What is Rosacea?

Rosacea is a chronic condition that includes flushing and blushing of the face. It can sometimes present as pimples or pus-filled bumps. Rosacea triggers include alcohol, spicy foods, and stress.

What Are The Causes of Rosacea?

While the exact cause of rosacea is not fully understood, several factors may contribute to its development. These include:

  • Genetics: There appears to be a genetic component to rosacea, as the condition often runs in families. Individuals with a family history of rosacea may be more likely to develop the condition themselves.
  • Inflammation is a key feature of rosacea, and the immune system’s response to various triggers may contribute to the characteristic redness and flushing associated with the condition.
  • Dysfunction of blood vessels: Blood vessels in the skin of individuals with rosacea may dilate more easily in response to certain triggers, leading to increased blood flow and redness.
  • Environmental factors: Various environmental factors can trigger or exacerbate rosacea symptoms in susceptible individuals. These triggers may include sun exposure, extreme temperatures (hot or cold), wind, humidity, spicy foods, alcohol consumption, certain medications, and stress.
  • Microscopic skin damage: Microscopic damage to the skin barrier may contribute to the development of rosacea. This damage can be caused by factors such as harsh skincare products, abrasive exfoliation, or other forms of skin irritation.

What Are The Signs And Symptoms of Rosacea?

Rosacea signs and symptoms can vary from person to person. Common signs and symptoms of rosacea include:

  • Facial redness (erythema): Persistent redness in the central part of the face, particularly on the cheeks, nose, forehead, and chin which may come and go or become more pronounced over time.
  • Flushing: Flushing or sudden episodes of facial redness can occur, often triggered by certain factors such as hot beverages, spicy foods, alcohol, sunlight, or emotional stress.
  • Visible blood vessels (telangiectasia): Small, dilated blood vessels may become visible, particularly on the cheeks, nose, and chin.
  • Papules and pustules: Small, red bumps and pustules may develop on the face, resembling acne. These lesions are often sensitive to the touch and may be accompanied by burning or stinging sensations.
  • Thickening of the skin: In some cases, the skin on the nose or other areas on the face may become thickened and bumpy.
  • Sensitive skin: Many people with rosacea have sensitive skin that may react strongly to skincare products, cosmetics, or environmental triggers such as wind, sunlight, or temperature changes.

What Are The Risk Factors of Rosacea?

  • Genetics: A family history of rosacea may increase your risk of developing the condition.
  • Fair Skin: Rosacea is more common in individuals with fair skin, particularly those of Celtic or northern European descent.
  • Sun Exposure: Excessive exposure to sunlight can trigger or worsen rosacea symptoms. Protecting your skin from the sun with sunscreen and protective clothing can help minimize this risk.
  • Environmental Factors: Extreme temperatures, hot weather, wind, humidity, and cold can exacerbate rosacea symptoms.
  • Heat: Hot baths, saunas, hot beverages, and spicy foods can trigger flushing and exacerbate rosacea symptoms.
  • Alcohol: Alcohol consumption, particularly of red wine and other alcoholic beverages, can trigger rosacea flare-ups in some individuals.
  • Certain Foods: Spicy foods, hot beverages, and foods high in histamines or that cause blood vessel dilation can exacerbate rosacea symptoms in some people.
  • Stress: Emotional stress or anxiety can trigger or worsen rosacea symptoms in some individuals.
  • Physical Exertion: Strenuous exercise or physical exertion can lead to flushing and exacerbate rosacea symptoms.
  • Medical Conditions: Certain medical conditions, such as gastrointestinal disorders or autoimmune diseases, may be associated with rosacea.
  • Demodex Mites: These microscopic mites that live on human skin have been associated with rosacea.

How is Rosacea Diagnosed?

Diagnosing rosacea typically involves a physical examination by a healthcare professional, often a dermatologist. There is no specific test to diagnose rosacea, but your doctor will consider your medical history, review your symptoms, and perform a physical examination of your skin to make a diagnosis. In some cases, additional tests or examinations may be done to rule out other conditions that may mimic rosacea.

During the examination, the healthcare provider will look for common signs and symptoms of rosacea, such as persistent facial redness, flushing, visible blood vessels (telangiectasia), and acne-like bumps or pustules. They may also ask about factors that can trigger or exacerbate your symptoms, such as sun exposure, alcohol consumption, and certain foods.

What Are Possible Treatments For Rosacea?

  • Topical Medications:
    • Creams or gels, such as metronidazole, azelaic acid, or ivermectin, may help reduce inflammation and control bacterial overgrowth associated with rosacea.
    • Topical Retinoids: Retinoid creams or gels may help reduce inflammation and improve the appearance of skin affected by rosacea.
  • Oral Medications:
    • Oral Antibiotics: Oral antibiotics, such as doxycycline, minocycline, or tetracycline, may be prescribed for moderate to severe rosacea to reduce inflammation and control bacterial overgrowth.
    • Isotretinoin: In severe cases of rosacea, isotretinoin, a powerful oral medication, may be prescribed to reduce oil production and inflammation. It’s typically used when other treatments have failed.
  • Laser and Light Therapy:
    • Intense Pulsed Light (IPL) Therapy: IPL therapy targets blood vessels and reduces redness associated with rosacea.
    • Fractional Laser Therapy: Fractional lasers can improve the texture and appearance of skin affected by rosacea.
  • Dermabrasion and Chemical Peels: These procedures can help improve the appearance of skin affected by rosacea by removing damaged outer layers and promoting skin regeneration.
  • Skincare and Lifestyle Modifications:
    • Gentle Cleansing: Use gentle cleansers and avoid harsh scrubs or exfoliants that can irritate the skin.
    • Sun Protection: Protect your skin from the sun by wearing sunscreen with SPF 30 or higher and using protective clothing and hats.
    • Avoid Triggers: Identify and avoid triggers that worsen your rosacea symptoms, such as spicy foods, hot beverages, alcohol, and extreme temperatures.
    • Moisturize: Use a gentle, non-comedogenic moisturizer to keep your skin hydrated and reduce irritation.

Are There Preventative Steps or Measures To Avoid Rosacea?

Preventive measures and lifestyle modifications can help reduce the frequency and severity of rosacea flare-ups.

  • Sun Protection: Protect your skin from the sun by wearing sunscreen with SPF 30 or higher daily, even on cloudy days. Opt for broad-spectrum sunscreens that protect against both UVA and UVB rays. Additionally, wear protective clothing, such as wide-brimmed hats and sunglasses, when outdoors.
  • Avoid Triggers: Identify and avoid triggers that worsen your rosacea symptoms. Common triggers include spicy foods, hot beverages, alcohol, caffeine, extreme temperatures (hot or cold), wind, sun exposure, stress, and certain skincare products containing irritants. Use humidifiers in dry indoor environments to help maintain moisture in the air.
  • Gentle Skincare Routine: Adopt a gentle skincare routine tailored to sensitive skin. Use mild, non-abrasive cleansers and lukewarm water to wash your face. Avoid harsh scrubs, exfoliants, and skincare products containing alcohol, fragrance, or other irritants that can exacerbate rosacea symptoms.
  • Moisturize: Keep your skin hydrated by using a gentle, non-comedogenic moisturizer daily. Moisturizers help maintain the skin barrier and reduce irritation.
  • Skincare Product Selection: Choose skincare products labeled as suitable for sensitive skin and free from common irritants. Patch-test new products before applying them to your face to check for any adverse reactions.
  • Regular Follow-Up with Dermatologist: Schedule regular follow-up appointments with your dermatologist to monitor your rosacea and adjust your treatment plan as needed. Early intervention and proactive management can help prevent worsening of symptoms.
  • Camouflage Makeup: Consider using makeup to conceal redness and improve the appearance of skin affected by rosacea. Choose non-comedogenic, fragrance-free products formulated for sensitive skin.

What Are The Risks If Rosacea Is Left Untreated?

  • Worsening Symptoms: Rosacea tends to worsen over time if left untreated. What may start as occasional flushing and redness can progress to persistent facial redness, visible blood vessels (telangiectasia), and acne-like bumps (papules and pustules).
  • Permanent Skin Changes: Chronic inflammation associated with untreated rosacea can cause permanent skin changes, including skin thickening, scarring, and enlargement of blood vessels.

Are There Other Related Conditions To Rosacea?

  • Seborrheic Dermatitis: Seborrheic dermatitis is a common inflammatory skin condition characterized by red, scaly patches, often occurring on the scalp, face, and other oily areas of the body. It can sometimes occur concurrently with rosacea, especially when affecting the facial area.
  • Acne Vulgaris: Rosacea and acne vulgaris can share some similarities in terms of acne-like bumps (papules and pustules) appearing on the face. However, acne vulgaris typically affects younger individuals and is characterized by comedones (blackheads and whiteheads) along with inflammatory lesions, while rosacea tends to occur in adults and is associated with persistent facial redness, flushing, and visible blood vessels.
  • Perioral Dermatitis: Perioral dermatitis is a facial rash that typically affects the area around the mouth, nose, and eyes. It is characterized by redness, bumps, and scaling and can resemble rosacea.

Key Takeaways About Rosacea (Top 3-5 points to remember from everything)

  1. Rosacea signs and symptoms can vary from person to person commonly including facial redness/flushing, papules and pustules, and thickening of the skin.
  2. Common triggers include spicy foods, hot beverages, alcohol, caffeine, extreme temperatures (hot or cold), wind, sun exposure, stress, and certain skincare products containing irritants.
  3. Topical, oral, and cosmetic treatment options are available for rosacea

Recommended Next Steps

Follow up with the dermatologist for diagnosis and treatment options