Rosacea

Rosacea

Rosacea Treatment and Sensitive Skin Care

What is rosacea? 

Rosacea (say "roh-ZAY-shuh") is a very common skin disease that affects people over the age of 30. It causes redness on your nose, cheeks, chin, and forehead. Some people get little bumps and pimples on the red parts of their faces. Rosacea can also cause burning and soreness in your eyes. Some people say that having rosacea keeps them from feeling confident at work or in social situations. If your rosacea bothers you or has gotten worse, talk to your doctor. Getting treatment can help your skin look and feel better. And it may keep your rosacea from getting worse. What causes rosacea? Experts are not sure what causes rosacea. They know that something irritates the skin, but rosacea doesn't seem to be an infection caused by bacteria. It tends to affect people who have fair skin or blush easily, and it seems to run in families. The pattern of redness on a person's face makes it easy for a doctor to diagnose rosacea. And most of the time medical tests are not needed or used. Rosacea is not caused by alcohol abuse, as people thought in the past. But in people who have rosacea, drinking alcohol may cause symptoms to get worse (flare). Rosacea often flares when something causes the blood vessels in the face to expand, which causes redness. Things that cause a flare-up are called triggers. Common triggers are exercise, sun and wind exposure, hot weather, stress, spicy foods, alcohol, and hot baths. Swings in temperature from hot to cold or cold to hot can also cause a flare-up of rosacea. What are the symptoms? People with rosacea may have: A flushed, red face with sensitive, dry skin that may burn or sting. Small bumps and pimples or acne-like breakouts. Skin that gets coarser and thicker, with a bumpy texture. Dry, red, irritated eyes. In rare cases, rosacea that is not treated may cause permanent effects, such as thickening of the skin on your face or loss of vision. It may cause knobby bumps on the nose, called rhinophyma (say "ry-no-FY-muh"). Over time, it can give the nose a swollen, waxy look. But most cases of rosacea don't progress this far.

Rosacea Treatment and Sensitive Skin Care

Rosacea. DermNet NZ
What Is Rosacea? Who Has Rosacea Rosacea (pronounced roh-ZAY-sha) is a common but poorly understood disorder of the facial skin that is estimated to affect well over 16 million Americans -- and most of them don't know it. In fact, while rosacea is becoming increasingly widespread as the populous baby boom generation enters the most susceptible ages, a National Rosacea Society survey found that 95 percent of rosacea patients had known little or nothing about its signs and symptoms prior to their diagnosis. Rosacea cannot be cured, but it can be controlled. Click here to learn more about this conspicuous condition. Because of its red-faced, acne-like effects on personal appearance, however, it can cause significant psychological, social and occupational problems if left untreated. Emotional effects In other surveys by the NRS, more than 90 percent of rosacea patients said their condition had lowered their self-confidence and self-esteem, and 41 percent reported that it had caused them to avoid public contact or cancel social engagements. Among rosacea patients with severe symptoms, 88 percent said the disorder had adversely affected their professional interactions, and 51 percent said they had even missed work because of their condition. Symptoms & Treatments While the cause of rosacea is unknown and there is no cure, today medical help is available that can control the signs and symptoms of this potentially life-disruptive disorder. Any one of the following warning signs is a signal to see a dermatologist or other knowledgeable physician for diagnosis and appropriate treatment before the signs and symptoms become increasingly severe: Redness on the cheeks, nose, chin or forehead. Small visible blood vessels on the face. Bumps or pimples on the face. Watery or irritated eyes. To learn more about rosacea, what it looks like and how to control it, click here. Information is also available for health professionals, medical researchers and the media. Follow us on Facebook arrow
What Is Rosacea? Who Has Rosacea Rosacea (pronounced roh-ZAY-sha) is a common but poorly understood disorder of the facial skin that is estimated to affect well over 16 million Americans -- and most of them don't know it. In fact, while rosacea is becoming increasingly widespread as the populous baby boom generation enters the most susceptible ages, a National Rosacea Society survey found that 95 percent of rosacea patients had known little or nothing about its signs and symptoms prior to their diagnosis. Rosacea cannot be cured, but it can be controlled. Click here to learn more about this conspicuous condition. Because of its red-faced, acne-like effects on personal appearance, however, it can cause significant psychological, social and occupational problems if left untreated. Emotional effects In other surveys by the NRS, more than 90 percent of rosacea patients said their condition had lowered their self-confidence and self-esteem, and 41 percent reported that it had caused them to avoid public contact or cancel social engagements. Among rosacea patients with severe symptoms, 88 percent said the disorder had adversely affected their professional interactions, and 51 percent said they had even missed work because of their condition. Symptoms & Treatments While the cause of rosacea is unknown and there is no cure, today medical help is available that can control the signs and symptoms of this potentially life-disruptive disorder. Any one of the following warning signs is a signal to see a dermatologist or other knowledgeable physician for diagnosis and appropriate treatment before the signs and symptoms become increasingly severe: Redness on the cheeks, nose, chin or forehead. Small visible blood vessels on the face. Bumps or pimples on the face. Watery or irritated eyes. To learn more about rosacea, what it looks like and how to control it, click here. Information is also available for health professionals, medical researchers and the media.
Pariser Dermatology
Rosacea. DermNet NZ
It Works for Me Tips from patients on lifestyle management. Read more about It Works for Me Join Us Join the Fight Against Rosacea The National Rosacea Society (NRS) is the world's largest organization dedicated to improving the lives of the untold millions who suffer from this widespread but poorly understood disorder. Through education and advocacy, our mission is threefold: Read more about Join Us Visit the new Causes of Rosacea section From Demodex to the innate immune system, learn about research into the potential causes of this chronic disease. Newly diagnosed? Learn more about this widespread disorder. Rosacea research Read the latest results of NRS-funded research into the potential causes and other key aspects of rosacea. Take our survey! Your opinion counts! Help us learn more about rosacea and product ingredients. ● ● ● ●
Rosacea is considered a chronic (long term), incurable skin condition with periodic ups and downs. As opposed to traditional or teenage acne, most adult patients do not "outgrow" rosacea. Rosacea characteristically involves the central region of the face, mainly the forehead, cheeks, chin, and the lower half of the nose. It is most commonly seen in people with light skin and particularly in those of English, Irish, and Scottish backgrounds. Some famous people with rosacea include the former U.S. President Bill Clinton and W.C. Fields. Rosacea is not directly caused by alcohol intake, but it is presumed to aggravated by it. Rosacea is not considered contagious or infectious.
Pariser Dermatology
Rosacea is a long-term disease that affects your skin and sometimes your eyes. It causes redness and pimples. Rosacea is most common in women and people with fair skin. It most often affects middle-aged and older adults. In most cases, rosacea only affects the face. Symptoms can include Frequent redness of the face, or flushing Small, red lines under the skin Acne A swollen nose Thick skin, usually on the forehead, chin, and cheeks Red, dry, itchy eyes and sometimes vision problems No one knows what causes rosacea. You may be more likely to have it if you blush a lot or if rosacea runs in your family. Rosacea is not dangerous. There is no cure, but treatments can help. They include medicines and sometimes surgery. NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases
Studies of rosacea and Demodex mites have revealed that some people with rosacea have increased numbers of the mite, especially those with steroid-induced rosacea. When large numbers are present, they may play a role along with other triggers. On other occasions, demodicidosis (mange) is a separate condition that may have "rosacea-like" appearances. Demodex mites have also been implicated in rosacea in that it may be caused by a reaction to bacteria in the mite's feces.
Rosacea (ro-zay-sha) is a common, acne-like, benign skin condition of adults, with a worldwide distribution. Rosacea is estimated to affect at least 16 million people in the United States alone and approximately 45 million worldwide. Most people with rosacea are Caucasian and have fair skin. The main symptoms of rosacea include red or pink facial skin, small dilated blood vessels, small red bumps sometimes containing pus, cysts, and pink or irritated eyes. Many people who have rosacea may just assume they have very sensitive skin that blushes or flushes easily.
Small intestinal bacterial overgrowth (SIBO) was demonstrated to have greater prevalence in rosacea patients and its eradication led to skin lesion improvement in two studies, and in rosacea patients who were SIBO negative, the antibiotic therapy had no effect on the skin lesions. The effectiveness of SIBO eradication in rosacea may suggest that these bacteria play a role in the pathogenesis of rosacea lesions.
Medications and topical irritants have also been known to trigger rosacea flares. Some acne and wrinkle treatments reported to cause rosacea include microdermabrasion and chemical peels, as well as high dosages of isotretinoin, benzoyl peroxide, and tretinoin. Steroid-induced rosacea is caused by the use of topical or nasal steroids. These steroids are often prescribed for seborrheic dermatitis. Dosage should be slowly decreased and not immediately stopped to avoid a flare-up.
Our Mission The National Rosacea Society is a 501(c) nonprofit organization whose mission is to improve the lives of people with rosacea by raising awareness, providing public health information and supporting medical research on this widespread but little-known disorder. The information the Society provides should not be considered medical advice, nor is it intended to replace consultation with a qualified physician. The Society does not evaluate, endorse or recommend any particular medications, products, equipment or treatments. Rosacea may vary substantially from one patient to another, and treatment must be tailored by a physician for each individual case. 

The National Rosacea Society is a 501(c) nonprofit organization whose mission is to improve the lives of people with rosacea by raising awareness, providing public health information and supporting medical research on this widespread but little-known disorder. The information the Society provides should not be considered medical advice, nor is it intended to replace consultation with a qualified physician. The Society does not evaluate, endorse or recommend any particular medications, products, equipment or treatments. Rosacea may vary substantially from one patient to another, and treatment must be tailored by a physician for each individual case. 
Left untreated, rosacea tends to worsen over time. Rosacea signs and symptoms may flare up for a period of weeks to months and then diminish before flaring up again. Rosacea can be mistaken for acne, an allergic reaction or other skin problems.
The redness in rosacea, often aggravated by flushing, may cause small blood vessels in the face to enlarge (dilate) permanently and become more visible through the skin, appearing like tiny red lines (called telangiectasias). Continual or repeated episodes of flushing and blushing may promote inflammation, causing small red bumps that often resemble teenage acne. Rosacea is also referred to as acne rosacea.
Photodynamic Therapy & Rosacea In dermatology, PDT with the photosensitizer Levulan Kerastick (20% delta-aminolevulinic acid HCl) is used for the treatment of very early, thin skin cancers called actinic keratoses (AK). The initial approval was specifically for the treatment of actinic keratosis of the face and scalp with a combination of an application of the photosensitizer followed by a timed exposure to a special blue light source. PDT is also used for acne, rosacea, skin cancer, sun damage, cosmetic skin improvement, oily skin, enlarged sebaceous glands, wrinkles, rejuvenation (anti-aging), warts, hidradenitis suppurativa, psoriasis, and many other skin conditions. Read more about photodynamic therapy for rosacea »
Rosacea results in red spots (papules) and sometimes pustules. They are dome-shaped rather than pointed and unlike acne, there are no blackheads, whiteheads or nodules. Rosacea may also result in red areas, scaling (rosacea dermatitis) and swelling.
Rosacea /roʊˈzeɪʃiə/ is a chronic skin condition characterized by facial redness, small and superficial dilated blood vessels on facial skin, papules, pustules, and swelling. Rosacea affects all ages and has four subtypes, three affecting the skin and the fourth affecting the eyes (ocular type). Left untreated, it worsens over time. Treatment in the form of topical steroids can aggravate the condition.
Therapy for the treatment of rosacea is not curative, and is best measured in terms of reduction in the amount of facial redness and inflammatory lesions, decrease in the number, duration, and intensity of flares, and concomitant symptoms of itching, burning, and tenderness. The two primary modalities of rosacea treatment are topical and oral antibiotic agents. Laser therapy has also been classified as a form of treatment. While medications often produce a temporary remission of redness within a few weeks, the redness typically returns shortly after treatment is suspended. Long-term treatment, usually one to two years, may result in permanent control of the condition for some patients. Lifelong treatment is often necessary, although some cases resolve after a while and go into a permanent remission.
Because sunlight is a common trigger, avoiding excessive exposure to sun is widely recommended. Some people with rosacea benefit from daily use of a sunscreen; others opt for wearing hats with broad brims. Like sunlight, emotional stress can also trigger rosacea. People who develop infections of the eyelids must practice frequent eyelid hygiene.
Using alpha-hydroxy acid peels may help relieve redness caused by irritation, and reduce papules and pustules associated with rosacea. Oral antibiotics may help to relieve symptoms of ocular rosacea. If papules and pustules persist, then sometimes isotretinoin can be prescribed.
In other surveys by the NRS, more than 90 percent of rosacea patients said their condition had lowered their self-confidence and self-esteem, and 41 percent reported that it had caused them to avoid public contact or cancel social engagements. Among rosacea patients with severe symptoms, 88 percent said the disorder had adversely affected their professional interactions, and 51 percent said they had even missed work because of their condition.
Rosacea (roe-ZAY-she-uh) is a common skin condition that causes redness in your face and often produces small, red, pus-filled bumps. Although rosacea can occur in anyone, it most commonly affects middle-aged women who have fair skin.
Experts are not sure what causes rosacea. They know that something irritates the skin, but rosacea doesn't seem to be an infection caused by bacteria. It tends to affect people who have fair skin or blush easily, and it seems to run in families.
Rosacea is not caused by alcohol abuse, as people thought in the past. But in people who have rosacea, drinking alcohol may cause symptoms to get worse (flare).
Rosacea often flares when something causes the blood vessels in the face to expand, which causes redness. Things that cause a flare-up are called triggers. Common triggers are exercise, sun and wind exposure, hot weather, stress, spicy foods, alcohol, and hot baths. Swings in temperature from hot to cold or cold to hot can also cause a flare-up of rosacea.
In rare cases, rosacea that is not treated may cause permanent effects, such as thickening of the skin on your face or loss of vision. It may cause knobby bumps on the nose, called rhinophyma (say "ry-no-FY-muh"). Over time, it can give the nose a swollen, waxy look. But most cases of rosacea don't progress this far.
Matrix metalloproteinases (MMPs) such as collagenase and elastase also appear important in rosacea. These enzymes remodel normal tissue and help in wound healing and production of blood vessels (angiogenesis). But in rosacea, they are in high concentration and may contribute to cutaneous inflammation and thickened, hardened skin. MMPs may also activate cathelicidins contributing to inflammation.
Tetracycline antibiotics including doxycycline and minocycline reduce inflammation. They reduce the redness, papules, pustules and eye symptoms of rosacea. The antibiotics are usually prescribed for 6 to 12 weeks, with the duration and dose depending on the severity of the rosacea. Further courses are often needed from time to time, as the antibiotics don't cure the disorder.
It primarily affects people of northwestern European descent and has been nicknamed the "curse of the Celts" by some in Britain and Ireland, although recently this has been questioned. Rosacea affects both sexes, but is almost three times more common in women. It is commonly found in people between the ages of 30 and 50, and is more common in Caucasians.
Rosacea typically begins as redness on the central face across the cheeks, nose, or forehead, but can also less commonly affect the neck, chest, ears, and scalp. In some cases, additional signs, such as semipermanent redness, dilation of superficial blood vessels on the face, red domed papules (small bumps) and pustules, red gritty eyes, burning and stinging sensations, and in some advanced cases, a red lobulated nose (rhinophyma), may develop.
The exact cause of rosacea is unknown. Triggers that cause episodes of flushing and blushing play a part in its development. Exposure to temperature extremes, strenuous exercise, heat from sunlight, severe sunburn, stress, anxiety, cold wind, and moving to a warm or hot environment from a cold one, such as heated shops and offices during the winter, can each cause the face to become flushed. Certain foods and drinks can also trigger flushing, such as alcohol, foods and beverages containing caffeine (especially hot tea and coffee), foods high in histamines, and spicy foods.
The disorder can be confused with, and co-exist with, acne vulgaris and/or seborrheic dermatitis. The presence of rash on the scalp or ears suggests a different or co-existing diagnosis as rosacea is primarily a facial diagnosis, although it may occasionally appear in these other areas.
Dermatological vascular laser (single wavelength) or intense pulsed light (broad spectrum) machines offer one of the best treatments for rosacea, in particular the erythema (redness) of the skin. They use light to penetrate the epidermis to target the capillaries in the dermis layer of the skin. The light is absorbed by oxyhemoglobin, which heats up, causing the capillary walls to heat up to 70°C (158°F), damaging them, and causing them to be absorbed by the body's natural defense mechanism. With a sufficient number of treatments, this method may even eliminate the redness altogether, though additional periodic treatments will likely be necessary to remove newly formed capillaries.
consultation with a qualified physician. The Society does not evaluate, endorse or recommend any particular medications, products, equipment or treatments. Rosacea may vary substantially from one patient to another, and treatment must be tailored by a physician for each individual case. 

While there's no cure for rosacea, treatments can control and reduce the signs and symptoms. If you experience persistent redness of your face, see your doctor for a diagnosis and proper treatment.
In dermatology, PDT with the photosensitizer Levulan Kerastick (20% delta-aminolevulinic acid HCl) is used for the treatment of very early, thin skin cancers called actinic keratoses (AK). The initial approval was specifically for the treatment of actinic keratosis of the face and scalp with a combination of an application of the photosensitizer followed by a timed exposure to a special blue light source. PDT is also used for acne, rosacea, skin cancer, sun damage, cosmetic skin improvement, oily skin, enlarged sebaceous glands, wrinkles, rejuvenation (anti-aging), warts, hidradenitis suppurativa, psoriasis, and many other skin conditions.

In most cases, no investigations are required and the diagnosis of rosacea is made clinically. Occasionally a skin biopsy is performed, which shows chronic inflammation and vascular changes.
When antibiotics are ineffective or poorly tolerated, oral isotretinoin may be very effective. Although isotretinoin is often curative for acne, it may be needed in low dose long-term for rosacea, sometimes for years. It has important side effects and is not suitable for everyone.