About the Treatment
Rosacea is a common skin condition that causes areas of the face to become red with visible blood vessels. Unlike psoriasis, which can be quite painful, rosacea usually isn’t physically painful, but it is emotionally irritating because of how it affects the appearance of your facial skin.
At Signature Plastic Surgery and Dermatology, we help our patients treat and control their rosacea, as well as understand the potential triggers that may be causing flare-ups.
What is rosacea?
Rosacea is common, afflicting an estimated 14 million Americans. The skin condition is characterized by redness and visible blood vessels on the facial skin. It may include small, red, pus-filled bumps. Flare-ups can last for weeks, even months, and then the skin calms down for a period of time before flaring up again. People often mistake rosacea either for blushing, acne, or an allergic reaction.
Who gets rosacea?
Anyone of any background or race can develop rosacea, but it is more likely in certain people:
- Between the ages of 30 and 50
- Fair-skinned, often with blonde hair and blue eyes
- Celtic or Scandinavian ancestry
- Family history of rosacea or severe acne
- Likely to have had severe acne, usually the cystic form
- Women are more likely, although men develop severe rosacea more often
Causes of Rosacea
Rosacea isn’t fully understood, but it’s thought to be caused by a combination of genetic and environmental factors. It also may have an immune function association. Contrary to what some believe, a lack of personal hygiene does not cause rosacea. Rosacea also is not contagious.
Symptoms of Rosacea
These are common signs and symptoms of rosacea:
- Facial redness — Persistent redness in the central area of the face. Small blood vessels on the nose and cheeks often swell and become visible.
- Swollen red bumps — People with rosacea may develop red bumps that resemble acne. They may contain pus, and the skin may feel hot and sensitive.
- Eye problems — About half of the people with rosacea have eye dryness, and irritated, swollen reddened eyelids.
- Enlarged nose — In rare cases, rosacea can cause the skin on the nose to become thicker. This makes the nose appear bulbous. This occurs more in men.
What are triggers for a rosacea flare-up?
A number of factors can trigger an outbreak or aggravate your symptoms because they increase blood flow to the surface of the skin. These factors include:
- Spicy foods
- Hot drinks
- Temperature extremes
- Sun exposure
- Wind exposure
- Drugs that dilate the blood vessels
Types of rosacea
There are four subtypes of rosacea:
- Erythematotelangiectatic Rosacea — Redness, flushing, visible blood vessels
- Papulopustular rosacea — Redness, swelling, acne-like breakouts
- Phymatous rosacea — Skin thickens and has a bumpy texture
- Ocular rosacea — Eyes become red and irritated, eyelids can be swollen, and the person appears to have a sty
How is rosacea diagnosed?
To diagnose rosacea, we look at the patient’s medical history in combination with a physical examination of the skin. Other conditions, such as acne, psoriasis, eczema, and lupus, can cause similar symptoms, so it’s important to rule those out. There is not a specific test for rosacea.
The key to treating rosacea is to provide both treatment of flare-ups and education as to potential triggers causing those flare-ups. There is no cure.
Treatment focuses on controlling flare-ups. For most patients, this is accomplished with a combination of skincare and medication. Even with successful treatment, recurrence is common with rosacea.
At Signature Plastic Surgery and Dermatology, we use three types of drugs for treating rosacea:
- Medications to address the redness — The drug brimonidine is effective for reducing redness. When applied topically to the skin it works to constrict the blood vessels. Other topical products that reduce redness and the pimples with mild rosacea are azelaic acid and metronidazole. These drugs take from 3-6 weeks to improve rosacea.
- Oral antibiotics — Oral antibiotics, such as doxycycline, may be used to fight the inflammation showing in pimples and bumps.
- Isotretinoin — This powerful acne drug also helps to clear up acne-like lesions stemming from rosacea.
Treatments and triggers
Light treatments, such as intense pulsed light, can be effective at shrinking the facial blood vessels, lessening the redness.
Your skincare regimen can also involve triggers. Actions such as scrubbing the skin can cause a flare-up. Many skincare products and cosmetics can irritate your skin.
Sun protection is very important for rosacea patients. Wearing sunscreen with at least SPF 30 is crucial. Hats and protective clothing are helpful, as well.
Beyond that, Dr. Booth can isolate the triggers that are leading to your flare-ups. Educating you about these can help you avoid or minimize these foods or behaviors that are aggravating your rosacea.