Rosacea

Answer 1

Definition

Rosacea is a chronic skin condition involving inflammation of the cheeks, nose, chin, forehead, or eyelids. It may appear as redness, prominent spider-like blood vessels, swelling, or skin eruptions similar to acne.

Alternative Names

Acne rosacea

Causes, incidence, and risk factors

Although the cause of rosacea is unknown, you are more likely to develop this harmless skin condition if:

• You are fair-skinned
• You blush easily
• You are a woman (however, men with the condition are usually more severely affected)
• You are between the ages of 30 and 50

Rosacea involves swelling of the blood vessels just under the skin. It may be associated with other skin disorders (acne vulgaris, seborrhea) or eye disorders (blepharitis, keratitis).

Symptoms

• Redness of the face in discrete areas or covering the entire face
• A tendency to flush or blush easily
• Increased number of spider-like blood vessels (telangiectasia) of the face
• A red, bulbous nose
• Acne-like skin eruptions (may ooze or crust)
• A burning or stinging sensation of the face
• Irritated, bloodshot, watery eyes

Signs and tests

Your physician can usually diagnose rosacea with a thorough medical history and physical exam.

Treatment

There is no known cure for rosacea. The goal is to identify and avoid possible triggers, and thus reduce flare-ups. By keeping a symptom diary to identify the specific triggers you may have, you may be able to see a pattern of what makes your rosacea worse. Use this information to avoid future flare-ups.

Here are some steps that may help:

• Avoid sun exposure. Use sunscreen every day.
• Avoid prolonged exertion in hot weather.
• Try to reduce stress. Try deep breathing, yoga, or other relaxation techniques.
• Limit spicy foods, alcohol, and hot beverages.

Triggers vary from person to person. Other triggers may include wind, hot baths, cold weather, specific skin products, exercise, or other factors.

Antibiotics taken by mouth (such as tetracycline, minocycline, or doxycycline) or applied to the skin (such as metronidazole) may control skin eruptions. Other medications (isoretinol or Accutane), which are similar to vitamin A, are stronger alternatives that your doctor or dermatologist might consider. Rosacea is not acne and will not improve with over-the-counter acne treatment.

In severe cases, laser surgery may help reduce the redness. Surgical reduction of enlarged nose tissue may also improve your appearance, if you so choose.

Expectations (prognosis)

Rosacea is not medically dangerous. It is not curable, but can usually be controlled with treatment. It may be persistent and chronic.

Complications

• Permanent changes in appearance (for example, a bulbous nose)
• Psychological damage, loss of self esteem

References

Habif TP. Acne, rosacea, and related disorders. In: Habif TP, ed. Clinical Dermatology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 7.

Goldgar C, Keahey DJ, Houchins J. Treatment Options for Acne Rosacea. Am Fam Phys. 2009 Sep;80(5).

van Zuuren EJ, et al. Systematic review of rosacea treatments. J Am Acad Dermatol. 2007:56(1):107-115

Answer 2

Definition

Rosacea is a chronic skin condition that makes your face turn red and may cause swelling and skin sores that look like acne.

Alternative Names

Acne rosacea

Causes, incidence, and risk factors

Rosacea is a harmless condition, but it may cause you to be self-conscious or embarrassed. The cause is not known. You may be more likely to have this if you are

• Age 30-50
• Fair-skinned
• A woman (but men usually have more severe symptoms)

Rosacea involves swelling of the blood vessels just under the skin. It may be associated with other skin disorders (acne vulgaris, seborrhea) or eye disorders (blepharitis, keratitis).

Symptoms

• Redness of the face
• Blushing or flushing easily
• A lot of spider-like blood vessels (telangiectasia) of the face
• Red nose (called a bulbous nose)
• Acne-like skin sores that may ooze or crust
• Burning or stinging feeling in the face
• Irritated, bloodshot, watery eyes

Signs and tests

Your health care provider can usually diagnose rosacea by performing a physical exam and asking questions about your medical history.

Treatment

There is no known cure for rosacea.

Your doctor will help you identify the things that make your symptoms worse. These are called triggers. Avoiding your triggers may help you prevent or reduce flare-ups.

Here are some steps that may help ease or prevent symptoms:

• Avoid sun exposure. Use sunscreen every day.
• Avoid a lot of activity in hot weather.
• Try to reduce stress. Try deep breathing, yoga, or other relaxation techniques.
• Limit spicy foods, alcohol, and hot beverages.

Triggers vary from person to person. Other triggers may include wind, hot baths, cold weather, specific skin products, exercise, or other factors.

• Antibiotics taken by mouth (such as tetracycline, minocycline, or doxycycline) or applied to the skin (such as metronidazole) may control acne-like skin problems.
• Other medications (isoretinol or Accutane), which are similar to vitamin A, are stronger alternatives that your doctor or dermatologist might consider.
• Rosacea is not acne and will not improve with over-the-counter acne treatment.

In severe cases, laser surgery may help reduce the redness. Surgery to remove some swollen nose tissue may also improve your appearance.

Expectations (prognosis)

Rosacea is a harmless condition, but it may cause you to be self-conscious or embarrassed. It may be a long-term (chronic) problem. It cannot be cured, but may be controlled with treatment.

Complications

• Permanent changes in appearance (for example, a red, swollen nose)
• Loss of self-esteem

References

Habif TP. Acne, rosacea, and related disorders. In: Habif TP, ed. Clinical Dermatology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 7.

Goldgar C, Keahey DJ, Houchins J. Treatment Options for Acne Rosacea. Am Fam Phys. 2009 Sep;80(5).

Webster GF. Rosacea. Med Clin North Am. 2009 Nov;93(6):1183-94.

Reviewed By

Review Date: 10/22/2011

Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.