Rosacea is a facial disorder that affects millions. If you don't know the early warning signs, you could be one of them.
Richard Dudley first noticed a glow across his cheeks and nose and he says, "People used to ask me if I got sun over the weekend, if I’d been out in the sun.”
Meg Groom’s face would suddenly get bright red. Later she noticed tiny broken blood vessels.
Neither suspected that they had the early signs of a potentially serious disorder called rosacea.
Dr. Hayes Gladstone says, "If you don’t treat it early enough, the redness will only get worse and it can progress to thickened skin and larger bumps.”
At first the redness will come and go, then become more persistent. Eventually blood vessels, bumps and pimples appear. Rosacea can irritate the eyes. Later, the nose can become bulbous from excess tissue.
Dr. Gladstone says, "That’s end stage rosacea and that’s the W.C. Fields nose.”
In a recent survey by the national rosacea society, 74 percent of patients said they cancelled social events because of their appearance.
The good news is that there are treatments. Antibiotic creams and gels help tame bumps and pimples. Lasers can fade redness and blood vessels.
Dr. Gladstone says, "For intense pulse light, I usually recommend about five treatments and that can take up to three months. It’s important to remember that rosacea is a chronic disease, so you will need maintenance treatments.”
Patients should take note of the things that trigger flare ups and then avoid them. The most common include sun exposure, stress, alcohol, spicy foods and hot drinks.
“It’s actually the heat that’s going to end up dilating blood vessels and make your face more red,” Dr. Gladstone says.
Gentle cosmetics are best but you have to test them out. A trial and error approach will help find what works for a particular individual.
It’s unclear what causes rosacea but theories run the gamut.
Dr. Gladstone says, "There may be inflammation from mites, little bugs that are on everyone’s face actually, but in those people with rosacea, they may have more mites than others on their face.”
New research suggests that bacteria from the demodex mite could stimulate an immune response that causes tissue inflammation. For more information and to receive a free rosacea diary, visit the National Rosacea Society Web site or call toll-free: 888-NO-BLUSH.
Fast Facts:
Rosacea is a chronic skin disease that can cause flushing, redness, bumps or pimples, appearance of tiny blood vessels near the surface of the skin and excess thickening of the skin.
About 14 million Americans have rosacea.
The exact cause of rosacea isn’t known. Some believe a tiny skin mite may be the culprit.
There is no cure for rosacea but the symptoms can usually be treated. However, the condition is often mistaken for adult acne and patients may not seek help.
Rosacea
Rosacea is a chronic disease that affects the skin and sometimes the eyes. Symptoms can vary from person to person. The disease is characterized by four main symptoms: flushing, redness, bumps and pimples and visible blood vessels. Flushing, or blushing, is an early sign of rosacea. Some patients complain of a stinging pain that occurs during facial flushing. Persistent redness appears like a rash or sunburn across the cheeks, nose, chin or forehead. Red bumps or pus-filled pimples eventually appear in the area. In some patients, tiny blood vessels become visible near the surface of the skin.
The signs of rosacea appear primarily on the face. However, the scalp, neck, ears, chest and back can also be affected. Some patients may develop eye symptoms (irritation, redness and swelling). Over time, the condition can damage the cornea and lead to vision loss. In severe cases, patients with rosacea can develop a thickening of the skin on the nose (rhinophyma, characterized by swollen and bumpy excess tissue).
Four subtypes of rosacea have been identified. A patient may have one or more subtypes. Subtype 1 (erythematotelangiectatic rosacea) causes flushing and persistent redness. Some patients may also have visible blood vessels near the surface of the skin. Subtype 2 (papulopustular rosacea) leads to persistent redness and transient appearance of bumps and pimples. Subtype 3 (phymatous rosacea) causes a thickening of the skin, like an enlargement of the end of the nose. Subtype 4 (ocular rosacea) is characterized by the presence of eye problems, like dry eye, burning and tearing, swollen eyelids, and potential corneal damage and loss of vision.
Prevalence and Cause
According to the American Academy of Dermatology, about 14 million Americans have rosacea. The condition is more common in women than in men. But men are more likely to develop severe symptoms. It’s more common in people with fair skin who blush easily, blonde hair and blue eyes. Signs typically first appear between 20 and 50. In some cases, the symptoms can cause extreme embarrassment, low self-esteem and loss of self-confidence.
The exact cause of rosacea isn’t known. Some experts theorize the symptoms are caused by inflammation related to the presence of a skin mite, called Demodex folliculorum (not the same as the common dust mite found in bedding). This tiny, transparent mite is found on nearly everyone’s skin. Stanford University Dermatologic Surgeon, Hayes Gladstone, M.D., says, in some people, the fecal matter deposited on the skin by the mites causes irritation that leads to chronic inflammation, redness, and other symptoms associated with rosacea. Other experts believe rosacea may be associated with Helicobacter pylori infection (the bacterium associated with peptic ulcer disease).
Rosacea symptoms are often aggravated after a person has been exposed to certain triggers (like foods, emotions, weather or irritants). A survey by the National Rosacea Society found some of the most common triggers to be: sunlight (reported by 81 percent of patients), emotional stress (79 percent), hot weather (75 percent), wind (57 percent), heavy exercise (56 percent), alcohol consumption (52 percent) and hot baths (51 percent). Some other common triggers include hot and spicy foods or drinks, chocolate and use of certain cosmetics.
Treating Rosacea
An important step in the treatment of rosacea is avoidance of triggers that can cause a flare up of symptoms. Initially, patients may need to keep a diary to keep track of their symptoms and determine what trigger gives them problems. Sun exposure and irritating skin care products should be avoided. Gentle cleansers and moisturizers are recommended. Women should be careful about using harsh facial cosmetics. For men, shaving can be a problem because the razor irritates the skin. In addition, many pre-shave and after-shave lotions are irritating and can worsen symptoms of rosacea. Men who use skin care products to shave should look for a gentle product and use a light, non-irritating moisturizer after using the razor.
Bumps and pimples associated with rosacea may be treated with oral and topical antibiotics. Redness can sometimes be covered up with green-tinted cosmetics. Some doctors use laser therapy or intense pulsed light therapy to target the abnormal blood vessels. Dermatolgic surgeon, Hayes Gladstone, M.D., says laser therapy may also kill the mites that may cause rosacea (this is only a temporary fix since the mites will eventually return).
Early stages of rhinophyma can sometimes be treated with antibiotics. More advanced stages require surgery to remove the excess tissue.
Signs of rosacea are often mistaken for adult acne. So many patients don’t seek help for their symptoms. However, symptoms can eventually get worse. People who have persistent skin problems should seek advice from a dermatologist or healthcare provider.
Web Resources
For information about rosacea:
American Academy of Dermatology Web site or the RosaceaNet Web site.
National Institute of Arthritis and Musculoskeletal and Skin Diseases Web site.
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