Rosacea (ro-ZAY-sha) is a skin condition with no definitive cause and no cure. The condition is recurring in nature, with flare-ups and remissions. It prevalently affects women in their middle ages.
The signature sign of rosacea appears during a flare-up. Small red-colored bumps appear on your face, particularly the nose, cheeks, and forehead. That is why it is often confused with other skin conditions like acne. However, the condition is very different than acne, with four distinct types.
Here is what you need to know if you experience reddening and flushing of skin periodically.
Types of Rosacea
The four subtypes of rosacea include;
- Sub-type one
Also known as erythematotelangiectatic rosacea (ETR), the condition presents as flushing of the face with redness. The blood vessels on the face are usually visible.
- Sub-type two
The second type of rosacea is also known as papulopustular rosacea. It presents with acne-like breakouts.
- Sub-type three
Also called rhinophyma, this rare sub-type usually affects men. The condition causes thickening of the skin of the nose. Signs and symptoms of other sub-types often accompany this type.
- Sub-type four
This type of rosacea involves the skin around the eyes and is known as ocular rosacea.
Symptoms of rosacea
The signs and symptoms of rosacea depend on the different sub-types and the stage of the condition.
Some of the symptoms of rosacea include;
- Face flushing
A blushed appearance of the face may appear as flushing in severe cases. The symptoms are more pronounced in fair-skinned individuals. With recurrent attacks, there might be a persistent flushing present centrally on the face.
- Spider veins
Our face is highly vascularized. Rosacea causes the tiny veins and capillaries of the face to become more pronounced. There is breakage of the minute vessels in severe cases, which gives a web-like appearance on the face called spider veins.
- Bumpy skin
The facial skin becomes dry, rough, scaly, and bumpy due to the presence of small swollen bumps. These are sometimes filled with pus and may resemble acne breakouts.
- Burning sensation
The facial skin feels warm and tender to touch. The bumps may become painful with a burning sensation.
- Eye symptoms
In the case of ocular rosacea, the skin of the eyelids becomes dry, swollen, and irritable to touch. The dryness may extend into the eyes. The eye symptoms are usually earlier to develop than the one affecting the skin.
- Enlarged nose
The nose does not become enlarged in rosacea. What happens is that with recurrent flare-ups, the skin of the nose becomes thick due to repeated inflammation, a process called rhinophyma. The nose takes a bulbous look.
Symptoms specific to each subtype of rosacea
- erythematotelangiectatic rosacea (ETR)
- Centralized flushing and redness of the face
- Evidence of broken blood vessels
- Dry, rough, and scaly skin texture
- Swelling of skin
- Skin sensitivity
- A sensation of stinging skin
- Papulopustular rosacea
- Intensely red skin with acne-like breakouts
- Oily and sensitive skin
- Visibly broken blood vessels
- Skin raising in patches
- Rhinophyma
An overall bumpy skin texture
Skin thickening over the nose, chin, forehead, cheeks, and ears
Visible large pores with broken blood vessels
- Ocular rosacea
- A gritty feeling in the eyes
- Dry and itchy eyes
- Burning sensation in the eyes bloodshot and watery eyes
- Visual sensitivity to light
- Cyst formation on eyes
- Vision disturbances as blurring
- Visibly broken blood vessels on eyelids
Causes of rosacea
There is no single definitive cause of rosacea. Many factors are attributed to causing the skin condition, including;
- Genetics
- Familial tendency
- An overactive immune system
- Environmental stimuli
- Infection with a skin mite (Demodex)
- Intestinal infection with H. Pylori
- Combination of all or some
Contrary to layman belief, rosacea is not the result of improper skin care. Also, the condition is not contagious.
What are the triggers of rosacea?
Some of the triggers that are identified by clinical evidence result in a flare-up of rosacea. These include;
- Exercise
- Extremes of weather
- Exposure to sun or wind
- Emotional stress
- Dietary elements like spicy foods, cinnamon-containing foods, tomatoes, citrus fruits, etc.
- Consumption of hot drinks, red wine, and alcoholic beverages
- Sun or wind
- A side effect of specific vasodilators (medicines causing dilation of blood vessels like those used for managing blood pressure)
- Reaction to the use of specific skin or hair care products
Are there any risk factors for rosacea?
Though nobody is exempt from developing rosacea, the skin condition is more prevalent in people with some risk factors. These include;
- Gender; women are more prone to developing rosacea
- Age; the condition is more prevalent in women above thirty years of age
- Ethnicity; Celtic or Scandinavian ancestors
- Family history; individuals with a close family member suffering from rosacea may develop the condition
- Sensitive skin; having sensitive skin can result in rosacea
- Smoking; smokers are more at risk of developing rosacea
How to diagnose rosacea?
Relevant history of the presenting symptoms and physical examination usually indicate the diagnosis for rosacea.
A dermatologist may perform certain tests to rule out allergic skin reactions or psoriasis. Ocular rosacea requires appropriate evaluation by an eye specialist.
How to treat rosacea?
Since no definitive cause is known for rosacea, there is no specific treatment for rosacea. However, the skin condition can be managed.
It is possible to cut back the frequency of flare-ups and remissions. Let us see how.
- Medications for rosacea
The medications for rosacea are aimed at alleviating signs and symptoms. So different drugs are prescribed to address different subtypes of rosacea.
- Drugs to reduce flushing
Topical medications to treat mild to moderate rosacea include creams or gels. These work by constricting the blood vessels and work within twelve hours of the first application. Though effective, these topical medications require regular applications.
Examples of such drugs include Brimonidine and oxymetazoline.
- Drugs to reduce acne
The bumpy skin appearance of rosacea is improved by topical application of drugs like azelaic acid, metronidazole, and ivermectin.
Oral antibiotics like doxycycline are also prescribed to treat moderate to severe cases of acne associated with rosacea. Topical antibiotics may also be prescribed.
Prescription medication like isotretinoin and other vitamin A derivatives also help to ease away severe acne.
Antibiotic drops and other eye medicines manage ocular rosacea.
- Laser therapy for rosacea
Laser therapy for managing rosacea is a good option for people with fair skin. Repeated laser sessions are required to reduce the appearance of visible veins on the face.
Laser therapy is not for every case of rosacea. People with dark skin tones do not benefit much. Laser therapy is not recommended due to side effects like permanent discoloration on brown and black skin.
- Lifestyle and home remedies
Self-care and regular skincare practices help alleviate the symptoms of rosacea. However, always consult your dermatologist before selecting skincare products if you have rosacea.
Some of the lifestyle remedies for rosacea include;
- Learn, identify, and avoid the triggers that cause a flare-up of rosacea.
- Rev up the protective measures for your skin. Application of SPF-30 sunscreen is a must-to-do after using medication for rosacea if you are going outdoors.
- Protect your skin from extremely dry weather in summers and winters.
- Select skincare products carefully. Do not use harsh scrubs and cleansers on your face.
- Keep your facial skin moisturized. Use fragrance-free skin range after consulting with your doctor.
- Use water-based and oil-free skin care products and cosmetics.
- Avoid skin products containing alcohol, menthol, witch hazel, and exfoliating agents.
- Alternative medicine
Facial massage for rosacea helps reduce swelling, skin inflammation, and the appearance of spider veins.
Similarly, skincare products with caffeine are touted to work best for rosacea-affected skin.
Always use herbal products under the guidance of your dermatologist.