Living with Rosacea

Millions of people suffer from rosacea, a chronic skin disorder that primarily affects the face. The onset of rosacea is typically after age 30, with symptoms appearing as redness or blushing that comes and goes initially. Over time, the redness tends to become 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 called rhinophyma.

The severity of rosacea can vary significantly from one person to another, and in most cases some rather than all of the potential symptoms appear. Many people with rosacea have a history of blushing or flushing. This is often the earliest sign of the disorder.

Rosacea always includes at least one of the following primary signs: flushing, persistent redness, bumps and pimples, and/or visible blood vessels. Various secondary signs and symptoms may also develop. These include eye irritation, dry skin, thickening of the skin, red patches or plaques, and swelling.

Four subtypes of rosacea of have been identified based on common patterns or groupings of signs and symptoms:

• Subtype 1 (erythematotelangiectatic rosacea), characterized by flushing and persistent redness, and may also include visible blood vessels.
• Subtype 2 (papulopustular rosacea), characterized by persistent redness with transient bumps and 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

Image courtesy rosacea.org

Rosacea may or may not progress from one subtype to another, but each individual symptom can progress from mild to moderate to severe. Therefore, early diagnosis and treatment are recommended. The cause of rosacea remains unknown, and while there is no cure, medical therapy is available to control, and sometimes reverse, the symptoms.

Prescription oral and topical medications are often used to treat the bumps and pimples associated with rosacea. Treatments with lasers, intense pulsed light sources or other medical and surgical devices may also be used to remove visible blood vessels, reduce extensive redness or correct disfigurement of the nose.

There are two relatively new medications on the market. Onrealtea is a topical prescription specifically designed to treat the facial redness of rosacea. Apprilon is an oral, once-daily treatment designed to treat the bumps and pimples associated with rosacea. It is low dose and therefore does not cause complications associated with long-term antibiotic use.

The key to caring for skin affected by rosacea is to treat it gently. I recommend using a mild skin cleanser and products that are non-drying and free of alcohol or astringents. When washing your face, do not scrub, rinse with lukewarm water and pat dry. It is a good idea to moisturize your skin and use a sunscreen (SPF 30 or higher) every day.

A number of lifestyles factors may cause rosacea to flare up. Some common triggers thought to affect rosacea include hot and cold weather extremes, sun exposure, mental stress, and hot or spicy food and drinks. These triggers vary from person to person, so it is important to find out which ones make your rosacea symptoms flare up. This can help you to better manage your condition by avoiding things that can potentially aggravate your skin. 

If you suspect you may have rosacea the best first step is always to talk to a dermatologist.