It’s a condition that’s sometimes mistaken for acne. Rosacea is a skin disorder that affects over 13 million Americans. Unlike acne, a skin disease most common in teenagers and young adults, rosacea is more likely to affect middle-aged and older adults between the ages of 30 and 60. This frustrating condition is varied in its manifestations, but people who have it frequently complain of a red face, facial flushing and blemishes that closely resemble acne breakouts. As you’ll soon see, this condition can manifest with signs and symptoms not typically seen with acne.
Rosacea can be divided into four degrees based on its signs and symptoms. Not everyone who has this condition will progress to all of these stages or experience all of the signs and symptoms.
During the first phase, frequent blushing and transient facial redness may be the only signs of the condition. At this juncture, a person typically experiences skin irritation and redness when they use certain makeup or beauty products. At this point, he or she may think it’s an allergic reaction and change personal care products, which usually does little to improve the symptoms.
During the second stage of rosacea, facial redness becomes more prominent, especially around the nose and the inner portion of the cheeks. Superficial blood vessels on the surface of the skin dilate, enlarge and form thin red lines on the face which can be difficult to camouflage even with makeup. These dilated blood vessels are known as telangiectasias. At this point, the redness usually still comes and goes and is often aggravated by soaps, cleansers, creams and cosmetics.
As the condition progresses to the third phase, the facial redness deepens and becomes more persistent. Dilated blood vessels on the face also increase in number. At the same time, red pustules and pimples appear that resemble those of acne.
During the fourth and most advanced degree of rosacea, the facial redness and other symptoms worsen and the eyes may become bloodshot and irritated, a condition known as ocular rosacea. In some people the nose takes on a swollen, red and bumpy appearance called rhinophyma. In the latter phases of the condition, the skin can become thickened and rough with a texture similar to that of an elephant. Needless to say, rosacea can be a disfiguring condition that causes a great deal of mental anguish. That’s why it’s important to diagnose and treat the signs as early as possible.
Until recently, the cause of rosacea has been somewhat of a mystery. In 2007, a team of scientists discovered that people with the condition overproduce proteins that trigger inflammation. Everyone has proteins that help to protect the skin against viruses and bacteria that cause infection. People with rosacea have elevated levels of these immune proteins. In addition, they have higher levels of enzymes that cause proteins to become active. When too many skin proteins are activated, inflammation can follow.
A number of factors can trigger and worsen the symptoms of rosacea . The list of possible triggers is long, and they aren’t necessarily the same for every person. Some of the most common ones are exposure to the sun, emotional stress, heat, wind, strenuous exercise, cold winds, sudden changes in temperature and alcohol consumption. Other common triggers are caffeinated beverages, spicy foods, medications and cosmetic products.
To deal with these triggers and keep symptoms at bay, it’s important to avoid sun exposure and rapid temperature changes. Regular use of a mineral-based sunblock made for sensitive types is helpful since the sun’s rays frequently aggravate the condition. It also helps to stay away from spicy foods and alcohol. Some people find food journals useful for identifying foods that can worsen symptoms.
Since cosmetics and beauty products can aggravate the symptoms of rosacea, dermatologists suggest that patients with the condition use products that are hypoallergenic and formulated for sensitive types. Mineral makeup is a good choice since it often doesn’t contain ingredients that can irritate the skin and trigger flare ups. Mineral cosmetics also often contain titanium oxide and zinc oxide that block the sun’s rays.
Dermatologists frequently prescribe the antibiotic tetracycline or its derivative doxycycline for treating rosacea. This is frequently combined with the topical medical metronidazole gel. The combination of the two treatments is effective for reducing the number of bumps, pimples and redness, although they won’t improve the appearance of dilated blood vessels. These may require laser or pulsed light therapy.
Another topical therapy, azelaic acid cream also reduces the number of bumps and pimples while alleviating redness. Azelaic acid comes from barley, wheat and rye and appears to be as effective as metronidazole gel for rosacea.
Are there non-prescription treatments for rosacea that work? One small but promising study showed that women with the condition who used a cream containing green tea extract twice a day had fewer pimples and pustules than those who used a placebo. Another study showed that niacinamide, a B vitamin, improved the symptoms of rosacea when applied topically. Both of these creams work by reducing inflammation. Before using a cream that contains green tea extract or niacinamide, check with a dermatologist since some products contain other ingredients that can aggravate rosacea.
Antibiotics along with topical creams and gels play a role in treating rosacea, but the condition can be improved by identifying and eliminating triggers that bring on the symptoms. Take steps to reduce stress, limit the use of alcohol and caffeinated beverages, avoid spicy foods and always wear sun protection when outdoors.
Choose a gentle, glycerin-based soap to reduce skin irritation, and follow with a mineral-based sunscreen. Stay away from facial scrubs or creams containing alpha-hydroxy-acids or vitamin C in order to reduce skin irritation. Consider using a cream that contains niacinamide or green tea extract. If these options don’t work, antibiotics and prescription topical creams are an option that works well for many people.
Rosacea presents many daily challenges, but it can be successfully treated when diagnosed early, and that’s good news for anyone with this common skin condition.