Rosacea

Written by Shannon Johnson | Published on 20 August 2012
Medically Reviewed by George Krucik, MD

What Is Rosacea?

According to the National Rosacea Society, rosacea is a chronic skin disease that affects more than 16 million Americans (NRS). The cause of rosacea is still unknown, and there is no cure. However, research has allowed doctors to develop a course of treatment that effectively controls rosacea by minimizing its symptoms.

There are four subtypes of rosacea. Each subtype has its own set of symptoms. It is possible for an individual to have more than one subtype of rosacea at a time. Rosacea’s trademark are small, red, pus-filled bumps on the skin that are present during flare-ups. Typically, rosacea affects only skin on your nose, cheeks, and forehead. Flare-ups often occur in cycles. This means that you will experience symptoms for weeks or months at a time, the symptoms will go away, and then they will return.

The German Institute for Quality and Efficiency in Health Care reports that rosacea affects around one in 10 adults and usually first appears by age 20 (IQWiG).

Types of Rosacea

Subtype one, known as erythematotelangiectatic rosacea (ETR), is associated with facial redness, flushing, and visible blood vessels.

Subtype two, papulopustular (or acne) rosacea, is associated with acne-like breakouts and often affects middle-aged women.

Subtype three, known as rhinophyma, is a rare form that is associated with thickening of the skin of your nose. It usually affects men and is often accompanied by another subtype of rosacea.

Subtype four is ocular rosacea, and its symptoms are centered on the eye area.

Risk Factors for Rosacea

People who fall into the following categories run a higher risk of developing rosacea:

  • between 30 and 50 years old
  • fair-skinned with blond hair and blue eyes
  • Celtic or Scandinavian ancestry
  • a family history of rosacea
  • suffered with severe acne in the past
  • women (however, men can also develop rosacea, and they tend to have more serious symptoms)

Symptoms of Rosacea

Signs of rosacea ETR (subtype one):

  • flushing and redness in center of face
  • visible broken blood vessels
  • swollen skin
  • sensitive skin
  • skin stinging and burning
  • dry, rough, and scaly skin

Signs of acne rosacea (subtype two):

  • acne-like breakouts and very red skin
  • oily skin
  • sensitive skin
  • broken blood vessels that are visible
  • raised patches of skin

Signs of thickening skin (subtype three)

  • bumpy skin texture
  • thick skin on nose
  • thick skin on chin, forehead, cheeks, and ears
  • large pores
  • visible broken blood vessels

Signs of ocular rosacea (subtype four)

  • bloodshot and watery eyes
  • eyes that feel gritty
  • burning or stinging sensation in the eyes
  • dry, itchy eyes
  • eyes that are sensitive to light
  • cysts on eyes
  • diminished vision
  • broken blood vessels on eyelids

What Causes Rosacea?

The cause of rosacea has not been determined. It may be a combination of hereditary and environmental factors. It is known that some things may make your rosacea symptoms worse. These include:

  • eating spicy foods
  • drinking alcoholic beverages
  • having the intestinal bacteria Helicobacter pylori
  • a skin mite called demodex and the bacterium Bacillus oleronius it carries
  • the presence of cathelicidin (a protein that protects the skin from infection)

How Do I Know if I Have Rosacea?

Your doctor can easily diagnose rosacea from a physical examination of your skin. He or she may refer you to a dermatologist who can determine whether you have rosacea or just a severe case of acne.

How Can I Control My Symptoms?

Rosacea cannot be cured, but you can take steps to control your symptoms.

Make sure to take care of your skin using gentle cleansers and oil-free, water-based skin-care products. Avoid products that contain ingredients that may irritate your symptoms. These include alcohol, menthol, witch hazel, and exfoliating agents.

Stick with the treatment plan given to you by your doctor. This is usually a regimen of antibiotic creams and oral antibiotics.

Avoid your triggers. Keeping a journal to help you discover what triggers or makes your rosacea worse.

Other steps include:

  • avoiding direct sunlight and wearing sunscreen
  • avoiding drinking alcohol
  • trying lasers and light treatment to help with some severe cases of rosacea
  • trying dermabrasion to reduce thickening skin
  • taking eye medicines and antibiotics for ocular rosacea

Rosacea’s Effect on Quality of Life

Rosacea is a chronic skin disease that you will need to learn to manage. Some people who have rosacea suffer considerable emotional distress because of the appearance of their skin. A study by the National Rosacea Society revealed that 41 percent of people with rosacea avoided public contact and canceled social engagements (AAD).

In addition, the same survey found that close to 70 percent of people with rosacea said the condition lowered their confidence and self-esteem. Techniques to help individuals with rosacea cope with their condition include:

  • fully educating themselves about the disease
  • strictly following all of their doctor’s recommendations
  • maintaining a strong support system of family and friends
  • joining supports with other people who have the disease

Long-Term Outlook for Rosacea

Rosacea cannot be cured, but it can be controlled with treatment. Some people will experience more flare-ups than others. With the proper treatment people can remain free of the signs and symptoms of rosacea for years. The most important step to a successful outlook is to seek treatment at the first sign of rosacea.

Alternative Remedies

According to the Mayo Clinic, there are alternative treatments rumored to help rosacea. They include emu oil, laurelwood, oregano oil, vitamin K, and colloidal silver.

However, there is no firm evidence that any of these treatments is effective. In the case of colloidal silver, a suspension of submicroscopic silver particles in a colloidal base, it could even do harm. Long-term use of treatments involving silver can lead to argyria, a condition in which silver salts are deposited in the skin, eyes, and internal organs. People with argyria have skin that is a blue-gray color.

If you decide to try an alternative therapy, it is important that you first discuss it with your doctor.

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