What Is Rosacea?
Rosacea is an inflammatory, chronic, or fluctuating skin disease affecting the facial area. Symptoms are usually most prominent in the central parts of the face, such as the cheeks, nose, chin, and forehead. In addition to redness, flushing, and dilated blood vessels, rosacea may also involve acne-like bumps. Sometimes it can also cause thickening of the skin. Rosacea usually only develops in adulthood and is more common in fair-skinned people. There is also a hereditary predisposition to rosacea.
How Does Rosacea Present?
Facial redness: The superficial blood vessels in the facial skin dilate. This causes redness of the skin and sometimes also flushing. The blood vessels may also grow and dilate permanently, remaining visible on the surface of the skin as telangiectasias, especially around the nose and cheeks. This can cause social discomfort and stigma.
Bumps and pimples: Red and inflamed bumps resembling acne may appear especially in the central facial area. Unlike acne, rosacea does not usually involve blackheads.
Burning and stinging: The skin may feel hot, itchy, stinging, or sore, and it may react sensitively to various external factors, such as sunlight, cold or hot air, and strong skincare products. Skin affected by rosacea is sensitive.
Thickening of the skin: In some cases, as the disease progresses, the skin may thicken and become rougher, especially around the nose. This is known as rhinophyma, and it is clearly more common in older men. However, only a small proportion of rosacea patients suffer from rhinophyma.
Eye symptoms: Rosacea can also affect the eyes, causing redness, dryness, stinging, or inflammation of the eyes, known as ocular rosacea. Eye symptoms may occur before other rosacea symptoms, alongside them, or on their own without skin symptoms.
Can Rosacea Be Prevented?
Preventing rosacea focuses on managing symptoms and preventing flare-ups, as there is no complete cure. Many people with rosacea have certain triggers that can worsen symptoms. Identifying and avoiding these factors is an important part of preventing rosacea. Here are effective ways to prevent rosacea and manage its symptoms:
Skincare: Gentle skin cleansing and moisturizing are important. Avoid products that irritate the skin, such as alcohol-based toners and exfoliating products.
Sun protection: The sun’s UV radiation often worsens rosacea, so daily sun protection is essential. A good sun protection factor is at least SPF 30. It is advisable to start sun protection already when there is snow on the ground in spring.
Diet: Certain foods and drinks, such as spicy foods, hot drinks, caffeine, and alcohol, may sometimes worsen symptoms. Monitor which foods affect your skin and avoid them if needed.
Sauna: Skin affected by rosacea often reacts more strongly than usual to temperature changes, which is why sauna worsens symptoms for many people with rosacea. If sauna worsens your symptoms, avoid it or at least keep sauna use moderate.
How Can Rosacea Be Treated?
The aim of treatment is to reduce symptoms, prevent flare-ups, and improve the appearance of the skin. Treatment options are usually selected according to the severity of the patient’s symptoms and the subtype of the disease. The most common rosacea treatments include:
Medical treatments: Topical medicated creams, such as metronidazole, ivermectin, azelaic acid, and pimecrolimus, are often the primary form of treatment for rosacea. They can reduce inflammation and thereby redness and bumps. If medicated creams are not sufficient to treat rosacea, an oral anti-inflammatory medication, often a tetracycline antibiotic, can also be used. In more severe cases, acne medication that acts directly on the sebaceous glands, isotretinoin, may be used. Flushing and redness can be treated with medications that affect the blood vessels, such as beta blockers and brimonidine.
Laser treatments: Vascular laser treatment can effectively treat dilated blood vessels in the skin, known as telangiectasias, and persistent redness. It can also reduce flushing of the skin. The laser permanently closes excess blood vessels, which reduces redness. Laser treatments usually require one to three treatment sessions. Laser treatment also reduces skin inflammation and the unpleasant sensations associated with rosacea. Rhinophyma can be stopped with medical treatment, isotretinoin, and treated with an ablative laser, such as a carbon dioxide laser.
Summary
Rosacea is a diverse and chronic disease, but its symptoms can be managed with the right treatment methods and lifestyle changes. It is important to book an appointment with a knowledgeable dermatologist if you suspect that you have rosacea. The doctor diagnoses rosacea based on symptoms and an interview, and other examinations are usually not needed. Early diagnosis and an individual treatment plan can significantly improve both skin condition and quality of life. Contact a dermatologist with a low threshold if you have questions or concerns related to rosacea.