Rosacea

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Introduction

What is rosacea?

Rosacea is a chronic condition that causes inflammation of the skin on the face. Rosacea can occur on the cheeks, chin, forehead, eyelids and nose. This disorder may cause general redness to the face or bumpy eruptions that look like acne.

Rosacea is not a life-threatening disease, but it is chronic. However, rosacea can be controlled with treatment, and it will worsen if left untreated. The redness of the skin may extend to the back, chest and ears. Rosacea is not the same condition as acne and cannot be treated with over-the-counter acne medications.

Rosacea generally affects people with fair skin who blush easily. It occurs more frequently in women than in men, but men with rosacea experience more-severe symptoms. The disease generally affects people between the ages of 30 and 50. Rosacea is one of the most common skin disorders. One in 20 people in the United States currently live with this condition (Source: PubMed).

Seek prompt medical care if you are being treated for rosacea but mild symptoms recur or are persistent.

Symptoms

What are the symptoms of rosacea?

The main symptom of rosacea is inflammation of the skin on the face. This redness can start on the nose and cheeks and then slowly spread to others parts of the face or body. Women more often have cheek and chin involvement, whereas men have more nose involvement.

Common symptoms of rosacea

You may experience rosacea symptoms daily or just once in a while. At times any of these symptoms can be severe:

  • Acne-like rash
  • Blushing
  • Bumpy texture to the skin
  • Redness
  • Skin thickening
  • Swelling
  • Visible blood vessels

Common symptoms of ocular rosacea

You may experience ocular rosacea symptoms daily or just once in a while. At times any of these symptoms can be severe:

Symptoms that might indicate a serious condition

In some cases, rosacea can be a serious condition that should be promptly evaluated. Seek prompt medical care if you, or someone you are with, have any of these serious symptoms including:

  • Bacterial infection of an oil gland or eyelash follicle in the eyelid margin (stye, or hordeolum)

  • Persistent, enlarged tissue of the nose

  • Red, sore eyes (bloodshot eyes)

  • Skin eruptions that may ooze or crust

  • Skin tingling or burning

  • Vision changes

Causes

What causes rosacea?

The cause of rosacea is not known. However, certain risk factors for developing the condition have been identified.

What are the risk factors for rosacea?

A number of factors increase the risk of developing rosacea. Not all people with risk factors will get rosacea. Risk factors for rosacea include:

  • Alcohol
  • Consumption of hot drinks
  • Environmental triggers: sun, wind, cold
  • Family history of rosacea
  • Skincare products, especially oil-based

    Reducing your risk of rosacea

    Rosacea is not a curable disease, but it can be managed with treatment and lifestyle changes. Some of these changes involve minimizing potential triggers for worsening the condition.

    You may be able to lower your risk of rosacea by:

    • Applying sunscreen daily
    • Avoiding excessive sun exposure
    • Limiting alcohol intake
    • Limiting consumption of hot beverages
    • Limiting consumption of spicy foods
    • Reducing stress
    Treatments

    How is rosacea treated?

    There is no known cure for rosacea. As part of your treatment plan, your health care provider will help you identify potential triggers for rosacea in order to reduce flare-ups. Your health care provider may ask you to maintain a symptom diary to pinpoint your triggers and determine a pattern for your rosacea outbreaks.

    Rosacea flare-ups can be treated with antibiotics and, in severe cases, surgery.

    If you are experiencing ocular rosacea, your health care provider may prescribe an eye medicine and suggest that you wash your eyelids several times a day.

    Oral antibiotics for rosacea treatment

    Oral antibiotics for rosacea are taken by mouth. The course of treatment generally lasts as long as it takes for the rosacea symptoms to lessen. Oral antibiotics for rosacea include:

    • Doxycycline (Monodox)
    • Minocycline (Minocin, Dynacin)
    • Tetracycline

    Topical treatments for rosacea

    Topical treatments for rosacea are applied directly to the skin and best on minor flare-ups. Topical treatments for rosacea include:

    • Azelaic acid (Finacea)
    • Isotretinoin (Accutane)
    • Metronidazole (Metrocream, Metrogel)
    • Vitamin A

    Surgical rosacea treatment

    Surgery is generally reserved for very severe cases of rosacea. The surgery can be used to reduce redness, remove damaged skin, or destroy damaged tissue with electricity. Surgical options for rosacea include:

    • Dermabrasion
    • Electrocautery
    • Laser surgery

    What you can do to improve your rosacea

    In addition to reducing your exposure to rosacea triggers, you can also prevent or limit rosacea outbreaks by:

    • Avoiding over-the-counter treatments that may contain ingredients that will make the rosacea worse

    • Following the rosacea skincare plan given to you by your health care provider

    • Seeking treatment promptly as untreated rosacea can worsen

    What are the potential complications of rosacea?

    Rosacea is not a life-threatening disease, but it is not curable. However, rosacea can be controlled with treatment and lifestyle changes that reduce disease triggers. Complications of untreated rosacea can be serious. When skin is irritated and inflamed, you may develop secondary bacterial infections, which have the potential to spread. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of rosacea include:

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      Medical Reviewer: William C. Lloyd III, MD, FACS
      Last Review Date: 2018 Oct 17
      1. Domino FJ (Ed.) Five Minute Clinical Consult. Philadelphia: Lippincott Williams & Wilkins, 2013.
      2. Rosacea. American Academy of Dermatology. http://www.aad.org/search/?k=Rosacea.
      3. Rosacea. PubMed Health, a service of the NLM from the NIH. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001882/.
      4. van Zuuren EJ, Kramer S, Carter B, et al. Interventions for rosacea. Cochrane Database Syst Rev 2011; :CD003262.
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