Sun
19
Apr

Rosacea: the not-so-rosy glow

by Rick Alan

You're talking with friends when you accidentally say something embarrassing. You blush and your whole face turns red. Now you're even more embarrassed, although after a few minutes, the redness goes away. But how would feel if your face was that shade of red all the time? Unfortunately, there is a condition that results in just that. And its called rosacea ("rose-A-she-uh").

Rosacea is a skin condition that causes certain areas of the face to become red and, if left untreated, can cause even more serious symptoms. Affecting an estimated 13 million Americans (about five percent of the population), rosacea usually occurs in people between the ages of 30 and 60. Although it can affect anyone, rosacea is most common in people with light or fair complexions, blonde or red hair, and is much more common in women than in men. To date, neither the exact cause nor a cure for rosacea is known, but there are a number of treatments that can control it.

Symptoms and stages

There are a number symptoms—or stages—of rosacea, that tend to progress from one stage to the next if left untreated. The symptoms/stages are:

Reddening of the face

  • - Greatly increased blood flow results in an expansion of the blood vessels in the face. This reddening looks like a blush or sunburn that won't go away, and affects the cheeks, nose, chin and/or forehead.

Pimples -

  • In its second stage, the reddened areas of the face start to form pimples. Although slightly different in nature from the pimples common to teenagers, they tend to look similar and are referred to as "adult acne."

Broken blood vessels of the face

  • - Ultimately, the continuous flushing and enlargement of the blood vessels in the face cause the vessels to show through the skin (usually in the area of the cheeks), appearing as permanent red lines. This symptom of rosacea is referred to as telangiectasia ("te-lan-jee-eck-taze-yah").

Disfiguring of the nose

  • - In its worst stage, rosacea can cause the oil producing glands of the face—usually on the nose—to become enlarged. The result—a disfigured, bulbous nose—is referred to as rhinophyma ("rye-no-feye-ma"). Although jokes were frequently made about W.C. Field's red nose, the actual cause was rhinophyma.
  • In addition, a condition referred to as ocular rosacea can effect the eyes, causing them to become red or inflamed—a condition similar to conjunctivitis.

What triggers rosacea?

Although the exact cause of rosacea is not known, the triggers are. As Dr. Jeffery Dover, associate chairman of the Department of Dermatology at Boston's Beth Israel Deaconess Medical Center, explains, "A common trigger of rosacea is heat, which causes the blood vessels to dilate. This can be heat from exposure to the sun or heat from hot drinks or spicy food. And alcohol is another common trigger, since it causes the blood vessels to dilate."

Other triggers include:

  • Stress and anxiety
  • Hard physical exercise or exertion
  • Some medications
  • Using soaps or skin cleaners that contain alcohol or other harsh ingredients
  • Using facial products—usually those that contain oil or acetone—that can clog skin pores. (Products marked "noncomedogenic" do not clog skin pores.)
  • Foods containing histamines (including tomatoes, eggplant and spinach) and/or foods containing niacin (such as liver and yeast).

Treatments vary according to stages.

Attacks of rosacea tend to be cyclical: appearing, clearing on their own, and then appearing again. There are several treatments that can control the condition and, if started early enough, prevent rosacea from progressing to its more severe stages.

The following treatments for rosacea are grouped according to the stages they are used to treat.

Facial reddening

  • In less severe cases of facial reddening, regular and continued application of topical antibiotics and/or topical ointments containing sulfur are usually effective in controlling the condition.
  • In more severe cases, an oral antibiotic (usually tetracycline) is prescribed.

Adult acne

  • In rosacea patients suffering from adult acne, the drug isotretinoin (known as Accutane) may be prescribed. This is likely to be prescribed only in more severe cases, since the drug—which is taken orally—can cause a number of side effects, the most common being severe drying of the skin and nose, mild nosebleeds, and eye irritation.

Broken blood vessels

  • Laser treatment has proved effective in treating patients suffering from broken blood vessels of the face.

Disfigured nose

  • Surgery to reshape a disfigured nose is often effective in patients suffering from rhinophyma.

Ocular rosacea

  • Those suffering from ocular rosacea are generally treated with eye drops and/or topical eye ointments that control eye redness and conjunctivitis.

Prevention: avoiding triggers

Along with seeking early treatment to prevent the condition from progressing to a more severe stage, those suffering from rosacea should work with their doctors to identify their triggers and avoid them. In addition, all rosacea suffers should:

  • Use moisturizers that do not contain oil, but preferably do contain vitamin A, to prevent drying
  • Avoid long exposure to the sun and, when in the sun, use sunblock with SPF 15 or higher.