Rosacea

What is acne rosacea?

Acne rosacea is a skin problem that affects the nose and face. It causes redness and lumps. Blood vessels become more visible. Sometimes the nose gets larger and looks misshapen.

Rosacea can happen at any age, but it is most often seen in adults who are fair-skinned between the ages of 30 and 50.

How does it occur?

The cause of acne rosacea is not well understood. It seems to run in families and so may be inherited. It may be caused by overactive blood vessels in the skin. Contrary to popular belief, rosacea is not caused by alcoholism.

Rosacea is not related to the pimples and cysts of acne. But people who have rosacea may also have acne. Acne and rosacea are often treated with the same medicines.

What are the symptoms?

The most common symptoms are a red nose and visible blood vessel patterns on the nose. In women, redness and blood vessels may appear only on the cheeks and chin.

Over time the nose may develop small lumps and look swollen. The nose can become quite enlarged, and its surface may become thickened with scar tissue.

Sometimes rosacea also affects the eyelids, which become red and swollen. Rarely, the surface of the eyes may be affected, causing a sense of burning and grittiness.

How is it diagnosed?

Your healthcare provider will examine your skin. In rare cases a skin biopsy (removal of a small sample of skin) may be done to confirm the diagnosis.

How is it treated?

If you have increased flushing and blushing that does not go away and gets worse, you should see your healthcare provider. Treatment of rosacea is very important because it can permanently damage facial tissues.

Rosacea is often first treated with antibiotics. Some of these medicines are taken by mouth. Others are put on the skin.

If rosacea is affecting your eyes, your provider may prescribe antibiotic medicine for your eyes. You may be referred to an eye doctor.

For more severe cases of rosacea, an oral medicine called isotretinoin (Accutane) may be prescribed. Women must use isotretinoin very carefully. It causes birth defects if a woman takes it 1 to 2 months before she gets pregnant or during pregnancy.

A new medicine that may be prescribed for rosacea is called Finacea (azelaic acid). It is a gel medicine for acne that can be put on your skin.

Steroid creams put on the face can sometimes help. These creams should be used only under the supervision of a healthcare provider even if they are nonprescription. Sometimes prolonged use of steroids can cause skin damage, especially when they are not correctly used on the face.

If the usual medicines do not help the problem, and especially if your nose is significantly enlarged or deformed, you may be referred to a dermatologist. Dermatologists are skin specialists and can suggest other possible treatments, including various types of surgery. In some cases laser surgery is an effective treatment for rosacea.

How long will the effects last?

It is rare for rosacea to go away on its own and the condition usually worsens over time. Rosacea can be successfully treated if it is diagnosed in its early stages.

How can I take care of myself?

• Follow the treatment prescribed by your healthcare provider. Use the medicines as prescribed.
• Avoid rubbing or massaging your face if it seems to irritate the inflamed skin.
• Overexposure to sunlight can worsen the effects of rosacea. Limit your exposure to sunlight. When you are out in the sun, use sunscreen.
• Both men and women with rosacea often use makeup to cover the skin changes. Make sure you avoid using irritating cosmetics.
• Avoid getting hairspray and other irritating cosmetics on your face.
• For more information, contact:

  National Rosacea Society
  Phone: 888-NO-BLUSH
  Web site: http://www.rosacea.org.

  American Academy of Dermatology
  Phone: 888-462-3376
  Web site: http://www.aad.org.

How do I prevent acne rosacea?

Because the cause of rosacea is not well understood, prevention of this problem is also not well understood. Rosacea may be inherited and therefore it may not be easy to prevent. However, people who have just started having rosacea, or who have a family history of rosacea, should avoid any foods, drinks, or other irritants (such as sunburn) that cause facial flushing. Frequent facial flushing may cause rosacea to appear for the first time or to worsen.