Rosacea

What is rosacea?

Rosacea is a relatively common disorder, affecting 2-10% of the population, the cause of which is unknown. Since it appears most often on the cheeks, chin, forehead and ears as flushing and redness combined with pimple-like bumps, it can also result in psychological problems.

In the United States, the National Rosacea Society conducted a survey in which 70% of the interviewed patients claimed that the illness reduced their self-confidence, 41% became more reclusive and many lost their jobs as a result of the flare-ups of the illness.

Since the exact cause of rosacea is not known, there are no cures at this time. However, regular medical monitoring is necessary. Without treatment, the symptoms of rosacea tend to worsen. It is therefore imperative that patients consult with a specialized dermatologist at the first signs of symptoms.

What do we need to know about rosacea?

Rosacea is primarily an illness of the 30-50 year age group, women are most frequently affected. The underlying cause is not known; however, we do know that many factors influence the development of the illness. Light-skinned people are more susceptible to rosacea.

Rosacea is a chronic illness which worsens without treatment, the first symptoms of which are intermittent flushing or redness of the cheeks, nose, chin and forehead. Rosacea rarely appears on the neck, chest, scalp and ears. As time goes on, the flushing is no longer intermittent, but becomes a persistent redness, and visible veins appear on the affected skin. Without adequate medical treatment, the condition can worsen and pimple-like bumps may appear. In severe cases, the nose may swell and thicken, resulting in so-called rinofima. Many rosacea patients also suffer from symptoms affecting the eyes.

What are the symptoms of rosacea?

  • Flushing or redness: This symptom appears in most patients and is usually temporary. This is most frequently the first symptom of rosacea.
  • Persistent redness: This is the most frequently occurring symptom of rosacea. It is similar to sunburn, but does not fade over time.
  • Pimples and bumps: Tiny red bumps similar to pimples appear. There are no blackheads. May be accompanied by burning and itching.
  • Visible veins

Other signs associated with rosacea

  • Irritation of the eyes: 50% of all patients complain of eye symptoms, which include irritation, redness and tearing. The eyelid may swell and become red. In severe cases, damage to the cornea may lead to blindness without treatment!
  • Burning sensation: This symptom is present mainly on the cheeks and may be accompanied by itching and tightness of the skin.
  • Dry skin
  • The appearance of plaques: Raised red patches, most frequently on the cheeks.
  • Thickening of the skin: The skin may swell and thicken, especially on the nose, causing rinofima; this symptom appears mainly in men.
  • Edema: Swelling of the cheeks may accompany the other symptoms of rosacea.

What are the different types of rosacea?

Four subtypes of rosacea have been identified:

Temporary or persistent redness and visible blood vessels (erythematotelangiectatic rosacea)

  1. Persistent redness and intermittently appearing pimple-like bumps (papulopustular rosacea)
  2. Thickening of the skin, affecting mainly the nose as a result of tissue growth (phymatous rosacea)
  3. Mainly eye symptoms, such as dryness, tearing, burning sensation, swollen eyelids (ocular rosacea),

Many patients exhibit symptoms that are a combination of subtypes. The individual symptoms are mild initially, but worsen with time. For this reason, it is essential that rosacea be diagnosed as early as possible and be treated by a dermatologist.

Treatments of rosacea

Treatment depends on the types of symptoms of individual patients. Numerous topical preparations and orally taken medications are available. As of January, 2010, a prescription gel is available in Hungary, which effectively reduces the symptoms of redness and pimple-like bumps. Swollen veins may be treated with IPL (intense pulsar light) and lazer technology.

How should the skin be cared for?

Regular skin care is required for patients with rosacea and should be discussed with the dermatologist. Commercial cleansers may be very irritating; therefore, mild, non-irritating cleansers and skin care products must be used. The skin should be rinsed with lukewarm water and blotted dry with a cotton towel. Rubbing is not allowed! The effect of the medical treatments can be further improved if skin care products which help to reestablish the skin’s natural defenses are used (e.g., glukonolactone-containing preparations).

Protection from sunlight is important. Sunscreens are recommended which contain physical protection.

Cosmetics: green tones are recommended to correct for the redness, together with a natural yellow-toned foundation. Reds and oranges should be avoided!

Is a change in lifestyle necessary?

In addition to receiving medical care, flare-ups decrease in number if the patients note which of the many possible triggers worsen their symptoms, and make changes in their lifestyle to avoid these.

What can trigger roseacea flare-ups?

The list below contains triggers which can cause roseacea to flare up; the order of the triggers from top to bottom reflects the frequency with which they trigger the illness. Each patient must identify their “own” triggers, which may be very different from that of other patients.

  • Excessive sunlight
  • Psychological stress
  • Hot temperatures
  • Wind
  • Physical exertion
  • Alcohol consumption Hot baths 51%
  • Cold temperatures
  • Spicy foods
  • Humidity
  • Overheated rooms
  • Various skin-care products
  • Hot drinks
  • Various cosmetics
  • Some fruits
  • Meats (marinated)
  • Some vegetables
  • Milk products