Rosacea is a common, chronic skin condition that affects up to 10 percent of the population, although many people are unaware that they have it. It usually affects the face, causing redness and the formation of small, pus-filled bumps similar to acne, and, like other skin conditions, can cause emotional distress for the sufferer. Rosacea typically affects fair-skinned women between 30 and 60 years of age. It can first appear during menopause and is more prevalent in people with a family history of the condition. Although rosacea is a chronic condition that cannot be cured, there are several treatments available to relieve its symptoms and prevent flareups.
What is rosacea?
Rosacea is a 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.
What causes rosacea?
Despite its prevalence, the causes of rosacea are still somewhat of a mystery. It is thought to be a combination of hereditary and environmental factors. There may be an immune function relationship. Personal hygiene, or lack thereof, does not cause rosacea.
Researchers believe there is a genetic tendency to rosacea. Research also points to a bug that is common to those with rosacea, H pylori. Also, the predominance of a skin mite seems to have a link with the condition. These factors have not been definitively proven, however.
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
What do flare-ups look like?
Rosacea usually causes persistent redness in the central part of the person’s face. Small blood vessels on the nose and cheeks often swell and become visible on the surface. Often, the person develops swollen red bumps that resemble pimples and can contain pus. But unlike acne, these pimples can feel hot and tender. Over time, rosacea can thicken the skin on the nose, causing the nose to appear more bulbous. In ocular rosacea, the person’s eyes and eyelids become red and swollen.
Triggers of rosacea symptoms
Rosacea symptoms, which tend to worsen periodically, can be triggered by the following:
- Hot or spicy food or drink
- Alcoholic beverages
- Extreme temperatures
- Hot baths or saunas
- Anger, embarrassment or stress
- Strenuous exercise
- Medications that dilate blood vessels
- Corticosteroids (such as prednisone)
Although the specific causes of rosacea are unknown, a combination of hereditary and environmental factors appears to be involved.
Symptoms of rosacea
Symptoms of rosacea are usually visible on the nose, cheeks, mouth, and forehead; they occasionally spread to the neck, chest, scalp, or ears. Symptoms typically come and go, flaring up for weeks or months, and then fading for a period of time. They tend to worsen as the condition progresses, and are sometimes used to distinguish its four stages.
Pre-rosacea symptoms include frequent flushing or blushing, which progresses to a persistent redness on the face. Vascular rosacea symptoms involve the swelling of small blood vessels (commonly referred to as spider veins and, medically, as telangiectasia) around the nose and cheeks. Oily skin and dandruff are also common during this phase. Inflammatory rosacea is the stage during which small bumps or pustules begin to develop; they then spread across the nose, cheeks, forehead, and chin. Late rosacea is the most advanced phase, during which all earlier symptoms intensify.
If left untreated, symptoms continue to worsen and may cause permanent skin damage. Some patients develop a form of the disorder that affects the eyes (ocular rosacea), and which may, in severe cases, affect vision. The symptoms of rosacea may include the following:
- Flushing or blushing easily
- Small red bumps or pustules
- Visible blood vessels
- Burning or stinging
- Dry, irritated eyes
- Red or swollen eyelids
In late rosacea, patients may develop a complication called rhinophyma in which facial tissue builds up and hardens, causing the nose to enlarge and become bulbous. This complication is more common in men than in women.
What are the different 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 and treated?
The diagnosis of rosacea is typically made through a simple physical examination of the skin on the face. Sometimes tests are administered to rule out other possible causes, such as eczema or lupus. Although there is no cure for rosacea, several treatments are available to relieve symptoms. Through medical consultation, patients should be able to pinpoint at least some of their symptoms’ triggers and learn to avoid them. It may be necessary for them to avoid the sun, spicy foods, alcoholic beverages, or certain medications. Participation in a stress-management program may also be recommended.
Using makeup to disguise rosacea helps many sufferers feel less self-conscious. Medical treatments, the use of which depends on the severity of the condition, may include the following:
- Topical ointments
- Acne medications
- Laser therapy
If the patient is suffering from symptoms of ocular rosacea, our doctors may prescribe oral antibiotics and steroid eye drops
Is there a cure for rosacea?
There is no cure for rosacea. At Advanced Laser and Skin Cancer Center, we work with our rosacea patients to help them identify potential triggers that are causing their flare-ups and to help them manage their flare-ups.
Can diet affect rosacea?
It seems that dietary choices can cause or exacerbate flare-ups. This is because certain foods can affect inflammation and dilate blood vessels. This varies by the person, so no one needs to avoid all trigger foods, only the foods that seem to affect your individual situation.
As with allergies, it’s important to determine which foods affect your symptoms. That’s one area we focus on when Dr. Ragi and the rest of our team help patients manage their rosacea.
What are the different foods that do trigger flare-ups in some people?
As mentioned above, everyone is different. Whereas a Cajun dish may be a problem for one person with rosacea, it’s yogurt or avocados in another.
This is a list produced by the National Rosacea Society of foods that may trigger flare-ups. Again, this doesn’t apply for all foods for all people, not even close. These are simply potential foods that may be triggers for certain people:
- Sour cream
- Cheese (not cottage cheese)
- Soy sauce
- Yeast extract (bread is OK)
- Broad-leaf beans and pods, including lima, navy, and peas
- Citrus fruits, tomatoes, bananas, red plums, raisins, or figs
- Spicy and thermally hot foods
- Foods high in histamine
- And these beverages: alcohol, especially red wine, beer, bourbon, gin, vodka, or champagne; hot drinks, including hot cider, hot chocolate, coffee, or tea.
How to prevent flare-ups
Some people’s rosacea seems to worsen during exercise, but the benefits of exercise outweigh the potential flare-ups. But there are other areas of your life that you can adjust to help.
- Identify and avoid triggers — Learn what foods or actions tend to cause flare-ups and avoid those triggers.
- Protect your face — Apply sunscreen daily, a broad spectrum of at least 30 SPF. Apply any topical medication prior to applying the sunscreen. Cover your skin when possible, such as a scarf in the winter.
- Treat your skin gently — Try not to touch or rub your face too often. Use a non-soap cleanser and moisturize your skin frequently. Avoid products that contain alcohol or other skin irritants.
- Reduce visible redness with makeup — You can use some makeup products and techniques that help mask the visible redness of your skin.