Rosacea

This skin condition is characterised by a red, flushed facial appearance, spots and visible blood vessels. It mainly affects fair skinned people from the UK and Europe.

Twice as many women are affected compared to men. But the symptoms are much worse in men. It affects people aged between 30 and 50.

There is no risk of scarring with this condition.

Causes of rosacea

Difficult to say although it appears to be caused by a combination of several factors which include:

  • Genetics: this often runs in families
  • Abnormality in blood vessels in the face
  • Helicobacter pylori bacteria
  • Tiny insect which lives on normal human skin but appears in greater numbers on rosacea skins.

These are possible causes rather than clearly defined reasons but they do seem to link together.

But what has been noticed is that anyone with rosacea finds that their condition is triggered by any of the following:

  • Stress
  • Exposure to direct sunlight
  • Exposure to extreme of temperature, e.g. high winds
  • Caffeine
  • Hot showers/baths
  • Alcohol
  • Dairy foods
  • Spicy foods
  • Extreme exercise
  • Acute medical conditions which cause a raised temperature
  • Vasoldilatory medication: prescribed for high blood pressure
  • Chronic medical conditions, e.g. high blood pressure

Not two people with rosacea experience the same trigger for their condition. Everyone is different in this aspect. But these are the most common.

Symptoms of rosacea

These vary between individuals and not every person will experience all the symptoms all of the time. But the most likely symptoms are:

  • Redness on the face which persists
  • Flushing
  • Formation of pustules (spots)
  • Small visible blood vessels
  • Eye problems
  • Thickened skin

Flushing is the most obvious sign of rosacea. This is the trigger for the other symptoms and can last for several minutes. It is accompanied by a warm sensation around the face, neck and possibly the chest.

The spots are either small, red swellings or pus filled bumps which appear on the face. They look similar to acne but do not turn into blackheads or whiteheads.

The skin on your face takes on a red, blotchy appearance which may look as if you have had a few too many drinks. Alcohol is a trigger for this condition but there are people with rosacea who are teetotal.

Eye problems include dry, itchy eyes which are highly sensitive to bright lights, a bloodshot appearance and a feeling of grit in your eye.

Your skin feels hot, tingly and rough and is prone to dryness. It flushes easily and red, raised patches develop which engender a feeling of self-consciousness. Your skin is also very sensitive at this time which prevents you from wearing make up.

Rosacea goes through periods of flare ups and remission.

Diagnosing rosacea

This is a distinctive skin condition which responds well to treatment. If you notice any of the symptoms listed above then visit your GP who will form a diagnosis from looking at your skin. He or she will also ask you about your general health and if there is a family history of rosacea.

This also includes questions about your lifestyle, for example alcohol/caffeine consumption etc.

You may be referred for tests if your GP suspects another similar condition, for example the menopause as this causes hot flushes. This will be a blood test.

Treatment for rosacea

Rosacea cannot be cured but there is a range of treatment available to manage the symptoms. These include creams, gels, antibiotics, camouflage make up and laser therapy.

  • Topical creams or gels: topical means that they are rubbed onto your skin. An example of this is metronidazole.
  • Azelaic acid cream which is applied to the skin and helps to unblock the pores. It also reduces the inflammation as well.
  • Antibiotics, e.g. tetracyclines.
  • Acne medication, e.g. isotretinoin
  • Eye drops: to soothe dry, irritated eyes

Your GP will discuss the benefits and side effects of all of these options.

Complications of rosacea

This condition can affect you both mentally and physically.

For example, eye problems such as dry eyes or light sensitivity can result in eye conditions such as blepharitis (an inflammation of the eyelids). Another potential risk is scarring on the cornea which requires specialist treatment.

But the flushed appearance, visible blood vessels, spots and bloodshot eyes can cause a great deal of psychological distress as well. The main reason is because it affects your facial appearance which many of us are sensitive about.

There are people with rosacea who become self-conscious about their appearance which then affects their confidence and self-esteem.

Living with rosacea

The difficulty is in accepting that this is a chronic condition which cannot be cured, but, it can be managed and very successfully. Once your physical symptoms improve this will boost your psychological mood and enable you to cope with this condition.

You may find counselling helps or advice and support from organisations such as the National Rosacea Society.

Plus you may also find it helpful to adopt a few preventative measures such as applying a suncream when outside; reducing stress levels; minimising alcohol and caffeine intake; avoiding spicy foods and protecting your skin in cold weather.

Pay particular attention to your skincare routine. Avoid excessive rubbing of your face and use a moisturiser if your skin is sore. Do not use skincare products which contain ingredients that will irritate your skin. Clean your face each day with warm not hot water and dry it thoroughly before applying make up.

Do NOT use steroids cream unless prescribed by your GP.

Men: use an electric razor rather than wet shaving to reduce the risk of irritation.