Rosacea Treatments, Diagnosis, Causes, Symptoms, Prevention, Natural Remedies

Rosacea Treatments, Causes, Symptoms, Prevention


What is rosacea? Is rosacea contagious?


Rosacea (roz-ay-sha) is a very common red, acne-like benign skin condition that affects many people worldwide. As of 2010, rosacea is estimated to affect at least 16 million people in the United States alone and approximately 45 million worldwide. Most people with rosacea are Caucasian and have fair skin. The main symptoms of rosacea include red or pink patches, visible tiny broken blood vessels, small red bumps, sometimes containing pus, red cysts, and pink or irritated eyes. Most people with the disease may not even know they have rosacea or that it is a diagnosable and treatable condition. Many people who have rosacea may just assume they blush or flush easily or are just very sun sensitive.

Rosacea Treatments, Diagnosis, Causes, Symptoms, Prevention, Natural Remedies
Rosacea


Rosacea is considered a chronic (long-term), noncurable skin condition with periodic ups and downs. As opposed to traditional or teenage acne, most adult patients do not "outgrow" rosacea. Rosacea characteristically involves the central region of the face, causing persistent redness or transient flushing over the areas of the face and nose that normally blush -- mainly the forehead, the chin, and the lower half of the nose. It is most commonly seen in people with light skin and particularly in those of English, Irish, and Scottish backgrounds. Some famous people with rosacea include the former U.S. President Bill Clinton and W.C. Fields. Rosacea is not directly related to alcohol intake.

Rosacea is not considered contagious or infectious. There is no evidence that rosacea can be spread by contact with the skin, sharing towels, or through inhalation.

The redness in rosacea, often aggravated by flushing, may cause small blood vessels in the face to enlarge (dilate) and become more visible through the skin, appearing like tiny red lines (called telangiectasias). Continual or repeated episodes of flushing and blushing may promote inflammation, causing small red bumps that often resemble teenage acne. In fact, rosacea can frequently be mistaken for common acne. Rosacea is also referred to as acne rosacea.

What are the causes and risk factors of rosacea?


Doctors do not know the exact cause of rosacea but believe that some people may inherit a tendency to develop the disorder. People who blush frequently may be more likely to develop rosacea. Some researchers believe that rosacea is a disorder where blood vessels dilate too easily, resulting in flushing and redness.

Factors that cause rosacea to flare up in one person may have no effect on another person. Although the following factors have not been well-researched, some people claim that one or more of them have aggravated their rosacea: heat (including hot baths), strenuous exercise, sunlight, wind, very cold temperatures, hot or spicy foods and drinks, alcohol consumption, menopause, emotional stress, and long-term use of topical steroids on the face. Patients affected by pustules may assume they are caused by bacteria, but researchers have not established a link between rosacea and bacteria or other organisms on the skin, in the hair follicles, or elsewhere in the body.

Swings in temperature from hot to cold or cold to hot can also cause a flare-up of rosacea.

Rosacea risk factors include fair skin, English, Irish or Scottish heredity, easy blushing, and having other family members with rosacea. Additional risk factors include female gender, menopause, and being 30-50 years of age.

Who Gets Rosacea?


Approximately 14 million people in the United States have rosacea. It most often affects adults between the ages of 30 and 60. Rosacea is more common in women (particularly during menopause) than men. Although rosacea can develop in people of any skin color, it tends to occur most frequently and is most apparent in people with fair skin.

What are rosacea symptoms and signs of Rosacea?


There are several symptoms and conditions associated with rosacea. These include frequent flushing, vascular rosacea, inflammatory rosacea, and several other conditions involving the skin, eyes, and nose.

Rosacea Treatments, Diagnosis, Causes, Symptoms, Prevention, Natural Remedies
Rosacea Symptom


Frequent flushing of the center of the face--which may include the forehead, nose, cheeks, and chin--occurs in the earliest stage of rosacea. The flushing often is accompanied by a burning sensation, particularly when creams or cosmetics are applied to the face. Sometimes the face is swollen slightly.

A condition called vascular rosacea causes persistent flushing and redness. Blood vessels under the skin of the face may dilate (enlarge), showing through the skin as small red lines. This is called telangiectasia. The affected skin may be swollen slightly and feel warm.

A condition called inflammatory rosacea causes persistent redness and papules (pink bumps) and pustules (bumps containing pus) on the skin. Eye inflammation and sensitivity as well as telangiectasia also may occur.

In the most advanced stage of rosacea, the skin becomes a deep shade of red and inflammation of the eye is more apparent. Numerous telangiectases are often present, and nodules in the skin may become painful. A condition called rhinophyma also may develop in some men; it is rare in women. Rhinophyma is characterized by an enlarged, bulbous, and red nose resulting from enlargement of the sebaceous (oil-producing) glands beneath the surface of the skin on the nose. People who have rosacea also may develop a thickening of the skin on the forehead, chin, cheeks, or other areas.

In rare cases, rosacea that is not treated may cause permanent effects, such as thickening of the skin on your face or loss of vision. It may cause knobby bumps on the nose, called rhinophymacamera. Over time, it can give the nose a swollen, waxy look. But most cases of rosacea don't progress this far.

How Is the Eye Affected by Rosacea?


In addition to skin problems, up to 50 percent of people who have rosacea have eye problems caused by the condition. Typical symptoms include redness, dryness, itching, burning, tearing, and the sensation of having sand in the eye. The eyelids may become inflamed and swollen. Some people say their eyes are sensitive to light and their vision is blurred or otherwise impaired.

How is rosacea diagnosed?


Rosacea is usually diagnosed based on the typical red or blushed facial skin appearance and symptoms of easy facial blushing and flushing. Rosacea is largely under-diagnosed and most people with rosacea do not know they have the skin condition. Many people may not associate their intermittent flushing symptoms with a medical condition. The facial redness in rosacea may be transient and come and go very quickly.

Rosacea Treatments, Diagnosis, Causes, Symptoms, Prevention, Natural Remedies
Rosacea

Dermatologists are physicians who are specially trained in the diagnosis of rosacea. Generally no specific tests are required for the diagnosis of rosacea.

In unusual cases, a skin biopsy may be required to help confirm the diagnosis of rosacea. Occasionally, a noninvasive test called a skin scraping may be performed by the dermatologist in the office to help exclude a skin mite infestation by Demodex, which can look just like rosacea. A skin culture can help exclude other causes of facial skin bumps like staph infections or herpes infections. Blood tests are not generally required but may be used to help exclude less common causes of facial blushing and flushing including systemic lupus, other autoimmune conditions, and dermatomyositis.

While most cases of rosacea are fairly straightforward, there are some atypical cases that are not as easy to diagnose.

Can Rosacea Be Cured?


Although there is no cure for rosacea, it can be treated and controlled. A dermatologist (a medical doctor who specializes in diseases of the skin) usually treats rosacea. The goals of treatment are to control the condition and improve the appearance of the patient's skin. It may take several weeks or months of treatment before a person notices an improvement of the skin.

Some doctors will prescribe a topical antibiotic, such as metronidazole, which is applied directly to the affected skin. For people with more severe cases, doctors often prescribe an oral (taken by mouth) antibiotic. Tetracycline, minocycline, erythromycin, and doxycycline are the most common antibiotics used to treat rosacea. The papules and pustules symptomatic of rosacea may respond quickly to treatment, but the redness and flushing are less likely to improve.

Some people who have rosacea become depressed by the changes in the appearance of their skin. Information provided by the National Rosacea Society indicates that people who have rosacea often experience low self-esteem, feel embarrassed by their appearance, and claim their social and professional interactions with others are adversely affected. A doctor should be consulted if a person feels unusually sad or has other symptoms of depression, such as loss of appetite or trouble concentrating.

Doctors usually treat the eye problems of rosacea with oral antibiotics, particularly tetracycline or doxycycline. People who develop infections of the eyelids must practice frequent eyelid hygiene. The doctor may recommend scrubbing the eyelids gently with diluted baby shampoo or an over-the-counter eyelid cleaner and applying warm (but not hot) compresses several times a day. When eyes are severely affected, doctors may prescribe steroid eye drops.

Electrosurgery and laser surgery are treatment options if red lines caused by dilated blood vessels appear in the skin or if rhinophyma develops. For some patients, laser surgery may improve the skin's appearance with little scarring or damage. For patients with rhinophyma, surgical removal of the excess tissue to reduce the size of the nose usually will improve the patient's appearance.

Can Rosacea Be Cured, Treated?


Although there is no cure for rosacea, it can be treated and controlled. A dermatologist (a medical doctor who specializes in diseases of the skin) usually treats rosacea. The goals of treatment are to control the condition and improve the appearance of the patient's skin. It may take several weeks or months of treatment before a person notices an improvement of the skin.

Some doctors will prescribe a topical antibiotic, such as metronidazole, which is applied directly to the affected skin. For people with more severe cases, doctors often prescribe an oral (taken by mouth) antibiotic. Tetracycline, minocycline, erythromycin, and doxycycline are the most common antibiotics used to treat rosacea. The papules and pustules symptomatic of rosacea may respond quickly to treatment, but the redness and flushing are less likely to improve.

Some people who have rosacea become depressed by the changes in the appearance of their skin. Information provided by the National Rosacea Society indicates that people who have rosacea often experience low self-esteem, feel embarrassed by their appearance, and claim their social and professional interactions with others are adversely affected. A doctor should be consulted if a person feels unusually sad or has other symptoms of depression, such as loss of appetite or trouble concentrating.

Doctors usually treat the eye problems of rosacea with oral antibiotics, particularly tetracycline or doxycycline. People who develop infections of the eyelids must practice frequent eyelid hygiene. The doctor may recommend scrubbing the eyelids gently with diluted baby shampoo or an over-the-counter eyelid cleaner and applying warm (but not hot) compresses several times a day. When eyes are severely affected, doctors may prescribe steroid eye drops.

Electrosurgery and laser surgery are treatment options if red lines caused by dilated blood vessels appear in the skin or if rhinophyma develops. For some patients, laser surgery may improve the skin's appearance with little scarring or damage. For patients with rhinophyma, surgical removal of the excess tissue to reduce the size of the nose usually will improve the patient's appearance.

Working With Your Doctor To Manage Rosacea


The role you play in managing your rosacea is important. You can take several steps to keep rosacea under control:

  • Keeping a written record of when flareups occur may provide clues regarding what is irritating the skin.
  • Most people should use a sunscreen every day that protects against UVA and UVB rays (ultraviolet rays) and has a sun-protecting factor (SPF) of 15 or higher, but sunscreen is particularly important for people whose skin is irritated by exposure to the sun.
  • Using a mild moisturizer may be helpful, but avoid applying any irritating products to the face. Some people find that a green-tinted makeup effectively conceals skin redness.
  • If your eyes are affected, faithfully follow your doctor's treatment plan and clean your eyelids as instructed.

How should I care for the skin of my face?


Proper skin care involves using a gentle cleanser to wash the face twice a day. Over-washing may cause irritation. A sunscreen lotion is advisable each morning. Your physician may prescribe a topical antibiotic to use once or twice a day under your sunscreen.

Rubbing the face tends to irritate the reddened skin. Some cosmetics and hair sprays may also aggravate redness and swelling.

Facial products such as soap, moisturizers, and sunscreens should be free of alcohol or other irritating ingredients. Moisturizers should be applied very gently after any topical medication has dried. When going outdoors, sunscreens with an SPF of 15 or higher are needed.

How can you prevent rosacea flare-ups?


There are some things you can do to reduce symptoms and keep rosacea from getting worse.

Get any bothersome symptoms under control


A dermatologist can prescribe treatments to reduce redness and any breakouts.

Find your triggers


One of the most important things is to learn what triggers your flare-ups, and then avoid them. It can help to keep a diarypdf(What is a PDF document?) of what you were eating, drinking, and doing on days that the rosacea appeared. Take the diary to your next doctor visit, and discuss what you can do to help control the disease.

Protect your face


Stay out of the sun between 10 am and 4 pm. When you are outdoors, protect your face by wearing a wide-brimmed hat or visor. Use a sunscreen that is rated SPF 15 or higher every day. If your skin is dry, find a moisturizer with sunscreen.

Be gentle with your skin


Use skin care products for sensitive skin, and avoid any products that scratch or irritate your skin. Try not to rub or scrub your skin.

Take care of your eyes


Gently wash your eyelids with a product made for the eyes. Apply a warm, wet cloth several times a day. Use artificial tears if your eyes feel dry. Or talk to your doctor about medicine you can put into your eyes.

What happens to the nose and the eyes?


The nose is typically one of the first facial areas to be affected in rosacea. It can become red and bumpy and develop noticeable dilated small blood vessels. Left untreated, advanced stages of rosacea can cause a disfiguring nose condition called rhinophyma (ryno-fy-ma), literally growth of the nose, characterized by a bulbous, enlarged red nose and puffy cheeks (like the old comedian W.C. Fields). There may also be thick bumps on the lower half of the nose and the nearby cheek areas. Rhinophyma occurs mainly in men. Severe rhinophyma can require surgical correction and repair.

Some people falsely attribute the prominent red nose to excessive alcohol intake, and this stigma can cause embarrassment to those with rosacea. Although a red nose may be seen in patients with heavy alcohol use, not every patient with rosacea abuses alcohol.

Rosacea may or may not affect the eyes. Not everyone with rosacea has eye issues. A complication of advanced rosacea, known as ocular rosacea, affects the eyes. About half of all people with rosacea report feeling burning, dryness, and grittiness of the eyes (conjunctivitis). These individuals may also experience redness of the eyelids and light sensitivity. Often the eye symptoms may go completely unnoticed and not be a major concern for the individual. Many times, the physician or ophthalmologist may be the first one to notice the eye symptoms. Untreated, ocular rosacea may cause a serious complication that can damage the cornea, called rosacea keratitis. An ophthalmologist can assist in a proper eye evaluation and prescribe rosacea eyedrops. Oral antibiotics may be useful to treat skin and eye rosacea. Untreated eye rosacea may cause permanent damage, including impaired vision.

What natural remedies can help rosacea?


Rosacea skin tends to be fairly sensitive and may easily flare with self-treatment or common acne therapies. Any home treatment or attempts for natural remedies should be approached with some caution. As with any rosacea therapy, some people may experience sensitivity or irritation with treatment. Several possible natural remedies, including dilute vinegar cleansing and green tea applications, may be useful in rosacea.

Dilute white vinegar facial soaks or cleansing daily or weekly using approximately 1 part regular table vinegar to 6 parts water may be helpful. Vinegar is thought to help as a natural disinfectant and can help decrease the number of yeasts and bacteria on the skin. Since vinegar may flare rosacea in some people, a small test area should be tried before applying to the entire face.

Green tea soaks to the face may also help decrease the redness and inflammation seen in rosacea. Green tea is thought to have anti-inflammatory properties. A few commercially available products also use green tea as the active ingredient.

What should be avoided?


While not all rosacea people are exactly the same, there are some common rosacea triggers. Avoiding these potential triggers may also help relieve symptoms and disease flares. It may be helpful to keep a personal diary of foods and other triggers that flare rosacea symptoms.

Smoking, spicy foods, hot drinks, and alcohol may cause flushing and should be avoided. Exposure to sunlight and to extreme hot and cold temperatures should be limited as much as possible. Red wine and chocolate are two well known rosacea triggers. Some listed foods may have no effect on your rosacea but severely affect someone else. Individual reaction patterns vary greatly in rosacea. Therefore, a food diary may help to elucidate your special triggers.

Potent cortisone or steroid medications on the face should be avoided because they can promote widening of the tiny blood vessels of the face (telangiectasis). Some patients experience severe rosacea flares after prolonged use of topical steroids.

Vasodilator pills can also flare rosacea. Vasodilators include certain blood pressure medications like nitrates, calcium channel blockers, and thiazide diuretics.

These potential triggers are found in many skin cleansers and should be avoided in rosacea.

What effect may rosacea have on my life?


Rosacea may affect your life minimally, moderately, or severely depending on how active the condition is and your overall tolerance of the skin symptoms.

Some individuals have absolutely no symptoms and are not bothered at all by their rosacea. They may enjoy perfectly healthy normal lives without any effect from this benign skin condition. Some patients really like the pink glow to their cheeks and find it gives them a pleasant color without having to use blush. They may not even know they have rosacea. They usually do not want to use any treatment.

People with moderate rosacea may have periodic flares that require treatment with oral antibiotics, lasers, and other therapies. They may continuously take an antibiotic daily for years and years to keep their symptoms under control. Many of these people may complain of embarrassment from the flushing and blushing of rosacea. They may have ups and downs and times that their disease is quiet and other times when it feels like it is on fire. With the help of their physician, these patients can learn the pattern of their rosacea and develop a treatment plan to keep it from interfering in their daily lives.

Other patients have very bothersome rosacea that causes them issues on a daily basis. There are subsets of severe rosacea sufferers who have extreme psychological, social, and emotional symptoms. Some have developed social phobias, causing them to cancel or leave situations when their rosacea is flaring or active. Some patients complain of looking like they have been drinking alcohol when in fact they don't drink at all. Although rosacea is not a grave medical situation, severe cases may wreak havoc in some patient's lives. It is important for these patients to discuss their physical and emotional concerns with their physicians and to get professional help in treating their rosacea.

Overall, promptly diagnosed and properly treated, rosacea should not prevent people with the condition from enjoying long and productive lives.