Rosacea

Rosacea is an inflammatory skin disease that causes facial redness. You may mistake some of its characteristics such as small, red, pus-filled bumps or pustules — for acne. In fact, rosacea has been called adult acne or acne rosacea, but the disease has little to do with the pimples and blackheads that commonly afflict teenagers. It's also a misconception that this red-faced condition is caused by drinking alcoholic beverages.

Rosacea affects mostly adults, usually people with fair skin, between the ages of 30 and 60. About 14 million Americans have this chronic skin condition. Although it's more common in women, men may develop more apparent signs of the disorder. It's not life-threatening, but it can affect your appearance and lower your self-esteem.

Left untreated, rosacea tends to be progressive, which means it gets worse over time. However, in most people rosacea is cyclic, which means it may flare up for a period of weeks to months and then signs and symptoms lessen for a while before rosacea flares up again. Besides acne, rosacea can also be mistaken for other skin problems, such as skin allergy or eczema. Once diagnosed, it's quite treatable.

Symptoms

Signs and symptoms of rosacea include:

  • Red areas on your face
  • Small, red bumps or pustules on your nose, cheeks, forehead and chin (but not the same as whiteheads or blackheads)
  • Red, bulbous nose (rhinophyma)
  • Visible small blood vessels on your nose and cheeks
  • Burning or gritty sensation in your eyes (ocular rosacea)
  • Tendency to flush or blush easily

Rosacea usually appears in phases:

  • Pre-rosacea ~ Rosacea may begin as a simple tendency to flush or blush easily, then progress to a persistent redness in the central portion of your face, particularly your nose. This redness results from the dilation of blood vessels close to your skin's surface. This phase may sometimes be referred to as pre-rosacea.
  • Vascular rosacea ~ As signs and symptoms worsen, vascular rosacea may develop — small blood vessels on your nose and cheeks swell and become visible (telangiectasia). Your skin may become overly sensitive. Rosacea may also be accompanied by oily skin and dandruff.
  • Inflammatory rosacea ~ Small, red bumps or pustules may appear and persist, spreading across your nose, cheeks, forehead and chin. This is sometimes known as inflammatory rosacea.

In severe and rare cases, the oil glands (sebaceous glands) in your nose and sometimes your cheeks become enlarged, resulting in a buildup of tissue on and around your nose (rhinophyma). This complication is much more common in men and develops very slowly over a period of years.

In addition, more than half the people with rosacea experience ocular rosacea — a burning and gritty sensation in the eyes. Rosacea may cause the inner skin of the eyelids.

Causes

The cause of rosacea is unknown, but researchers believe it's likely due to some combination of hereditary and environmental factors.

Several theories exist as to what causes rosacea. One theory is that a blood vessel disorder causes vessels in the face to swell. Another is that the cause of rosacea is a chronic bacterial infection in the gastrointestinal system caused by a Helicobacter pylori infection. Some researchers have suggested that tiny mites (Demodex folliculorum) living in human hair follicles may play a role by clogging up sebaceous gland openings. Most people with rosacea have sun-damaged skin which may also play a contributing role. None of these theories has been conclusively proved, however.

One thing is certain — alcohol doesn't cause rosacea. While the consumption of alcohol can lead to flushing of the skin and may worsen rosacea, people who don't consume alcohol at all still can get rosacea.

Risk Factors

Although the exact cause of rosacea remains a mystery, a number of factors can aggravate it or make it worse by increasing blood flow to the surface of your skin. Some of these include:

  • Hot foods or beverages
  • Spicy foods
  • Alcohol
  • Sunlight
  • Stress, anger or embarrassment
  • Strenuous exercise
  • Hot baths, saunas
  • Corticosteroids
  • Drugs that dilate blood vessels, including some blood pressure medications

When to Seek Medical Advice

Unfortunately, rosacea rarely clears up on its own, and it tends to worsen over time if left untreated. If you experience persistent redness of your face, come see us for a diagnosis and proper treatment. Many over-the-counter skin care products contain ingredients such as acids, alcohol and other irritants, that may actually worsen rosacea. Because of the progressive nature of rosacea, an early diagnosis is important. Treatments tend to be more effective the earlier they're started