Rosacea - Symptoms & Treatment

Rosacea is a skin disease that affects the middle third of the face, causing persistent redness over the areas of the face and nose that normally blush mainly the forehead, the chin and the lower half of the nose. Rosacea is a skin condition that produces red oily skin and acne. The tiny blood vessels in these areas gets dilate and become more visible through the skin, appearing like tiny red lines called telangiectasias. Pimples can occur in rosacea that resemble teenage acne. Rosacea usually occurs in the central part of the face and involves the nose, cheeks, chin and/or forehead. Long term Rosacea may produce Rhinophyma, an enlarged nose. Rosacea occurs in both men and women and, and although it may occur at any age, onset usually begins after the age of 30. People with rosacea often find that certain lifestyle and environmental factors trigger a flare-up or aggravate their individual conditions. Common triggers include certain foods (especially hot or spicy foods) and drink, (especially alcohol and caffeine), exercise, temperature changes, exposure to the sun, rain or wind, and stress. Rosacea responds to treatment but cannot be cured. Left untreated, the redness becomes more permanent and the tiny blood vessels may become more visible. Pimples often develop and in a few people, especially older men, the nose may become bumpy, red and swollen (Rhinophyma).

Rosacea is a common but often misunderstood condition that is estimated to affect over 45 million people worldwide. It more common in women, men may develop more apparent signs of the disorder. It's not life-threatening, but it can affect your appearance and self-esteem. It affects fair-skinned people of mostly north-western European descent, and has been nicknamed the 'curse of the Celts' by some in Ireland. It begins as flushing and redness on the central face and across the cheeks, nose, or forehead but can also less commonly affect the neck, chest, scalp or ears. The progresses of rosacea can lead to several other symptoms such as permanent redness, red bumps, red gritty eyes, burning and stinging sensations, small blood vessels visible near the surface of the skin, and in some advanced cases a bulbous nose. Rosacea tends to be progressive i.e. it gets worse over time. In most people rosacea is cyclic, which means it may flare up for a period of weeks to months and then signs and symptoms lessen for a while before it flares up again. 

Causes of Rosacea

The cause of rosacea is unknown. There are several theories regarding the origin of overactive facial blood vessels and inflammation, including genetic, environmental, vascular, inflammatory factors. A flare-up can be caused by changes in the weather like strong winds or a change in the humidity. Sun exposure generally aggravates rosacea. A mite sometimes found in hair follicles may play a role in the development of rosacea. The bacteria Heliobacter pylori (that is associated with stomach ulcers) and medications like vasodilators (that cause blood vessels to widen) have also been thought possibly to bring out rosacea.

Find common causes and risk factors of Rosacea :

• The drugs such as amiodarone or nitroglycerine -like drugs may cause roscea.
• Foods or beverages that cause facial flushing, such as alcohol, spicy foods, hot soups, coffee, and tea, may form rosacea.
• In 30-40% of patients have a family history of roscea.
• The immune abnormalities like different types of antinuclear antibodies in the blood may help in the formation of roscea.

Signs and Symptoms of Rosacea

Sign and symptoms may include the following :

• Red areas on your face.
• Small, red lines under the skin.
• Tendency to flush or blush easily.
• Acne.
• A swollen nose.
• Visible small blood vessels on your nose and cheeks.
• Red, dry, itchy eyes and sometimes vision problems.

Treatment for Rosacea

The treatment of rosacea varies from patient to patient depending upon the type and the degree of severity. The important fact in all the treatments is to have a gentle skin cleansing routine with non-irritating cleansers. Protection from the sun is important and daily use of a sunscreen of at least SPF 15 containing a physical blocker such as zinc oxide or titanium dioxide is advised. Oral tetracycline antibiotics ( tetracycline , doxycycline , minocycline ) and topical antibiotics such as metronidazole are usually the first line of defence prescribed by doctors to relieve papules, pustules, inflammation and some redness. Dermatological vascular laser and Intense Pulsed light machines offer one of the best treatments. They use light to penetrate the epidermis to target the capillaries in the dermis layer of the skin. The light is absorbed by oxy-hemoglobin which heat up causing the capillary walls to heat up to 70ºC, damaging them, causing them to be absorbed by the body's natural defense mechanism thus preventing further rosacea. CO2 lasers can be used to remove excess tissue caused by phymatous rosacea. CO2 lasers emit a wavelength that is absorbed directly by the skin. The laser beam can be focused into a thin beam and used as a scalpel or defocused and used to vaporiouse rosacea tissue.

Treatment may include :

• Retin-A is an effective treatment for Rosacea and can decrease the number of small blood vessels.
• Avoid hot drinks , spicy foods , caffeine , and alcoholic beverages .
• Two drugs - Monoxidine and Clonodine are anti-hypertensives and very beneficial for roscea treatment.
• Vitamin A derivatives such as isotretinoin are useful in the treatment of rosacea.
• Typical treatment for rosacea is to take 500 mg of tetracycline in the morning,
• Use of sunscreen and avoidance of sunlight will help to prevent flares.