Rosacea (pronounced “roh-ZAY-sha”) is a chronic and potentially life-disruptive disorder primarily of the facial skin, often characterized by flare-ups and remissions.
Rosacea, sometimes called adult acne, is a chronic inflammation of the face of unknown cause and without a permanent cure. Four different types of rosacea have been described:
- “Red face” rosacea, with a tendency to face flushing (or blushing), which can progress to a persistent redness of the nose or central face
- “Acne”-like bumps and/or pus-filled lesions (papulopustular rosacea), with or without a red face or flushing
- Rhinophyma – slow enlargement of oil glands and skin thickening of the nose and sometimes other face areas, usually in men
- Eye problems (ocular rosacea), which may occur before skin changes – a burning or gritty feeling may be present as well as reddening of the eyes and lids
Who’s at risk?
Adults between 30 and 60 are most often affected by rosacea. Although rosacea can affect all segments of the population, individuals with fair skin who tend to flush or blush easily are believed to be at greatest risk, although dark-skinned people may also be affected. The disease is more frequently diagnosed in women, but more severe symptoms tend to be seen in men — perhaps because they often delay seeking medical help until the disorder reaches advanced stages.
While there is no cure for rosacea and the cause is unknown, medical therapy is available to control or reverse its signs and symptoms. Individuals who suspect they may have rosacea are urged to see a dermatologist or other knowledgeable physician for diagnosis and appropriate treatment.
Many have observed that it typically begins any time after age 30 as a redness on the cheeks, nose, chin or forehead that may come and go. In some cases, rosacea may also occur on the neck, chest, scalp or ears.
About 14 million Americans have rosacea. In most people rosacea comes and goes periodically; in some it gets worse with time.
Frequent triggers (things that increase face blood flow) of rosacea include sunlight, hot drinks, spicy foods, alcohol, exercise, hot baths or saunas, temperature extremes, and emotional stress. Prolonged use of cortisone creams on the face can also lead to rosacea. Some drugs may worsen flushing (nasal steroids, amiodarone, high doses of some B vitamins, tamoxifen, and rifampin).
What Should I Look For?
Rosacea can vary substantially from one individual to another, and in most cases some rather than all of the potential signs and symptoms appear. According to a consensus committee and review panel of 17 medical experts worldwide (see Classification of Rosacea), rosacea always includes at least one of the following primary signs, and various secondary signs and symptoms may also develop.
Over time, the redness tends to become ruddier and more persistent, and visible blood vessels may appear. Left untreated, bumps and pimples often develop, and in severe cases the nose may grow swollen and bumpy from excess tissue. This is the condition, called rhinophyma (pronounced “rhi-no-FY-muh”), that gave the late comedian W.C. Fields his trademark bulbous nose. In many rosacea patients, the eyes are also affected, feeling irritated and appearing watery or bloodshot.
W.C. Fields.. Image: nj.com
Primary Signs of Rosacea
Many people with rosacea have a history of frequent blushing or flushing. This facial redness may come and go, and is often the earliest sign of the disorder.
- Persistent Redness
Persistent facial redness is the most common individual sign of rosacea, and may resemble a blush or sunburn that does not go away.
- Bumps and Pimples
Small red solid bumps or pus-filled pimples often develop. While these may resemble acne, blackheads are absent and burning or stinging may occur.
- Visible Blood Vessels
In many people with rosacea, small blood vessels become visible on the skin.
Other Potential Signs and Symptoms
- Eye Irritation
In many people with rosacea, the eyes may be irritated and appear watery or bloodshot, a condition known as ocular rosacea. The eyelids also may become red and swollen, and styes are common. Severe cases can result in corneal damage and vision loss without medical help.
- Burning or Stinging
Burning or stinging sensations may often occur on the face. Itching or a feeling of tightness may also develop.
- Dry Appearance
The central facial skin may be rough, and thus appear to be very dry.
Raised red patches, known as plaques, may develop without changes in the surrounding skin.
- Skin Thickening
The skin may thicken and enlarge from excess tissue, most commonly on the nose. This condition, known as rhinophyma, affects more men than women.
Facial swelling, known as edema, may accompany other signs of rosacea or occur independently.
- Signs Beyond the Face
Rosacea signs and symptoms may also develop beyond the face, most commonly on the neck, chest, scalp or ears.
Subtypes of Rosacea
The consensus committee and review panel of 17 medical experts worldwide identified four subtypes of rosacea, defined as common patterns or groupings of signs and symptoms. These include:
- Subtype 1 (erythematotelangiectatic rosacea), mild rosacea characterized by flushing and persistent redness, and may also include visible blood vessels with rare pimples.
- Subtype 2 (papulopustular rosacea), moderate rosacea characterized by persistent redness with transient bumps and few pimples.
- Subtype 3 (phymatous rosacea), characterized by skin thickening, often resulting in an enlargement of the nose from excess tissue.
- Subtype 4 (ocular rosacea), characterized by ocular manifestations such as dry eye, tearing and burning, swollen eyelids, recurrent styes and potential vision loss from corneal damage. And/or large bulbous nose and/or lots of blood vessels on the face, all of which can be bothersome in appearance. This is the severe rosacea.
Many patients experience characteristics of more than one subtype at the same time, and those often may develop in succession. While rosacea may or may not evolve from one subtype to another, each individual sign or symptom may progress from mild to moderate to severe. Early diagnosis and treatment are therefore recommended.
Identify and minimize any exposure that triggers episodes of rosacea, such as:
- Sunlight – use a broad-spectrum sunscreen with a sun protection factor (SPF) of 30 or more on your face.
- Avoid drinking hot liquids and alcohol, eating spicy foods, and excessive heat exposure.
- Protect the face in winter with a scarf or mask.
- Avoid facial products with alcohol or other skin irritants (astringents, toners, sorbic acid, menthol, camphor), and use mild cleansers for the face.
- Fair-skinned people may find a green- or yellow-tinted makeup helps to hide redness.
- Cool compresses, gel masks, and central face massage may be of some benefit.
- Benzoyl peroxide may help some people but can also be easily irritating to the skin.
- Nicomide T is a combination of a vitamin (nicotinamide) and zinc available in cream and gel form, which may be helpful.
Eye rosacea can be treated with warm water compresses 2–4 times a day followed by gentle cleaning of the eyelid rims with baby shampoo on a Q-tip® and application of the topical antibiotic bacitracin/polymyxin B (but discontinue this if there is any worsening, as there can be rare allergic reactions to bacitracin).
How is Rosacea Treated?
Because the signs and symptoms of rosacea vary from one patient to another, treatment must be tailored by a physician for each individual case. Learn more about when to see a doctor.
Various oral and topical medications may be prescribed to treat the bumps and pimples often associated with the disorder, and a topical therapy to reduce facial redness is now available. Dermatologists often prescribe initial treatment with oral and topical therapy to bring the condition under immediate control, followed by long-term use of topical therapy to maintain remission. A version of an oral therapy with less risk of microbial resistance has also been developed specifically for rosacea and has been shown to be safe for long-term use.
When appropriate, treatments with lasers, intense pulsed light sources or other medical and surgical devices may be used to remove visible blood vessels, reduce extensive redness or correct disfigurement of the nose. Ocular rosacea may be treated with oral antibiotics and other therapy.
When to Seek Medical Care
If you have severe changes in appearance or symptoms that interfere with your daily life, you should seek care. If you have severe, persistent flushing, there are other possible causes of flushing requiring laboratory tests; see your doctor.
Treatments Your Physician May Prescribe
- Antibiotics – Topical antibiotics include creams or solutions with either metronidazole, erythromycin, sulfur, sodium sulfacetamide, azelaic acid, or benzoyl peroxide. If these are not helpful, oral antibiotics can be very effective (tetracyclines, erythromycin, ampicillin, or metronidazole).
- Nicomide is a combination pill with niacinamide and zinc, which may help.
- Isotretinoin is a strong medicine used for very severe cases of rosacea and has many side effects.
- Surgical treatment with lasers or electrocautery can reduce the visibility of blood vessels and the extra nose tissue in rhinophyma.
Patients should check with their physicians to ensure their skin-care routine is compatible with their rosacea. A gentle skin-care routine can also help control rosacea. Patients are advised to clean their face with a mild and non-abrasive cleanser, then rinse with lukewarm water and blot the face dry with a thick cotton towel. Never pull, tug or use a rough washcloth.
Patients may apply non-irritating skin-care products as needed, and are advised to protect the skin from sun exposure using a sunscreen with an SPF of 15 or higher.
Cosmetics may be used to conceal the effects of rosacea. Green makeup or green-tinted foundations can be used to counter redness. This can be followed by a skin-tone foundation with natural yellow tones, avoiding those with pink or orange hues.
In addition to medical treatment, rosacea sufferers can improve their chances of maintaining remission by identifying and avoiding lifestyle and environmental factors that trigger rosacea flare-ups or aggravate their individual conditions. For listings of common factors that may aggravate rosacea in individual cases, see Rosacea Triggers.
How can I treat Rosacea?
The best of course of action for treatment is to talk to your physician or a dermatologist, who can assess your unique case of rosacea. At Guelph Facial Plastics, we have some of the most advanced treatments available to treat a variety of skin issues.
Two of our most popular treatments are Syneron Candela’s CO2RE laser and VBeam Perfecta laser. The CO2RE is a fractional CO2 skin-resurfacing laser that can treat both the superficial and deep dermal levels simultaneously. The VBeam Perfecta Pulsed Dye Laser delivers a soft but powerful blast of power into the regions of skin targeted for treatment. The light is swallowed by the melanin pigmented sections or blood vessels, harmlessly managing the multiple kinds of discoloration and problems concerning skin composition. There are also topical, non-antibiotic ointments that can dramatically improve redness and compliment the result of the laser treatments.
Above is an example of what CO2RE can do. This is a conclusion after one month of CO2RE treatment for Rhinophyma. This is an extreme form of rosacea that can cause tumor like growths of oil glands on the nose. As you can see, CO2RE is great for treating this condition. A month after the treatment, Dr. Brace used the VBeam Perfecta to maintain positive results. Syneron Candela’s VBeam Perfecta is the world’s best selling pulsed-dye laser. It is a safe and effective in the treatment of vascular, pigmented and some non-pigmented lesions.
DIFFERENT TYPES OF ROSACEA:
18 COMMON ROSACEA TRIGGERS
You’ve probably noticed that certain foods, temperatures, activities, emotions — or something else entirely — will trigger your rosacea to flare up. Here are some common rosacea triggers.
Foods and drinks that cause rosacea:
- Spicy foods
- Hot drinks
- Hot foods (in temperature)
Activities that cause rosacea:
- Exercise or heavy exertion
- Hot baths or saunas
Weather conditions that cause rosacea:
- Hot weather
- Cold weather
- Humid weather
Emotions that cause rosacea:
- Stress or anxiety
- Sudden change in emotion, like feeling embarrassed or bursting out laughing
Medical conditions that cause rosacea:
Other rosacea triggers:
- Skin products
- Medications, such as topical steroids, some blood pressure drugs, and some opiate painkillers
Keep in mind that not all of these things will trigger your rosacea. Everybody is different. The important thing is to learn what causes your own rosacea symptoms. You can use a diary to keep track.
Why Do Triggers Make Rosacea Worse?
Doctors still aren’t sure what causes rosacea, but in a lot of people, things that make your face flush also make rosacea worse.
When you flush, blood rushes to your face, making it red and warmer. So avoiding activities, products, or emotions that cause flushing can reduce your rosacea symptoms.
Avoiding Rosacea Triggers
Once you’ve figured out what your rosacea triggers are, find ways to avoid them.
Food and drinks. Don’t eat foods that cause rosacea symptoms. You could also try some simple substitutions. For instance, in the morning, replace that steaming mug of coffee with iced coffee.
Exercise. Unfortunately, working out can worsen your rosacea. But you still need to be physically active. So change your routine. Instead of one long workout, try splitting it into several shorter segments. Try longer, low-intensity workouts instead of more demanding ones. And stay cool. Don’t exercise outside when it’s too hot. If you’re inside, use a fan or air conditioner. During your workout, drink plenty of water. Afterward, cover your face with a cool cloth.
Weather. You should always wear a hat and use sunscreen to protect your skin while outside. Also, do the obvious: dress warmly on cold days and lightly on hot ones.
Emotional stress. Learn ways to calm yourself before stress results in a rosacea flare-up. You might try deep breathing exercises or yoga.
Medication. If you think a medicine may be a trigger, talk to your doctor. See if you could take a different drug.
Unfortunately Rosacea can cause more than just facial redness. Rosacea can cause inflammation and acne-like breakouts on the skin known as Acne Rosacea, plus enlarged blood vessels on the face which appear as tiny red lines (called telangiectasias) and dry, irritated eyes. Approximately 10% of the Irish population is affected by Rosacea.
At your Free Consultation, one of our highly experienced Skin Experts will assess your skin and discuss the wide range of effective Rosacea treatments available, from individually prescribed products, facials and scientifically proven chemical peels to IPL. The best solution for you will be discussed at your free consultation.
I.P.L. (Intense Pulse Light) uses targeted pulses of light which are attracted to the problem areas of the skin, heating up the cells and collapsing them so that they can be flushed out by the body’s natural defences. This leaves only the healthy skin cells in the targeted area and evens out the tone of your skin in just a few short sessions.
Image Skincare Lightening Lift Peel
A skin peel is a resurfacing treatment designed to improve and enhance the skin. Benefits include skin clarity, even skin tone, uniform colour and improved texture. Our Image Skincare peel product line features all natural ingredients, such as Aloe Vera, Papaya, Green Tea and Vitamin C. This mega-lightening treatment gently blends lactic acid and a cocktail of lightening and brightening agents to reduce sun spots, brown spots and the redness caused by rosacea.
“Sandra explained what some of the motives of my rosacea may be and that the root cause is internal. She said that besides the external treatments she was going to do, I had to do my part too. I was in charge of the most important treatment, the internal. What she meant was that I had to commit to eating differently because it was obvious that it was something that I was ingesting that was causing my rosacea. Sandra recommended that I eliminate the following foods from my diet: eggs, shellfish, dairy, refined sugars, mangoes, and cold foods to see how my body/face reacted. She also recommended that I add the following to my diet: lots of Vitamin C, honey, melons, papaya and chlorophyll,” Nina Gonzalez said. Source: http://ninaonthemoon.com/rosacea-derma-bright-clinic/
Woman cures swollen rosacea with CAPER ointment after years of painful prescription creams. ROSACEA can affect sufferers many ways as Frances Batten reveals exclusively to Express.co.uk. The 33-year-old found a cure in caper cream and is overwhelmed with the treatment’s results. SOURCE: http://www.express.co.uk/life-style/life/787206/Rosacea-treatment-cream-before-after