Rosacea (114)

Acne Rosacea

The Facts

Rosacea is a chronic skin condition in which the facial skin appears red. Small red bumps filled with what looks like pus may accompany the skin redness. For this reason, rosacea is sometimes referred to as "adult acne." However, acne and rosacea are separate skin conditions.

Rosacea usually begins in middle age, but it can also affect young adults. People from 30 to 60 years old are most commonly affected. Although women are more often diagnosed with the condition, men are more likely to show severe symptoms. Rosacea is more common in individuals with fair skin, especially people of Irish and Northern European descent.

Without treatment, rosacea can get worse over time. However, early diagnosis and treatment can help prevent this from happening. Rosacea does not endanger a person's physical health, but it is a chronic (ongoing) condition and there is currently no known cure for it.

Causes

It is not known what causes rosacea,but genetics likely play a role. Drinking alcohol may simply cause flushing of the skin in people who already have the condition. Diet does not appear to cause rosacea, but spicy foods or hot beverages may trigger flare-ups. Some medications such as amiodarone and corticosteroids may worsen the condition if they are applied to the skin or inhaled through the nose. High doses of vitamins B6 and B12 can also worsen rosacea.

Scientists also point towards other potential factors that may include skin mites, gastrointestinal infection, blood vessel disorders, and sun damage of the skin. These and other theories are still under investigation.

Symptoms and Complications

Symptoms of rosacea include:

• enlarged nose and cheek tissue
• flushing of the face (skin may appear red or sunburned – the flushing comes and goes at first, but lasts longer if rosacea gets worse)
• grittiness or burning sensation in the eyes
• red bumps with pus-like areas of the nose, cheeks, forehead, or chin
• small but visible blood vessels on the face
• stinging sensation during flare-ups

The grittiness of the eyes is also known as ocular rosacea. Approximately 50% of individuals with rosacea also suffer from this condition.

Making the Diagnosis

There is no test for rosacea. Your doctor will examine your skin and ask about your symptoms in order to determine whether you have rosacea.

Treatment and Prevention

While there is no cure for rosacea, it is possible to manage the symptoms. As rosacea may worsen over time, the condition is less likely to get worse if treated early.

A combination of treatment with medication and changes to personal skin care often helps treat rosacea. Doctors may suggest avoiding certain types of moisturizers, soaps, or other skin care products that increase the appearance of redness in the skin.

Medications used to treat rosacea aim to kill bacteria and reduce inflammation and redness. Antibiotics are commonly prescribed in either topical (applied to the skin) or oral (taken by mouth) forms. Anti-inflammatory medications may also be used. Both types of medication take a few weeks before any results are seen. For persistent redness, a medication to constrict the blood vessels may be applied to the affected areas. Also, certain medications traditionally used for acne may be used in some cases. A key component to any treatment is taking medication as prescribed. If the medication prescribed by your regular doctor does not appear to be working, consider seeing a dermatologist.

Laser and light-based treatments may reduce or eliminate unsightly blood vessels and some of the other symptoms, but this is a very expensive option. Surgery can reduce rhinophyma, which is the excess tissue that can accumulate on the nose.

[references]

1. Merck Manual for Healthcare Professionals. Rosacea. http://www.merck.com/mmpe/sec10/ch111/ch111d.html
2. National Rosacea Society. http://www.rosacea.org/index.php.
3. Mayo Clinic. Rosacea. http://www.mayoclinic.com/health/rosacea/DS00308/METHOD=print. Accessed 17 May 2010.
4. Rosacea Awareness Program. Understanding Rosacea. http://www.rosaceainfo.com/understanding.asp?lang=en. Accessed 17 May 2010.
5. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Rosacea. http://www.niams.nih.gov/Health_Info/Rosacea/default.asp. Accessed 17 May 2010.
6. National Rosacea Society. Understanding rosacea. http://www.rosacea.org/patients/materials/understanding/whatisrosacea.php. Accessed 17 May 2010.
7. National Rosacea Society. Frequently asked questions. http://www.rosacea.org/patients/faq.php#test. Accessed 17 May 2010.
8.  Maier LE. Management of roscea. UpTodate. Last updated August 8, 2019.  Accessed 20200123.
9. Rosacea. The Merck Manual for Consumers [Online]. Available from Merck Manuals Online Medical Library. Last updated February 2022. Accessed Nov 3, 2023. Available at https://www.merckmanuals.com/en-ca/home/skin-disorders/acne-and-related-disorders/rosacea