Rosacea

Rosacea is a common and chronic condition affecting roughly 1 in 10 Britons, according to NHS data. The cause of rosacea is still unknown, and there is no cure, however with medical help, it can be managed.

Overview

While rosacea predominantly affects the face, there are different types of the skin condition, but it most commonly occurs in fair-skinned individuals from the age of 30 onwards, and women are more often affected than men.

There are four subtypes of rosacea, each with its own set of symptoms. It is possible for a person to have more than one type of rosacea, presenting either at different times during their life, or at any one time. 

Typically, rosacea presents as flare-ups of small, red, pus-filled bumps on the skin of the nose, cheeks, and forehead. These flare-ups often occur in cycles, meaning symptoms appear for weeks or months at a time before abating, and can recur.

As a result of the chronic, uncomfortable and sometimes unpredictable nature of the condition, many patients find that it negatively impacts their quality of life and self-confidence. For these reasons, it is common for patients suffering with rosacea – especially in its more severe forms - to also experience psychological issues, such as depression and anxiety.

For many individuals, living with rosacea can be upsetting and traumatic, so it may be helpful to seek support from groups or organisations that can provide additional resources, such as the National Rosacea Society. There are also communities on social media, and both male and female celebrities with rosacea now share their stories to help support others with the condition.



While rosacea cannot be cured, with medical help, the condition is manageable, and there are some techniques that patients may find helpful in identifying triggers and reducing their flare-ups.



Symptoms of Rosacea

The first signs of erythematotelangiectatic rosacea can include redness that may also be described as ‘blushing.’  

The blushing usually appears to come and go across the nose, or appear on cheeks, forehead or chin – thus without medical help, people may mistake the medical condition for the normal usual flushing of the face when overheated or embarrassed.

This redness may be accompanied by a burning or stinging feeling when using water or skincare products to cleanse the skin, and it may be harder to see on darker skin tones.

The four types of rosacea are: 

This presentation of the condition, which is also abbreviated as ETR, is associated with facial redness, flushing, and visible blood vessels. This type is what most people commonly think of as rosacea.
The condition, which is also known as acne rosacea, is associated with acne-like breakouts, and often affects middle-aged women.
This rare form of rosacea associated with thickening of the skin of the nose. Typically affecting men, rhinophyma is often accompanied by another subtype of rosacea.
This type occurs when rosacea symptoms are focused in the eye area. The inflammation of the eyes is called blepharitis.

As rosacea worsens, either all or some of these areas may become, or stay red all the time, and tiny broken blood vessels may appear on the skin and not resolve. Either or both of these symptoms may be accompanied by small pink or red bumps, which can sometimes become filled with a yellowish or whitish liquid, known as pus.

Other symptoms of rosacea can include:

  • Dryness of the skin
  • Swelling, especially around the eyes, or sensitive eyes
  • Discoloured yellow or orange ‘patches’ on the skin
  • Soreness in the eyelids, or ‘crust’ around the roots of eyelashes
  • Thickened skin, which typically appears on the nose after many years of living with the condition

Causes of Rosacea

There are certain factors that will make an individual more likely to develop rosacea. Another way of saying this is that there are predispositions to having the condition.

Rosacea often develops in people 30-50, and tends to be more common in people who are fair-skinned and have blond hair and blue eyes. 

The condition is seen as likely to be influenced by genetics, so it is possible that if an individual’s parents have experienced problems with rosacea, they may be more likely to have the same trouble – particularly if they have Celtic or Scandinavian ancestry.  

Women are more likely to develop rosacea than men, however, men who develop the condition often display more severe rosacea symptoms.

While it's not known what causes rosacea, research has indicated some triggers can make symptoms worse.

By avoiding known triggers and documenting the suspected causes of flare-ups, patients can hope to manage the condition more comfortably in the longer term, with the assistance of their doctor. Taking notes may also be helpful for patients to anticipate seasonal changes, as well as actions they can take to reduce the likelihood, or severity of a flare-up.

Common factors that may trigger or worsen rosacea include:

Whether a perfumed skin moisturiser, a cologne, or an additive in washing powder, synthetic fragrance is known to irritate the skin, and may contain chemicals that can be allergens. It is important to check that any skin product is suitable for people with rosacea, as some cosmetics are broadly marketed ‘for sensitive skins,’ however will still contain ingredients that will trigger or aggravate the condition. You may find it helpful to ask your GP or chemist for help in finding appropriate product to cleanse or soothe the skin; or alternately you may find help from others with the condition in specialised rosacea awareness groups. Alcohol, menthol, witch hazel and exfoliating agents have been known to worsen rosacea, so it’s best to avoid any products with these ingredients.
Fungal infections may trigger this type of psoriasis.
Aerobic exercise may cause the face to become flushed, which may trigger a flare-up of rosacea.
Wind, cold and sun exposure as well as indoor heat and low humidity are common triggers for flare-ups.
Some people find that eating spice can cause them feel itchy, and it can bring on other conditions, including rosacea flare-ups.
Some people find that eating cheese can trigger skin reactions and rosacea, but foods containing cinnamaldehyde (cinnamon, chocolate, tomatoes, and citrus) may also contribute to flare-ups.
As with certain foods, some people find that certain types of drinks, as well as their temperatures, can trigger rosacea.
Having the intestinal bacteria Helicobacter pylori, or being bitten by a skin mite called demodex that carries the bacteria bacillus oleronius can cause rosacea to flare up.

 

If foods are triggering rosacea, it may be helpful to keep a food diary to log reactions and track the presence of colouring agents or preservatives. This may limit individuals’ flare-ups to specific foods, and be helpful to show doctors.

Treatment of Rosacea at Derma

Your appointment will begin with a skin check and medical history, followed by recommended treatment options.

Together with the dermatologist, you will discuss how to care for your skin, the latest and most effective treatments, and explain all potential side-effects, enabling you to select the best options.

Mild to moderate forms of rosacea may be controlled using topical treatments available from chemists, but depending on your condition, prescription creams may be necessary. The dermatologist will let you know whether it is beneficial to continue with any over-the-counter treatment, or if it is advisable to stop.

Additionally, Derma may be able to offer treatments with tablets, which may be prescribed longer-term, or may only be needed seasonally during periods where the condition is more prone to flare-ups, such as during the dry, cold winter months.


If you have persistent or severe rosacea, you might be a candidate for treatment with isotretinoin (commonly known by its trade name, Roaccutane.) The side effects of isotretinoin can be serious, so close management is required during the treatment. If you are suitable for treatment with isotretinoin, and it is the right option for you, please note that further tests and follow-up appointments will be required to manage the treatment.

Depending on the treatment and the severity of your condition, further tests and follow-up appointments may be required to manage your treatment.

Each case of rosacea is different, but whatever your needs, you can rest assured that Derma will provide the very best care for your skin, with access to the latest research and treatments.

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