Rosacea

Pronounced: rose-AY-sha

Definition

Definition

Rosacea is a skin disorder. It causes chronic redness of the face. Rosacea usually affects the cheeks, forehead, chin, and nose. The ears, chest, and back may also be affected. More than half of people with rosacea also have mild eye symptoms. This may include redness, burning, and watering. This is known as ocular rosacea.

Rosacea Rash

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Causes

Causes

The cause of rosacea is unknown. Several theories exist.

Factors that can cause flushing or blushing may trigger flare-ups in people with rosacea.

These factors include:

  • Very hot or spicy foods
  • Caffeine
  • Alcohol
  • Sun exposure
  • Extreme temperatures (very hot or very cold)
  • Exercise
  • Emotional stress or social embarrassment
  • Rubbing, scrubbing, or massaging the face
  • Irritating cosmetics and other toiletries

Risk Factors

Risk Factors

Rosacea is more common in women, between 30 and 60 years old, and in people with fair skin.

Your risk of rosacea is increased if you have family members who also have rosacea.

Symptoms

Symptoms

The symptoms of rosacea vary from person to person. They include:

  • Frequent flushing on the face and neck
  • Redness and swelling on the face
  • Small pink bumps and/or pimples
  • Thin red lines showing the small blood vessels of the face
  • Redness, burning, dryness, and tearing of the eyes
  • An enlarged, bulbous red nose—less common, affecting men more than women

Diagnosis

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. Your skin will also be examined. You may be referred to a doctor who specializes in skin disorders. This type of doctor is called a dermatologist. Do not try to diagnose or treat yourself. Certain over-the-counter medications could make your condition worse.

Treatment

Treatment

Rosacea generally can’t be cured. It can be controlled. There are several ways to manage rosacea. Your doctor may recommend more than one, depending on your condition.

Medications

Prescription medications for rosacea include:

  • Antibiotics applied to the skin
  • Other topical treatments such as benzoyl peroxide, azelaic acid, sulfa, or tretinoin
  • Antibiotics taken by mouth

In more severe cases, medications may sometimes include:

  • Oral isotretinoin
  • In rare, more severe cases, oral methotrexate, dapsone, primaquine, chloroquine, or prednisone

Topical cortisone is generally avoided on the face. It can make rosacea worse when used long term. However, it can be effective as a short-term treatment.

Treatment for redness or flushing may include:

  • Clonidine in low doses
  • Beta blockers (certain types)

Surgery

The following procedures minimize redness, enlarged blood vessels, and an enlarged nose:

  • Electrosurgery
  • Laser surgery
  • Dermabrasion

Prevention

Prevention

Preventing rosacea can be difficult. If you have rosacea, there are several steps you can take to control the condition:

  • Avoid things that may trigger flushing or blushing. This includes certain foods, alcohol, and exposure to the sun.
  • Protect your skin from the sun. Use clothing, hats, or sunscreen with a sun protection factor (SPF) of 30 or higher.
  • Exercise in a cool environment to avoid overheating.
  • Avoid anything that irritates your skin:

    • Apply topical medications, moisturizers, and cosmetics gently
    • Use cleansers, moisturizers, cosmetics, and other toiletries that are gentle and alcohol-free

RESOURCES:

American Academy of Dermatology http://www.aad.org

National Rosacea Society http://www.rosacea.org

CANADIAN RESOURCES:

Canadian Dermatology Association http://www.dermatology.ca

Dermatologists.ca http://www.dermatologists.ca

References:

Tanzi EL, Weinberg JM. The ocular manifestations of rosacea. Cutis. 2001;68:112-114. Review.

Crawford GH, Pelle MT, et al. Rosacea: I. Etiology, pathogenesis, and subtype classification. J Am Acad Dermatol. 2004;51:327-341;quiz 342-344. Review.

Pelle MT, Crawford GH, et al. Rosacea: II therapy. J Am Acad Dermatol. 2004;51:499-512;quiz 513-514. Review.

Rosacea. American Academy of Dermatology website. Available at: https://www.aad.org/dermatology-a-to-z/diseases-and-treatments/q—t/rosacea. Accessed January 22, 2015.

Sunscreen FAQs. American Academy of Dermatology website. Available at: https://www.aad.org/media-resources/stats-and-facts/prevention-and-care/sunscreens. Accessed January 22, 2015.

Last reviewed January 2015 by Michael Woods, MD
Last Updated: 10/20/2014

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