Rosacea Causes And Treatments

Rosacea skin care 

Photo: Corinna Kennedy

Are you suffering from blushing, rashes or acne-like skin conditions? Especially when you have been too long in the sun, are nervous or have had a glass of red wine?

Then it is possible that you are suffering from rosacea. Rosacea is a complex and comprehensive illness. The illness usually manifests itself by blushing and red rashes but it can also a cause acne-like skin condition and in the worst case a swollen nose. Enlarged nose (rhinophyma) has often been associated with high alcohol consumption. This is not the case and many feel unfairly socially stigmatized.

Rosacea is one of the most common skin conditions and 5-10% of the population suffers from it. Even though it is so common we are not sure what causes it but it can be a combination of genetics and environment. As many as 40% of the people with rosacea have a relative with the same condition. There are several theories regarding the cause but we know that certain things worsen or trigger it.

Rosacea and acne are entirely different conditions and must not be confused.

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Can Rosacea Be Cured?

At the moment there are no treatments that cure the illness. However, there are there are several treatments the can keep rosacea in check. It is also possible that the illness goes away by itself after months or years.

Are There Different Types of Rosacea And What Are The Treatments?

Rosacea may look different from person to person. The illness is divided into four main groups depending on how the skin looks. The treatment will vary from the type the person has. However, the treatment should be both internal and external. This means both a diet and skin products that does not trigger rosacea.
The four groups of rosacea can be graded mild, moderate or serious. The intensity of the illness often varies and the person affected can have good or bad periods.

• Type 1 (Vascular Rosacea): Typical ailments are persistent redness and expanded small blood vessels at the extremities of the skin in the central parts of the face. The skin becomes easily irritated and is very sensitive.

Treatment: The aim of the treatment is to reduce the redness in the skin and prevent outbreaks. It is important to identify worsening factors and do your best to avoid these. Everyone should use high factor sunblock during the day. Recommended treatments are often anti-inflammatory creams. Another solution that might be good for some is laser or other light treatments.

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• Type 2 (Inflammatory Rosacea): Typical persistent redness in the central parts of the face with visible blood vessels, red nubs (papules) and possibly pimples (pustules).

Treatment: The aim of the treatment is to reduce redness, twitching, and tingling of the skin. Most people with type 2 rosacea are not bothered with sensitive skin. Most commonly used are Rozex gel (metronidazole) or Finacea gel (azelaic acid). In some cases, 10% sulfur in Essex lotion can be tried, but the treatment is malignant and must be specially mixed at the pharmacy. For those with more pronounced ailments, a tablet of antibiotics is often given, which must be taken over several weeks. Previously, tetracyclines were used, but it was shown that low-dose, depot-formulated doxycycline for 2-6 months is an effective treatment with little side effects and resistance development. Pregnant must discuss with their doctor what medications they can use during pregnancy. Protopic (tacrolimus) is a new cream that may have some effect, but its place in treatment is not yet fully clarified. In very rare cases, treatment with Roaccutane (isotretinoin) may be attempted.

• Type 3 (Phymatous Rosacea): Typically pronounced skin thickening with large pores. This variant usually affects the nose, cheek, forehead, ears, and eyelid. The skin thickening may come alone or with other symptoms such as redness, bumps, pimples and visible blood vessels.

Treatment: The aim of the treatment is to reduce sebum production in the skin, as well as the formation of acne and redness in the skin. Aberela cream (Vitamin A) can be helpful. Treatment, as mentioned for the other types, can also be attempted. Overgrowth of sebaceous glands on the nose (rhinophyma) can be treated surgically or with a CO2 laser. In some cases, treatment with Roaccutane tablets (isotretinoin) is given.

• Type 4 (Ocular Rosacea): Ocular rosacea in the form of redness and feeling of a foreign body on the eye. The condition may be accompanied by eyelid inflammation, eye catarrh and inflammation of the cornea of the eye (rare).

Treatment: Treat with eye drops or different types of antibiotics. These patients should be referred to the ophthalmologist

Advice for all affected by rosacea

• Use sunscreen daily to protect against UVA and UVB light. Sunscreens with physical filters like titanium dioxide and zinc oxide are best tolerated.
• “Rosacea skin” is easily irritated by cosmetics. Avoid waterproof make-up and heavy foundations.
• Use soap-free cleaning products.
• Use a moisturizer that is adapted to your own skin type at least once a day, and before applying other skin care products and make-up. Choose a moisturizer that dampens redness of the skin and which is not too fat.
For women who are bothered by the cosmetic aspect of the disease, a foundation with a slight green tint can help cover the redness.

Things To Avoid When You Have Rosacea
Rosacea causes

• Mental stress
• Sunlight
• Wind
• Temperature changes
• Warm baths, sauna, etc.
• Alcohol
• Warm drinks
• Medication
• Menstruation
• Spicy food
• Anger and/or embarrassment
• Corticosteroids (anti-inflammatory drugs, such as cortisone corts)
• Medications that expand blood vessels, such as some blood pressure medications

Rosacea, Acne or Something Else?

Rosacea can be difficult to separate from acne. One important difference is the age group that is affected (rosacea typically occurs in the age of 30-50) and that blackheads do not appear by rosacea.
Other skin diseases that should be considered are perioral dermatitis, seborrheic eczema, sun rash, lupus, and sarcoidosis.

When should you contact a doctor?

Talk to your doctor if you get an acne-like rash in adulthood. Several diseases can give similar symptoms, and it is important to have a thorough investigation for proper diagnosis and treatment.