Rosacea: Causes, Symptoms, & Treatment

What is rosacea?

Rosacea is an ongoing (chronic) skin condition that causes redness, pimples, broken blood vessels, and a misshapen nose. It most often affects the face and eyes. In a few cases, it can also affect the neck, chest, or other areas of skin. Redness may become long-term (permanent) as the tiny blood vessels of the face widen (dilate). There may be small, red, pus-filled bumps (pustules).It can look like adult acne. But it is not caused by the same things that cause acne.Rosacea has flare-ups that come and go. This may happen every few weeks or every few months. If not treated, it tends to get worse over time. It may also be made worse by:

• Sun
• Heat
• Spicy foods
• Drinking alcohol
• Blushing
• Exercise
• Stress, especially anger or embarrassment
• Hot drinks
• Irritation from skin products
• Certain medicines

What causes rosacea?

Researchers don’t know what causes rosacea. Certain things may make it more likely. They include:

• Family history of rosacea
• Skin reaction to mites in the hair follicles or bacteria in the skin
• Abnormal response by your immune system
• Disorder of the blood vessels that increases blood flow in the skin of the face.
• Some medicines

Who is at risk for rosacea?

You are more at risk if you are:

• Between ages 30 and 60
• Of Celtic or Scandinavian background
• Fair-skinned
• A woman in menopause
• Someone who blushes easily

What are the symptoms of rosacea?

Rosacea symptoms may vary from person to person. They often start with easy blushing and flushing of the facial skin. Then redness will last around the nose area. Over time, the area of redness extends to the rest of the face.These are the main symptoms:

• Flushing. Flushing (or blushing) occurs often and lasts a while. Areas normally affected are the chin, cheeks, forehead, nose, and neck. The flushing can come and go. It is made worse by triggers.
• Long-term (chronic) redness. Redness of the face that won’t go away is the most common sign of rosacea. It looks like a sunburn.
• Blood vessels you can see. The enlarged blood vessels (telangiectasia) appear under the facial skin, most commonly on the cheeks. The blood vessels may form a web-like pattern. They cause swollen, warm skin. This type is common in women.
• Skin bumps (papules) and boils (pustules). These are hard, red bumps or softer, liquid-filled pimples. They may look like acne. They usually to occur up above the nose, on the cheeks, and on the chin. The bumps may come and go.
• Thickened skin (phymatous rosacea). The skin thickens or creates extra skin tissue. It normally affects the nose, causing it to be enlarged and bulbous (rhinophyma). It can also occur on the forehead, chin, or cheeks. This happens more often in men.
• Eye irritation. Rosacea also often affects the eyes and eyelids. Eye symptoms may include redness, burning, tearing, inflamed eyelids, and feeling like you have grit or sand in your eye. Symptoms may get worse or get better from day to day.

Other symptoms may occur. These can include:

• Burning or stinging. Your face can feel like it burns or stings. Itching may also occur, but it is not common.
• Swelling (edema). Your face may have inflammation along with other symptoms of rosacea.
• Dry skin. The skin in the middle of your face may be dry, rough, and scaly.

The symptoms of rosacea can be like other health concerns. Make sure to speak to a healthcare provider for a diagnosis.

How is rosacea diagnosed?

Your healthcare provider will speak  about your symptoms and health history. He or she may also question your family’s health history. Your doctor will give you a physical exam. The physical exam will consist of your doctor looking closely at your skin and eyes. There are no tests that can certify a diagnosis of rosacea.

How is rosacea treated?

There's no absolute cure for rosacea, but treatment can help soothe symptoms. Treatment will rely on your symptoms, your age, and your general health. It will also depend on how serious the condition is. Treatment may include:

• Changes in what you eat and drink, such as not having caffeine, spicy foods, or alcohol
• Antibiotic medicine that you will prescribed by mouth (oral) or put on your skin (topical)
• Prescription creams, washes, or lotions. Creams containing metronidazole, azeleic acid, sodium sulfacetamide, and ivermectin are commonly used.
• Glycolic acid peels
• Prescription eye drops
• Laser therapy or electrosurgery to shrink blood vessels
• Surgery or scraping (dermabrasion) to treat scarring of the nose

Rosacea symptoms often get better with medicines. But they tend to get worse again if you stop taking the medicines. If your symptoms continue or get worse, speak about other treatment options, including combinations of treatments. Don’t use over-the-counter medications unless told to by your eye doctor. Some of these may make rosacea worse.Conversate with your healthcare providers about the risks, benefits, and possible side effects of all treatments.

What are possible complications of rosacea?

Some males with a more serious form of rosacea develop a condition called rhinophyma. The oil glands on the skin of the nose become obstructed. The nose gets bigger and can become big, bulbous, and red. The cheeks also become puffy. Alcohol may increase the flushing. But this condition is not caused by alcohol use. Ocular rosacea can cause eye issues such as corneal sores.

Can rosacea be prevented?

Researchers haven’t discovered a way to prevent rosacea other than to staying away from things that trigger it.

How to manage rosacea

Rosacea is a chronic condition. But you can manage it with self-care.Learn what your triggers are, such as:

• Hot drinks
• Spicy foods
• Caffeine
• Alcohol
• Exercise
• Stress
• Sun
• Extreme hot or cold weather

To manage your symptoms:

• Stay away from things that trigger them.
• Take your medicines as prescribed.
• Wash your face two times a day with a gentle facial cleanser. Rinse your skin well with warm (not hot) water. Pat your skin dry with a cotton towel.
• Don’t use sponges, brushes, loofahs, or other harsh tools.
• Don’t use scrubs or astringents.
• If you have to shave your face, you should use an electric razor.
• Put on sunscreen with SPF 15 or more every day. Sun can make rosacea symptoms worse.
• Choose skincare and cosmetics that don’t irritate the skin, and are oil-free and fragrance-free.
• Don’t put steroid cream on the skin sores. Steroid medicine may make rosacea worse.

When should I call my healthcare provider?

Call the healthcare provider if you have:

• Symptoms that don’t get better with medicine, or get worse
• Redness, burning, or a gritty feeling within your eyes
• Other new symptoms

Key points about rosacea

• Rosacea is an ongoing (chronic) skin condition that causes redness, pimples, and broken blood vessels.
• It most often affects the face and eyes. In a few cases, it can also affect the neck, chest, or other areas of skin.
• Rosacea has flare-ups that come and go. This may happen every couple of weeks or every few months. If not treated, it tends to get worse over time.
• It could also get worse by ingesting spicy foods and being exposed to heat, alcohol, and other triggers.
• There's no cure for rosacea, but treatment can help soothe symptoms.
• You can soothe with self-care. Educate yourself with what your triggers are, and take steps to treat your skin gently.

Next steps

Tips to aide you to get the most from a visit to your healthcare provider:

• Know the reason for your visit and what your wants and needs are.
• Before your visit, jot down questions you want answered.
• Bring an individual with you to help you ask questions and remember what your provider tells you.
• At the visit, jot down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider provides you.
• Become knowledgeable about why a new medicine or treatment is prescribed, and how it will help you. Also educate yourself on what the side effects are.
• Question if your condition can be treated in other ways.
• Know why a test or procedure is necessary and what the results could mean.
• Know what to expect if fail to take the medicine or have the test or procedure.
• If you have a follow-up appointment, jot down the date, time, and purpose for that visit.
• Know how you can contact your provider if you have concerns.