What is Rosacea?
Rosacea is a long-lasting skin condition causing red patches, pimples, and enlarged blood vessels exclusively on the face.
It is a non-contagious skin disease, and unfortunately, there is no known cure. However, symptoms can be reduced. (1)
This skin condition has left doctors unsure of its exact causes. It has shown to affect more women than men, and fair skin rather than dark. Genetics have also proven to play a role, seeing that those affected often have a parent with the disease. (2)
Rosy cheeks may often be thought of as a sign of health. However, for almost 14 million Americans with rosacea, red cheeks may be a cause of daily insecurity. Rosacea is often mistaken as bad acne or a sign of alcoholism, but in fact, this condition couldn’t be more different. (3)
This condition will generally initiate redness around the forehead, nose and cheeks. But as it progresses pimple-like spots and swelling may emerge, giving the skin a bumpy and uneven texture.
This in contrast to other skin conditions such as eczema which is more commonly seen in children. Rosacea tends to appear during adulthood where onset is generally between 30 to 60 years of age.
A typical complication of this condition is eye problems. About 50 percent of the time, rosacea is expected to spread to the eyes where it may severely compromise the vision of those affected. (4)
People affected may encounter bouts of redness and other symptoms during early stages, where a flare-up might last weeks or months at a time. It could occur after an encounter with a trigger which can include certain foods or drinks, allergens or extreme temperatures.
However, over time, symptoms might become more permanent. These tend to be more severe in men than women.
There are four subtypes of rosacea: erythematotelangiectatic, papulopustular, phymatous and ocular. These describe the numerous symptoms brought by this condition.
Excessive blushing might be the first and very early indicator of rosacea. It may begin as a mild rosy hue and progress to a more profound redness. It is often seen working its way from the center of the face, spreading outwards toward the cheeks and temples.
The small veins underneath the surface will become larger and more apparent through the skin. They may appear broken which might be described as “spider veins.”
Swollen, sensitive skin which is prone to dryness and scaling is likely to manifest. This may also associate with a sense of burning or stinging throughout the face.
In contrast to the first subtype, papulopustular rosacea will cause very oily skin. In places where redness was found an acne-like breakout is likely to appear along with patches of raised skin (plaques.) (6)
The small pimples or pustules will typically appear red. They very rarely resemble general acne, and fortunately usually won’t leave a scar.
Rosacea acne will generally flare up and then subside, leaving the skin very sensitive. Those affected are likely to feel burning and stinging around the tender areas.
This type is more prevalent among women than men, and it will generally become more apparent around the ages of 30 to 60 years.
This type of rosacea is not as widespread as the others, and will usually affect men. In the past, it was frequently mistaken for alcohol abuse. (7)
It generally manifests with thick, swollen skin, especially around the nose where the surface will appear profoundly red.
The thickened skin on the nose is known as rhinophyma, and it might develop with a rough exterior and enlarged pores. Thick skin may also become apparent around the forehead (metophyma) and chin (gnathophyma), although it is not as noticeable.
Oily skin with visible spider veins is still very obvious, giving the face a shiny, flushed look.
Those affected by ocular rosacea will encounter symptoms interfering with the eyes. (8)
The vision might be severely jeopardized as this rosacea subtype will cause lack of moisture. This leads to dry itchy eyes which may even feel as though they’re burning.
Small cysts and broken blood vessels can develop on the exterior or interior of the eyelid giving a gritty feeling, similar to sand in the eyes. The vision may become blurry. Sight is likely to suffer and the affected might exhibit sensitivity to bright lights.
Rosacea has been divided into four stages. These define how a person progresses through the subtypes. Not everyone will necessarily experience each stage. Some people may only encounter one, while others might be affected by several. (9)
This stage may manifest at around 20 years of age where the patient will show symptoms such as redness and broken veins. Small inflammations are likely to cause a burning sensation and the skin might feel slightly swollen.
Flare-ups of flushing are likely to appear more often following a meal, changes in weather and temperature. They also might manifest after consuming specific beverages such as alcohol or hot coffee.
During the second stage, redness and spider veins can become chronically permanent if they are left untreated. This can lead to the next stage.
The third stage involves rosacea acne breakouts consisting of small red pimples or bumps. It generally follows the prior stage, where inflammations have triggered a reaction in the skin. These may come and go over time, but the surface will continue to exhibit redness.
Due to inflammatory responses, parts of the face becomes prone to swelling. It will typically manifest around the nose, where it might appear as very thick skin.
This stage often has a significant effect on the patient, especially on a psychological level. People in the past were often taunted due to misconceptions of the cause of the redness and thick skin.
Rosacea will generally be treated by a dermatologist who specializes in skin care and diseases. (10)
This condition isn’t diagnosed with medical tests. Traits of rosacea cannot show up on any tests, so dermatologists usually diagnose it solely by examining the skin and eyes.
Sometimes other tests might be requested if there’s suspicion of another cause of symptoms, such as allergies or lupus. These are two conditions that can also affect the appearance of the skin but require a very different treatment.
Because rosacea cannot be cured, treatment will revolve around three primary goals. These are: reducing the symptoms, abating discomfort and preventing the condition from advancing. (11)
For those who suffer from rosacea, it is vital to practice good skin care.
This can include protecting the skin from the sun. UV light exposure often triggers redness, so applying sunscreen before spending time outside is essential. Using mild skin care products may also help reduce the symptoms. (12)
It is also crucial to recognize your triggers so you can avoid them as often as possible.
Specific topical creams and lotions are available to help treat the symptoms. These may include: azelaic acid or metronidazole, brimonidine gel or oxymetazoline hydrochloride cream. (13, 14)
Depending on the issue, these topical medicines can help reduce redness by calming the skin. They can also treat the rosacea acne and help improve its appearance.
Medication taken by mouth will generally work to treat acne symptoms. These can also help in the later stages where severely thickened skin around the center of the face is likely. (15, 16)
Procedures can involve laser or other light-based therapies to help treat the visible blood vessels causing profound redness. A dermatologist will use a beam of light to close off the broken veins. This usually requires follow up treatments but can produce pleasing end-results. (17)
Surgery is only done in cases where the skin has become severely thick and needs to be removed. It is typically done to correct rhinophyma. (18)
A surgeon will begin by removing the thick skin following which the doctor will proceed to reshape the nose. Medication is likely to be prescribed after the surgery. The patient should avoid triggers as the skin may still be prone to flare-ups.
What is rosacea? Rosacea is a chronic disease affecting the skin around the face.
What are the signs of rosacea? Rosacea will cause redness, which can be perceived either as a mild blush or intense redness. It can also cause swelling, oily or dry skin, acne-like breakouts and thick patches around the face.
How do you develop rosacea? The exact causes remain unknown. It has shown to frequently affect people with lighter skin and is able to pass through genes. Women tend to present a higher risk than men.
How are you diagnosed for rosacea? Dermatologists can generally diagnose the condition by examining the skin and asking a series of questions. (19)
What is the best treatment of rosacea? Treatment depends on how severe the symptoms are. It can include various topical creams, medications and medical procedures. Surgery might be performed to remove some skin.
What are the long term complications of rosacea? If left untreated, symptoms might become permanent. These may also include problems with eyesight. Other complications can include depression and anxiety, low self-esteem and insecurities which can have a definite effect on daily life. (20)
Is rosacea considered a disability? Rosacea is generally not considered a disability. However it can cause severe effects on eyesight which may be disabling for the affected.
Is there any cure for rosacea? No, it is a chronic condition. With treatment its symptoms can be improved.
Is rosacea life threatening? This condition on its own is not fatal.
Rosacea is a chronic, non-contagious skin disease causing intense redness and acne-like breakouts.
This condition tends to affect those who have fairer skin and is prevalent in Celtic and Scandinavian countries. (21)
Rosacea has shown to have a significant effect on people’s lives. The symptoms may cause deep insecurities. Unfortunately, there is no known cure. Those affected must take good care of their skin and apply mild creams or lotions to reduce unwanted symptoms.