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Rosacea is a common, long-term inflammatory skin condition of the face that mainly affects the face, causing redness, small pimples, skin irritation (burning or stinging), dry skin, swelling and visible blood vessels. Unlike acne which can affect the back, rosacea is usually concentrated on the inner area of the face, causing redness on the nose, chin, cheeks, and forehead. The redness may come and go, though in some cases it may be present all the time.
It is a long-term condition that can fluctuate in severity over time. Unfortunately, it cannot be cured but treatment can improve the symptoms.
Anyone can be affected by the condition but it more commonly affects people with fair skin and most often begins between the ages of 30 and 60. It is more common in women but if men are affected their symptoms are often more severe.
No specific test is used to diagnose rosacea. Instead, the clinician relies on the history of your symptoms and an examination of your skin. You may have tests to rule out other conditions, such as psoriasis or lupus.
Treatment for rosacea focuses on controlling signs and symptoms. Most often this requires a combination of good skin care and topical creams. The duration of your treatment depends on the type and severity of your signs and symptoms.
There are many signs and symptoms that could show you have rosacea, from main or primary symptoms to other potential signs and symptoms.
Signs and symptoms of Rosacea include:
People with the condition may feel embarrassed, have low self-esteem, anxiety and/or depression.
The cause of rosacea is unknown, but it could be due to an overactive immune system, heredity, environmental factors or a combination of these. Rosacea is not caused by poor hygiene and it's not contagious. Below we have listed several factors that may contribute to the condition.
Changes in blood vessels - When blood vessels near the surface of the skin are dilated, redness and flushing occur. This may be caused by changes that lead to increased blood flow and dilation of the blood vessels and an increased number of these blood vessels in the surface of the skin.
Microbes - Demodex folliculorum are mites that naturally live on the face. Research shows that there is an increase of these mites in rosacea sufferers. There is conflicting evidence currently but some evidence points to this excess of mites triggering an immune response from the body, leading to inflammation linked to rosacea.
Skin peptides - Our skin contains antimicrobial peptides that form part of the immune response of the body against viruses, bacteria and fungi. One of these peptides is cathelicidin which has been found to be present in abnormally high levels in rosacea patients. Cathelicidins increase dilation of blood vessels, increase inflammation and may cause bumps and pimples in the skin.
Flare-ups of rosacea might be triggered by:
Anyone can develop rosacea. But you may be more likely to develop it if you:
At Pharmacinta, we provide two topical treatments used to manage symptoms of rosacea. They include Metronidazole gel and Azelaic acid gel. The topical formulation helps to reduce the redness caused by rosacea by constricting the blood vessels. This also helps to soothe any discomfort like skin irritation.
Metronidazole gel helps to control inflammation and infection in the skin with results usually noticeable within 4 weeks of use. This medication is effective in mild to moderate cases. In clinical trials, the use of topical metronidazole to control the symptoms of rosacea has been very effective.
Azelaic acid products are particularly effective at treating rosacea. The anti-inflammatory properties of the acid treat visible rosacea symptoms such as redness, swelling and rashes. Azelaic acid also prevents spots and bumps by killing skin bacteria and keeping pores unblocked. Over time it will smoothen skin and reduce redness, flushing and the appearance of obvious blood vessels.
Dermalex
Dermalex is the most common non-prescription cream available for the management of rosacea. It helps to relieve flare-ups of rosacea, along with helping to make the skin stronger and soothe inflammation. There are no steroids or antibiotics in this cream.
Soolantra
Soolantra should only be used if you have rosacea related spots/inflammatory lesions.It is an active anti-inflammatory that contains ivermectin. This cream has anti-inflammatory ingredients which can help reduce rosacea acne-related symptoms.
Mirvaso gel
Mirvaso works to reduce the redness of rosacea temporarily. It contains Brimonidine, which works to shrink the blood vessels and reduce any swelling or redness, but in some users, can make the redness worse. Therefore, you should start with a small amount in one area of the face first, to check you will not react.
Oral Antibiotics
In severe cases of rosacea, you may be prescribed an antibiotic tablet or capsule, which you swallow with water. Antibiotics such as Oxytetracycline or Tetracycline can be used for periods of 6-12 weeks at a time.
Laser Therapy
Lasers have made a significant impact on the treatment of rosacea with a very low risk of damaging the skin. The pulse dye laser is usually used for rosacea treatment. The laser delivers a pulse of yellow light to the blood vessels causing them to seal up and fade away. Laser or light therapy can be effective but you need referral to a dermatologist for specialist care.
There are a number of conditions that have similar symptoms and patterns to rosacea such as acne, some types of dermatitis, lupus and keratosis pilaris.
Rosacea can affect the nose and cause rhinophyma, but this is uncommon. It usually only develops in rosacea which has been active and left untreated for many years and because of this it may be more common when patients are middle-aged.
Rosacea is not related to poor hygiene.
Patients should use a mild soap or non-soap cleansers. Use your fingertips to apply the cleanser, avoid using rough cloths or sponges. Wash the cleanser away with lukewarm water (hot or cold water may cause flushing) and pat your face dry with a towel. Avoid rubbing the skin with a towel because this may cause irritation.
Many rosacea sufferers will also have dry skin. Moisturising affected areas can help with any dryness, stinging and irritation. Patients may find creams designed for sensitive skin are gentler and cause less irritation. These can be used together with topical medication but make sure to leave at least 30 minutes between different creams or ointments.
Rosacea is not considered an infectious disease, and there is no evidence that it can be spread by contact with the skin or through inhaling airborne bacteria.
Although no scientific research has been performed on rosacea and heredity, there is evidence that suggests rosacea may be inherited. More than half of rosacea patients surveyed by the National Rosacea Society said they had at least one family member who had similar symptoms. In addition, although people of any race may have rosacea, there are strong signs that ethnicity is a factor in one's potential to develop rosacea.
It is sometimes possible to identify "prerosacea" in teenagers and persons in their early 20s. These individuals generally come to the dermatologist for acne treatment and exhibit flushing and blushing episodes that last longer than normal. The prolonged redness usually appears over the cheeks, chin, nose or forehead. Once identified, these rosacea-prone individuals can be counseled to avoid aggravating lifestyle and environmental factors known to cause repeated flushing reactions that may lead to full-blown rosacea.
There are no histological, serological or other diagnostic tests for rosacea. A diagnosis of rosacea must come from your physician after a thorough examination of your signs and symptoms and a medical history.
There is no way to predict for certain how an individual's rosacea will progress, although physicians have observed that the signs and symptoms tend to become increasingly severe without treatment.
Rosacea is a chronic disorder, rather than a short-term condition, and is often characterized by relapses and remissions. While at present there is no cure for rosacea, its symptoms can usually be controlled with medical therapy and lifestyle modifications. Moreover, studies have shown that rosacea patients who continue therapy for the long term are less likely to experience a recurrence of symptoms.
Rosacea can present itself in different ways for different individuals. Rosacea patients may exhibit varying levels of severity of symptoms over different areas of the face. Patients have often reported that the disorder actually began with a red spot or patch on one cheek or another part of the face, and then spread to other areas. On the other hand, many rosacea patients exhibit similar symptoms on both sides of their faces.
Rosacea and regular acne, usually appear separately, but some patients are affected by both. While both conditions in adults are often informally referred to as "adult acne," they are two separate diseases, each requiring different therapy.
It has been estimated that approximately half of all rosacea sufferers may appear to experience dry skin. With treatment, this dryness often eases along with disappearance of papules and pustules. To combat dry, flaky skin, use a moisturizer daily after cleansing and applying medication.
There is no standard skin type for rosacea patients. Many sufferers experience dry, flaky skin, while others may have normal or oily skin, or both. The key is to identify your skin type and use medication and skin-care products that are suitable for you.
It is not unusual for seborrheic dermatitis to appear concurrently with rosacea.
No, nothing in the medical literature links rosacea and atopic dermatitis, or eczema. The two diseases may share some symptoms, but also have many differences.
No medical evidence has linked rosacea directly with skin cancer. Rosacea sufferers may be more likely to develop skin cancer later in life because of their frequent light complexions and propensity to injury from ultra-violet radiation from the sun. It is important that you consult your dermatologist if you have any signs of possible skin cancer, such as a mole that is enlarged or asymmetric or that has an irregular border or varying color.
Although it is not a common feature of rosacea, symptoms have been reported to appear beyond the face.
The hot flashes sometimes associated with menopause may bring on a flare-up or even the initial onset of rosacea.
Yes. Known as ocular rosacea, eye symptoms may include a watery or bloodshot appearance and a dry, gritty feeling with burning, itching and/or stinging. Individuals with rosacea may be prone to styes, and light sensitivity and blurred vision may also be present. Left untreated, decreased visual acuity due to corneal involvement may occur.
some of the most common rosacea triggers include sun exposure, emotional stress, hot or cold weather, wind, alcohol, spicy foods, heavy exercise, hot baths, heated beverages and certain skin-care products.
Although there are no data available on how quickly a rosacea trigger may lead to a flare-up, the time is likely to vary depending on the individual and the nature of the trigger. Try monitoring your individual case to see how quickly your rosacea has responded.
Allergies may cause an altered reaction of the body that includes flushing, which frequently triggers rosacea symptoms. As with more common rosacea triggers, identifying and avoiding allergens — the substances you are reacting to — may also help control your rosacea.
Any activity such as exercise that causes flushing or overheats the face has the potential to spark a rosacea flare-up. Ways to help reduce the incidence of flare-ups include working out in the early morning or late evening when weather is cooler; working out more frequently but for shorter intervals; keeping cool indoors by running a fan or opening a window; and cooling off by keeping a damp towel on your neck, drinking cold fluids or chewing on ice chips.
The signs and symptoms of rosacea vary substantially from one patient to another, and treatment must therefore be tailored by a physician for each individual case. Some patients are troubled by redness and flushing, while others have bumps and pimples, thickening of the skin, or eye rosacea or combinations. For patients with bumps and pimples, doctors often prescribe oral and topical rosacea therapy, and a topical therapy to reduce facial redness is now available.
It is unknown exactly why antibiotics work against rosacea, but it is widely believed that it is due to their anti-inflammatory properties, rather than their bacteria-fighting capabilities.
Topical antibiotics result in such minimal levels of medication in the bloodstream, if any, that there is virtually no risk of developing bacterial resistance at sites other than where the topical antibiotic is being applied.
Topical therapy usually controls rosacea on a long-term basis, without loss of effectiveness.
While effective in treating certain skin conditions, long-term use of topical steroids may prompt rosacea-like symptoms informally called "steroid-induced rosacea." While some physicians may prescribe a short course of a steroid to immediately reduce severe inflammation, if you are concerned about a medication you are taking, your best bet is to discuss this with your physician.