It may look like you have spent too much time in the sun, or that you are embarrassed. But, if it weren’t for the red bumps, warm skin, and itching, it could actually be mistaken for overheating. But no, these symptoms are caused by a very common condition: rosacea.

What is Rosacea?

Rosacea is a chronic skin disease that affects more than 40 million people worldwide. The cause of rosacea is still unknown, but it has been widely studied. Rosacea can occur in anyone. But it usually affects middle-aged women with fair skin. Although there is no cure for rosacea, treatments can control and reduce the signs and symptoms. These signs and symptoms appear during a period that may last weeks to months and then reduce for a while. Rosacea may be mistaken for acne, an allergic reaction, or other skin problems.

Types of Rosacea

There are five subtypes of rosacea and each subtype has its own set of symptoms. It is possible to have more than one subtype of rosacea at the same time. The hallmark of rosacea is small red bumps filled with pus on the skin. Usually, rosacea affects only the skin of the nose, cheeks, and forehead. They usually occur in cycles, meaning that a person will experience symptoms for weeks or months. Soon after, the symptoms will disappear, and then return. Subtype 1 – Known as erythematotelangiectatic rosacea (ETR), is associated with facial redness, flushing and visible blood vessels. Subtype 2 – Papulopustular rosacea (or acne), is associated with flare-ups similar to acne. Subtype 3 – Known as rhinophyma or phymatous rosacea, is a rare form that is associated with thickening of the skin on the nose. It usually affects men and is often accompanied by another subtype of rosacea. Subtype 4 – As the name suggests, ocular rosacea affects the eye area. About 20% of cases are discovered during an eye doctor’s appointment. The sign of the disease is an inflammation (called blepharitis) with redness and flaking in the eyelid area. This type is the most severe, and may progress to vision loss. Subtype 5 – Another rare subtype of rosacea is called granulomatous rosacea. Its main characteristic is the appearance of small brownish nodules on the face. About 15% of patients with the condition may have lesions in other places. Its diagnosis is difficult and requires a high degree of suspicion from the dermatologist. Its treatment is also a challenge since this type of rosacea does not respond well to conventional treatments.

Symptoms of Rosacea

Symptoms of rosacea vary between each subtype.

  • Flushing and redness in the center of the face
  • Visible dilated blood vessels
  • Swollen skin
  • Sensitive skin
  • Burning sensation on the skin
  • Dry, rough, and scaly skin

Symptoms of papulopustular rosacea (acne rosacea):

  • Acne-like breakouts
  • Very red skin
  • Oily skin
  • Sensitive skin
  • Visible dilated blood vessels
  • Skin spots

Symptoms of phymatous rosacea:

  • Bumpy skin texture
  • Thickened skin on the nose
  • Thickened skin on the chin, forehead, cheeks, and ears
  • Large pores
  • Visible dilated blood vessels

Symptoms of ocular rosacea:

  • Swollen and watery eyes
  • Burning or stinging sensation in the eyes
  • Dry, itchy eyes
  • Eyes sensitive to light
  • Eye cysts
  • Decreased vision
  • Dilated blood vessels on the eyelids

Symptoms of granulomatous rosacea:

  • Acne-like breakouts
  • Brownish nodules on the skin
  • Crusts on the skin of the face and back
  • Sensitive skin
  • Non-itchy lesions

Causes of Rosacea

The cause of rosacea has not been determined. It may be a combination of hereditary and environmental factors. Rosacea is not caused by lack of hygiene. A number of factors can trigger or worsen rosacea, increasing blood flow to the surface of your skin. Some of these factors include:

  • Hot drinks and spicy foods
  • Alcoholic beverages
  • Extreme temperatures
  • Sunlight or wind
  • Stress, anxiety, nervousness, or embarrassment
  • Physical exercise
  • Cosmetics
  • Drugs that dilate blood vessels, including some blood pressure medications
  • The intestinal bacteria Helicobacter pylori
  • A skin mite called demodex and the bacteria it carries, Bacillus oleronius
  • The presence of cathelicidin (a protein that protects the skin from infection)

Risk Factors for Rosacea

There are some factors that will make some people more likely to develop rosacea than others. Rosacea usually develops in people between the ages of 30 and 50. It is also more common in people with fair skin, blonde hair, and blue eyes. There are also genetic factors for rosacea. It is more likely to develop rosacea if you have a family history of the disease or have Celtic or Scandinavian ancestry. Women, as mentioned above, are more likely to develop the condition, however, men who develop it generally show more severe symptoms.

Diagnosis of Rosacea

A doctor can easily diagnose rosacea with a physical examination. They may also refer you to a dermatologist to determine whether the cause of your condition is indeed rosacea or another skin condition.

Treatment for Rosacea

The most common treatment is with topical products such as metronidazole, azelaic acid, benzoyl peroxide, and topical retinoids. The main goal of treatment is to reduce inflammation using these substances about 1 to 2 times a day. In the case of papulopustular, ocular, and phymatous rosacea, it is necessary to use antibiotics from the cycline group: tetracycline and minocycline. Surgery is indicated for phymatous cases. To treat ocular rosacea, it is often necessary to use local (antibiotic) eye drops and also immunosuppressants. The use of laser or intense pulsed light is also important, as the laser light targets the vessels, destroying them and lightening the area.

How to Relieve Rosacea Symptoms?

Rosacea has no cure, but it is possible to take some measures to relieve and control its symptoms. It is important to take care of your skin using gentle, oil-free, water-based cleansing products. Avoid products that contain:

  • Alcohol
  • Menthol
  • Witch hazel
  • Exfoliating agents

These ingredients can irritate and worsen rosacea. Your doctor will develop a treatment plan that usually includes a regimen of topical antibiotic creams and oral antibiotics. It is helpful to keep a food diary of the foods eaten and the cosmetics used. This will help you figure out what worsens your symptoms. Other measures to relieve rosacea symptoms include:

  • Avoiding direct sunlight on the skin by using sunscreen
  • Not drinking alcoholic beverages
  • Seeking treatments to help in some severe cases of rosacea
  • Microdermabrasion treatment to reduce excess skin growth
  • Use of eye medications, usually antibiotics for ocular rosacea

Rosacea is a chronic skin disease that needs close monitoring. It can be difficult to cope with a chronic condition, but avoiding aggravating factors and following the treatment recommended by a dermatologist, together with adopting simple habits, can help combat skin sensitivity. See Also: Most Common Skin Diseases in Women Photos: M. Sand