Rosacea

Rosacea is a chronic skin condition mainly affecting the face.  The first signs may be redness or blushing that initially comes and goes.  The most common sites for symptoms of rosacea are the cheeks, nose, chin, and forehead, although rosacea can also affect the eyes, leaving them blood-shot and gritty feeling.  Bumps, tiny pus-filled pimples, or enlarged blood vessels may also appear, giving the skin a rough, uneven appearance.  Symptoms may vary from one person to another, and there is no way to predict severity.  There is no known cure for rosacea, although it can be managed with lifestyle changes and appropriate treatments. 

There are four forms of rosacea:

• Mild (Erythematotelangiectatic): Facial flushing and redness, which may only be present at some times.  There may also be some swelling, burning, stinging, roughness, or visible red blood vessels.

• Moderate (Papulopustular): A more advanced form of rosacea marked by persistent redness and pimple-like bumps (often mistaken for acne), as well as burning and stinging.

• Severe (Phymatous): In some patients, rosacea can affect the nose, causing the skin tissue to thicken and become bumpy, giving an enlarged appearance.  This advanced form of rosacea is called rhinophyma.

• Ocular rosacea: Affects the eyes and eyelids.  It may cause redness to the surrounding skin tissue, and also burning or stinging, dryness, light sensitivity, blurred vision, and watery, bloodshot eyes. 

Rosacea usually develops in adults between 30 and 50.  While women are affected more frequently, more serious cases of rosacea usually occur in men.  It more often affects people with fair skin, although it can develop in patients of any skin colour.

There are many factors that can trigger rosacea to flare up, and these triggers vary from person to person.  Some of the common triggers for rosacea are:

• Cosmetic products, especially those with fragrance, alcohols, abrasives, or irritating ingredients.  Try to choose gentle products without these ingredients.

• Some types of foods and drinks, such as hot drinks or soups, caffeinated beverages, spicy seasonings, and alcohol, especially red wine.

• Intense exercise where the body is overheated can trigger flushing.  Try to stay cool while working out, and divide rigorous exercises into shorter sessions.

• Some medications cause flushing, which can trigger a flare-up.  Drugs such as ACE-inhibitors and some cholesterol-lowering drugs may play a role in flare-ups.  As well, extended use of prescription-strength cortisone creams on the face can worsen symptoms.

• Stress, or emotional upset, is one of the most common triggers.  This can be managed by getting enough sleep, exercising regularly, deep breathing and stretching, and eating a healthy diet.

• Temperature extremes, such as with extremely hot or cold weather, or found in hot baths, showers, or saunas, can trigger a flare-up.  As well, rosacea can get worse with exposure to wind.

• Exposure to UV rays from the sun can cause rosacea to flare-up.  To combat this, wear sun protection (SPF 30 or higher) daily, and avoid the sun when its rays are at their strongest (11 am - 4 pm).

Treating rosacea is important, as it will not improve or resolve on its own, and, if left untreated, can worsen over time.  Over-the-counter products may not help, and may irritate skin even more.  Talk to your physician, as they can prescribe various forms of treatment, as well as recommending which skin care products and cosmetics will work for you.   Some of the most common treatments of rosacea include:

• Metronidazole - a topical agent which has anti-inflammatory and antimicrobial effects.  It can be used long term, and is available in a gel, cream, or lotion.

• Antibiotics - these work mainly by providing an anti-inflammatory effect, and can be either topical or oral.

• Steroid creams - mild topical steroids can be used short-term to help reduce skin redness and inflammation.

• Isotretinoin - an oral agent which may be prescribed if the rosacea is severe, or if symptoms do not respond to antibiotics.

• Tretinoin cream - a topical agent which may be prescribed for mild rosacea.

• Sodium sulfacetamide and sulphur - typically used in combination to treat redness and inflammation.

• Laser therapy and other cosmetic surgery - may be used to reduce the tissue overgrowth associated with severe rosacea or rhinophyma.

If you would like to learn more about rosacea, you can read more by clicking the links below!

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