Rosacea Treatment

Rosacea is a very common benign skin disorder that affects many people worldwide. As of 2008, it is estimated to affect more than 16 million people in the United States alone. The main symptoms of this facial condition include red or pink patches, visible broken blood vessels, small red bumps, red cysts, and pink or irritated eyes. Most people with the disease may not even know they have rosacea or that it is a diagnosable and treatable condition. Many patients may just assume they blush easily or have gotten sunburned.

Symptoms – Rosacea is considered a chronic (long-term), non-curable skin disease with periodic ups and downs. As opposed to traditional acne, most adult patients do not “outgrow” rosacea. It characteristically involves the central region of the face, causing persistent redness or transient flushing over the areas of the face and nose that normally blush — mainly the forehead, the chin and the lower half of the nose. It is commonly seen in people with fair or light skin, and particularly in those of Irish and Scottish backgrounds. Some famous people with rosacea have included former President Bill Clinton and W.C. Fields.

Red cheeks are a common symptom of rosacea. The redness, often aggravated by flushing, may cause small blood vessels in the face to enlarge (dilate) and become more visible through the skin, appearing like tiny red lines (called telangiectasias). Continual or repeated episodes of flushing may promote inflammation, causing red bumps that resemble teenage acne. In fact, rosacea can frequently be mistaken for common acne. Rosacea is also referred to as acne rosacea.

Causes – The exact cause of rosacea is still unknown and remains a mystery. The basic process seems to involve dilation of the small blood vessels of the face. Suspected causes of rosacea include but are not limited to genetic factors, genetics plus sun exposure, a mite sometimes found in hair follicles (Demodex folliculorum), the bacteria Helicobacter pylori (that is associated with stomach ulcers), gastrointestinal disease, and medications that cause blood vessels to widen. There seems to be a hereditary component in some people.

Rosacea tends to affect the “blush” areas of the face and is more common in people who flush easily. Additionally, a variety of triggers are known to cause rosacea to flare. Emotional factors (stress, fear, anxiety, embarrassment, etc.) may trigger blushing and aggravate rosacea. A flare-up can be caused by changes in the weather like strong winds or a change in the humidity. Sun exposure and sun-damaged skin is generally associated with rosacea. Exercise, alcohol consumption, emotional upsets, and spicy food are other well-known triggers that may aggravate rosacea. Many patients may also notice flares around the holidays, particularly Christmas and New Year’s holidays.

Typical signs and symptoms include facial flushing, redness, burning, red bumps, and cystscysts. The symptoms tend to come and go. The skin may be clear for weeks, months, or years and then erupt again. Rosacea tends to evolve in stages and typically causes inflammation of the skin of the face, particularly the forehead, cheeks, nose, and chin.

When rosacea first develops, it may appear, then disappear, and then reappear. However, the skin may fail to return to its normal color and the enlarged blood vessels and pimples arrive in time. Rosacea may rarely reverse itself. Rosacea generally lasts for years, and, if untreated, it tends to worsen.

Rosacea treatment – There are many treatment choices for rosacea depending on the severity and extent of symptoms. Available medical treatments include antibacterial washes, topical creams, antibiotic pills, and lasers.

Mild rosacea may not necessarily require treatment if the individual is not bothered by the condition. More resistant cases may require a combination approach, using several of the treatments at the same time. A combination approach may include home care of washing with a prescription sulfa wash twice a day, applying an antibacterial cream morning and night, and taking an oral antibiotic for flares.

Topical creams – With the proper treatment, rosacea symptoms can be fairly well controlled. Popular methods of treatment include topical (skin) medications applied by the patient once or twice a day. Topical antibiotic medication such asmetronidazole applied one to two times a day after cleansing may significantly improve rosacea. Azelaic acid (Finacea gel 15%) is another effective treatment for patients with rosacea. Both metronidazole and azelaic acid work to control the redness and bumps in rosacea.

Some patients elect combination therapies and notice an improvement by alternating metronidazole and azelaic acid: using one in the morning and one at night. Sodium sulfacetamide (Klaron lotion) is also known to help reduce inflammation. Other topical antibiotic creams include erythromycin and clindamycin (Cleocin).

Oral antibiotics – Oral antibiotics are also commonly prescribed to patients with moderate rosacea. Tetracycline, doxycycline, minocycline, and amoxicillin are among the many oral antibiotics commonly prescribed and they actually help reduce inflammation and pimples in rosacea. The dose may be initially high and then be tapered to maintenance levels. Common side effects and potential risks should be considered before taking oral antibiotics.

Sun protection – Sun exposure is a known flare for some rosacea sufferers. Sun protection using a wide-brimmed hat and sunscreens are generally encouraged. Because rosacea tends to occur in mostly fair-skinned adults, the use of an appropriate daily sunscreen lotion and overall sun avoidance is recommended. Zinc-based sunscreens (SPF 30 or higher) may provide adequate sun protection.

Triggers to avoid – While not all rosacea patients are exactly the same, there are some common rosacea triggers. Avoiding these potential triggers may also help relieve symptoms and disease flares.

Smoking, spicy foods, hot drinks, and alcohol may cause flushing and should be avoided. Exposure to sunlight and to extreme hot and cold temperatures should be limited as much as possible.

Smoking, spicy foods, hot drinks, and alcohol may cause flushing and should be avoided. Exposure to sunlight and to extreme hot and cold temperatures should be limited as much as possible.

Potent cortisone medications on the face should be avoided because they can promote widening of the tiny blood vessels of the face. Some patients experience severe rosacea flares after prolonged use of topical steroids.