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Rosacea is a common skin disease marked by facial flushing or persistent redness, often accompanied by the enlargement of blood vessels and the emergence of small, pus-filled bumps. Symptoms can vary, with flare-ups lasting weeks to months followed by temporary remission periods.
Due to its resemblance to acne, dermatitis, and other skin conditions, rosacea may be misdiagnosed. Although there’s no cure, it can typically be controlled with medication, gentle skincare routines, and avoidance of triggers that worsen symptoms.
Types of rosacea
There are four distinct types of rosacea, which are:
- Erythematotelangiectatic: Rosacea manifests as persistent facial redness accompanied by enlarged and visible blood vessels. This type of flare manifests with symptoms that arise and subside unexpectedly.
- Papulopustular: Pus- or fluid-filled pimples develop on the skin, resulting in swelling and symptoms resembling acne.
- Phymatous: Symptoms lead to skin swelling and thickening, often resulting in a bumpy texture, with the nose being the most commonly affected area. In severe cases, symptoms may cause the nose to appear bulbous, a condition known as rhinophyma.
- Ocular: Rosacea can impact the eyes, leading to sensations of irritation and redness, or excessive tearing. Light sensitivity may also occur, accompanied by the formation of painful bumps on the eyelids, known as styes.
Symptoms
Symptoms associated with rosacea comprise:
- Redness and flushing of the face. Rosacea may cause more frequent flushing of the face. You might observe that your face remains red over time. Depending on the tone of the skin, redness can appear more pink or purple or be faint.
- Visible blood vessels. The nose and cheeks have tiny blood vessels that rupture and enlarge. Another name for these is spider veins. Depending on the color of the skin, they could be faint and difficult to notice.
- Enlarged bumps. Many rosacea sufferers get facial pimples that resemble acne. There may be pus present in these bumps. They could also show up on the back and chest.
- A feeling of burning. The afflicted area’s skin may feel sensitive and heated.
- Enlarged nose. Over time, rosacea can thicken the skin on the nose, making the nose look bigger. This condition is also known as rhinophyma and affects more men than women.
- Eye problems. Many people with rosacea also have dry, irritated, swollen eyes and eyelids. Eye symptoms can appear before, after, or at the same time as skin symptoms. This condition is known as ocular rosacea.
If you’re dealing with persistent symptoms impacting your face or eyes, it’s important to seek medical assistance from a healthcare provider for accurate diagnosis and treatment. Dermatologists, specialized in skin conditions, can offer tailored care for rosacea and associated issues.
Causes
The precise cause of rosacea remains unknown. It may stem from genetic predispositions, an overactive immune response, or environmental triggers. Notably, rosacea isn’t linked to poor hygiene and isn’t contagious.
Flare-ups of rosacea may be triggered by:
- Alcohol.
- Hot drinks.
- Spicy foods.
- Sun or wind.
- Very hot and cold temperatures.
- Cosmetics and skin/hair care items.
- Emotional stress.
- Exercise.
- Certain medications for blood pressure, including those that dilate blood vessels.
Risk factors
While rosacea can affect anyone, certain factors may heighten the risk of developing it if you:
- Are between the ages of 30 and 50.
- Have skin prone to sunburn.
- Have a family member with rosacea.
- Have a history of smoking.
Diagnosis
To ascertain whether you have rosacea, a doctor will conduct a thorough examination of your skin and inquire about your symptoms. Tests may be performed to eliminate other conditions like psoriasis or lupus. Notably, certain symptoms of rosacea may be less visible on brown and Black skin, such as spider veins and flushing. Therefore, it’s crucial to be vigilant of other symptoms like bumps, swelling, facial stinging, and dry-looking skin.
If your symptoms affect your eyes, you may be referred to an eye doctor, also known as an ophthalmologist, for further evaluation.
Treatment
If your symptoms persist despite adhering to the self-care recommendations below, it’s advisable to consult your doctor regarding prescription gels or creams. These medications can help alleviate symptoms. In cases of severe rosacea, prescription pills may be required. Laser treatment may also be utilized to reduce facial flushing and enlarged blood vessels. The duration of treatment varies depending on the type and severity of rosacea. Even if your skin shows improvement with treatment, symptoms often recur over time.
Medications
Various medications are utilized to manage rosacea symptoms, with the specific type of medication prescribed contingent upon your individual symptoms. For instance, certain medications or treatments may be more effective for addressing flushing, while others may be more suitable for treating pimples and bumps. It may be necessary to experiment with one or more medications to identify the most effective treatment for your condition.
Medications for rosacea encompass:
- Topical gels or skincare products. To alleviate the flushing associated with mild to moderate rosacea, you may consider using a medicated cream or gel applied to the affected skin. Examples include brimonidine and oxymetazoline, which work by constricting blood vessels to reduce flushing. Results may become noticeable within 12 hours post-application, but the effect on blood vessels is temporary. Overuse of these medications may exacerbate flushing, so it’s advisable to reserve their use for special occasions rather than daily application.
Additionally, other prescription topical products are available to manage the pimples associated with mild rosacea. Examples include azelaic acid, metronidazole, and ivermectin. While results may take 2 to 6 weeks to manifest with azelaic acid and metronidazole, ivermectin may require even longer for noticeable skin improvement. However, the effects of ivermectin tend to last longer compared to metronidazole. In some cases, combining two or more of these products may yield the most optimal outcomes.
- Oral antibiotics. For severe rosacea characterized by bumps and pimples, your doctor may recommend an oral antibiotic medication such as doxycycline.
- Oral medications for acne. If severe rosacea fails to improve with other medications, your doctor may prescribe isotretinoin. This potent oral acne medication is also effective in addressing the bumps associated with rosacea. However, it’s crucial to note that isotretinoin must not be taken during pregnancy as it carries a risk of causing birth defects.
Laser treatment
Laser treatment is an effective option for improving the appearance of enlarged blood vessels and long-term redness associated with rosacea. It often yields better results compared to topical creams or oral medications for this symptom. However, since the laser targets visible veins, it is most effective on untanned or lighter skin tones.
Common side effects may include temporary redness, bruising, and mild swelling for a few days following the procedure. Rare side effects such as blistering and scarring can occur. Utilizing ice packs and gentle skincare can aid in the healing process.
It’s important to note that laser treatment may cause long-term or permanent changes to the color of the treated skin, especially on brown or Black skin.
The full effects of laser treatment may not be apparent for several weeks, and repeated treatments may be necessary to maintain improved skin appearance.
