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What is rosacea?

Rosacea is a common skin disease that causes redness and selling on the face.  Often referred to as “adult acne,” rosacea may begin as a tendency to flush or blush easily, and progress to persistent redness in the center of the face that may gradually involve the cheeks, forehead, chin, and nose.  It also may involve the ears, chest and back.  As the disease progresses, small blood vessels and tiny pimples begin to appear on and around the reddened area; however, unlike acne, there are no blackheads.  When it first develops, rosacea may come and go on its own.  When the skin doesn’t return to its normal color and when other symptoms, such as pimples and enlarged blood vessels, become visible, it’s best to seek advice from a dermatologist.  The condition rarely reverses itself and may last for years.  It can become worse without treatment. 

How to recognize rosacea

Pimples of rosacea appear on the face as small, red bumps, some of which may contain pus.  These may be accompanied by the development of many tiny blood vessels on the surface of the skin and persistent redness of the face.  In more advanced cases of rosacea, a condition called rhinophyma may develop.  The oil glands enlarge causing a bulbous, enlarged red nose and puffy cheeks.  Thick bumps can develop on the lower half of the nose and nearby cheeks.  Rhinophyma occurs less commonly in women. 

Who is at risk for rosacea?

Those most likely to develop rosacea are fair-skinned adults, especially women, between the ages of 30 and 50, although it may affect women of any age and even children.  For some unknown reason, women get rosacea more often than men, and some cases of this disorder have been associated with menopause.  Rosacea usually develops over a long period of time.

Dos and Don’ts for rosacea patients

Avoid hot drinks, spicy foods, caffeine and alcoholic beverages.  It’s important to note that although alcohol may worsen a case of rosacea, symptoms may be just as sever in someone who does not drink at all.  This condition has been unfairly linked to alcohol. 
Practice good sun protection. This includes limiting exposure to sunlight, wearing hats and using brood spectrum sunscreens with SPF 15 or higher and avoiding extreme hot and cold temperature, which may exacerbate the symptoms of rosacea.
Avoid rubbing, scrubbing or massaging the face.  Rubbing will tend to irritate the reddened skin.
Exercise in a cool environment.  Don’t overheat.
Avoid irritating cosmetics and facial products.  Use hair sprays properly.
Keep a diary of flushing episodes and not associated foods, products, activities, medications or other triggering factors.

Treatment Options

Many people with rosacea are unfamiliar with it and do not recognize it in its early stages.  Identifying the disease is the first step to controlling it.  Self-diagnosis and treatment are not recommended, as some over-the-counter skin applications may make the problem worse.  Dermatologists often recommend a combination of treatments tailored to the individual patient.  Together, these treatments can stop the progress of rosacea and sometimes reverse it.  The following are some of the options:

Gels and creams may be proscribed by a dermatologist.  A slight improvement can be seen in the first three to four weeks of use.  Greater improvement is usually noticed in two months.
Oral antibiotics tend to produce faster results than topical medications.
Cortisone creams may reduce the redness of rosacea.  They should not be used for longer than two weeks and strong preparations should be avoided.  It is best to use these creams only under the direction of your dermatologist.
The persistent redness may be treated with a small electric needle or by laser surgery to close off the dilated blood vessels. 
Cosmetics may offer an alternative to the more specific treatment.  Green tinted makeup may mask redness.

It’s important to eliminate factors that cause additional skin irritation.  Daily facial products such as soap, moisturizers, and sunscreens should be free of alcohol or other irritating ingredients.  Moisturizers used along with topical medications should be applied very gently after the medication has dried.  When going outdoors, especially on warm sunny days, sunscreens with an SPF of 15 or higher are necessary. 

The key to successfully management of rosacea is early diagnosis and treatment.  It is also important to follow all of your dermatologist’s instructions.  Rosacea can be treated and controlled if medical advice is sought in the early stages.  When left untreated, rosacea will get worse and may be more difficult to treat.