocular Treatments: Eyedrops such as cyclosporine are sometimes used in ocular rosacea.
Oral Treatments: Often reserved for more treatment-resistant cases, these include, among others, doxycycline, minocycline, erythromycin, metronidazole, and isotretinoin.
Laser Therapy: Pulsed-dye or similar lasers can be used to treat the redness and broken blood vessels. CO2 lasers are sometimes used for resurfacing in phymatous rosacea. Although Dermatology of North Asheville does not perform those techniques, if Dr. Hutchin or Dr. Michael determines during your visit that one of these treatments would be best for you, we will refer you to another facility for treatment.
Surgical Treatment: This is sometimes used for re-contouring in phymatous rosacea, particularly of the nose.
Next Steps for Your Rosacea Care
For more information on rosacea, either call to schedule an appointment with us, or visit the American Academy of Dermatology public education website.
