Have you ever wondered why some people seem to blush more easily than others? Rosacea, a common skin condition, can actually be behind that tendency.
It isn’t just about flushing or redness in the cheeks. It’s a chronic inflammatory condition that affects the central part of your face, sometimes causing pimples, swelling, and even visible blood vessels.
Millions Live With Rosacea, But It Can Be Missed
Rosacea is more widespread than you might think, affecting an estimated 20 million people globally. This number could be even higher because diagnosing it can be tricky, especially for people with darker skin tones.
Understanding Who Gets Rosacea
While women are more likely to experience rosacea than men, and it typically starts earlier for them (around 35-40 years old), anyone can develop this condition. It’s also surprisingly common, affecting anywhere from 2% to 18% of the population depending on location. Interestingly, the higher prevalence in people with lighter skin tones might simply be because the symptoms are easier to see. Rosacea absolutely affects people with darker skin tones as well, it just might be harder to diagnose.
One common factor for those with rosacea is a tendency to sunburn easily. This suggests a potential link between sun sensitivity and the development of the condition.
Symptoms
Rosacea is a chronic skin condition that can cause a variety of symptoms, from persistent blushing to bumpy breakouts. It often affects the central part of the face, the nose, cheeks, and forehead. While some people might experience occasional flushing, for others, rosacea can be a constant source of frustration and embarrassment.
Here’s what rosacea can look like:
Erythematotelangiectatic rosacea: Flushing, redness, and visible blood vessels
Papulopustular rosacea: Acne-like breakouts, swelling, and redness
Phymatous rosacea: Skin thickens and becomes bumpy.
Ocular Rosacea: Eyes that are red and irritated, eyelids that are swollen, and what appears to be a sty
The impact of rosacea goes beyond just skin deep. It can affect your confidence and social life. Studies show people with rosacea might experience anxiety, depression, and even struggle in their relationships because of the condition.
But the good news is, symptoms can be managed. If you suspect you have it, don’t hesitate to see a doctor or dermatologist. There are ways to manage the symptoms and improve your quality of life.
Causes
Experts aren’t exactly sure what causes rosacea, but it likely involves a combination of genes and things in your environment. Here’s what we know so far:
Family history: Rosacea runs in families, so genes likely play a role.
Immune system: Some people with rosacea may have an overactive immune system that reacts to a certain bacteria.
Stomach bug: An infection from a certain stomach bug (H. pylori) might be involved, but not everyone with rosacea has this infection.
Skin mites: Tiny mites that live on everyone’s skin (Demodex) might be a factor, but some people without rosacea also have a lot of these mites.
Body proteins: A protein in the body (cathelicidin) that usually fights infection might be involved in the redness and swelling of rosacea.
Comorbidities associated with Rosacea
Recent research suggests that an increased risk of rosacea is associated with inflammatory GI diseases such as Crohn’s disease, ulcerative colitis, celiac disease, or small intestinal bacterial overgrowth (SIBO) syndrome. Other links to metabolic diseases, such as diabetes, hypertension, dyslipidemia, and coronary artery disease, have been discovered.
Patients with rosacea have been linked to a variety of neurologic disorders and neurodegenerative diseases, including Alzheimer’s disease, Parkinson’s disease, migraine, depression, and anxiety disorders, complex regional pain syndrome and glioma.
Diagnosis and Tests
Rosacea is still diagnosed clinically, based on its distinctive morphology and patterns. A skin biopsy is not always necessary, but it may be useful when the diagnosis is unclear.
Rosacea Triggers
Because the cause of rosacea is unknown, the condition cannot be prevented. Rosacea patients, on the other hand, can improve their chances of remaining in remission by identifying and avoiding lifestyle and environmental factors that aggravate individual conditions or trigger rosacea flare-ups.
Several factors have been anecdotally linked to exacerbations of rosacea and these include the following:
- Exposure to extremes of temperature
- Sun exposure
- Hot beverages
- Spicy foods
- Alcohol
- Exercise
- Irritation from topical products
- Psychological feelings, especially anger, rage, and embarrassment
- Certain drugs, such as nicotinic acid and vasodilators
- Skin barrier disruption
Management and Treatment Options
There are several ways to manage rosacea, depending on your specific symptoms. Here’s a breakdown of the most common treatments:
Sun Protection is Crucial
Since sun exposure is a major trigger, consistent sun protection is key:
- Daily Sunscreen: Apply a broad-spectrum sunscreen with SPF 30 or higher every day, even on cloudy days.
- Minimize Midday Sun: Avoid going outside during peak sun hours, typically between 10 am and 4 pm.
- Seek Shade: Whenever possible, find shade outdoors.
- Protective Clothing: Wear wide-brimmed hats, sunglasses, and sun-protective clothing that covers your arms and legs.
Gentle Skincare:
Using gentle skincare products formulated for rosacea-prone skin can help prevent flare-ups. Avoid harsh scrubs and cleansers. If you’re unsure about a product, consult your dermatologist for recommendations.
Makeup: Green-tinted makeup can help conceal redness but won’t reduce it.
Lasers and Light Treatments:
These treatments can be very effective for persistent redness or visible blood vessels. They may offer long-lasting results (years for some) but often require multiple sessions.
Reducing Facial Redness:
Brimonidine gel and oxymetazoline cream: These prescription medications can reduce redness for up to 12 hours daily. However, the redness returns when the effects wear off. They are generally safe, but some people may experience mild side effects like burning or itching.
Ocular Rosacea:
For proper eye care, use warm compresses and gentle cleansers, and follow your doctor’s instructions for prescribed eye drops or medications. In some cases, antibiotics may be necessary. If your condition is moderate or severe, your doctor may refer you to an ophthalmologist, an eye specialist, for further evaluation and treatment.
Topical Medications:
Azelaic acid: Applied twice daily, this medication can significantly reduce rosacea symptoms (70-80% improvement) for many people.
Metronidazole (gel/cream): Effective for reducing both redness and pimples. Some patients can even stop using it after achieving clear skin.
Sodium sulfacetamide and sulfur: This combination has been used for decades to treat rosacea pimples and redness. It’s safe for most people, but consult your doctor if you have kidney disease, sulfur allergy, or are pregnant/planning to become pregnant. Studies show a significant reduction in pimples (65-78%) and redness (66-83%) within 6-8 weeks.
Other Considerations:
Retinoids: While they can irritate rosacea-prone skin, retinoids can help prevent flare-ups once your rosacea is under control.
Isotretinoin: This medication, typically used for severe acne, can prevent further development of phyma (thickened skin) but cannot remove existing thickening. Surgery is needed for that.
Phyma Removal Surgery: This is a complex procedure often requiring multiple surgeries to remove excess skin and reshape the nose or other affected areas.
Maintaining Results: Following surgery, you may need to continue taking isotretinoin and avoid rosacea triggers. Sun protection and gentle skincare are also crucial.
Remember, a dermatologist can help you develop a personalized treatment plan for your rosacea.
Over to You
There is no cure for rosacea, but it can be successfully managed. Changing your lifestyle and treating your rosacea can help you avoid flare-ups. It can also keep rosacea from getting worse. Many people find that doing these things makes living with rosacea much easier. They also claim to be feeling and looking better.
Consult your healthcare provider or a dermatologist if you suspect you have Rosacea. They will examine you to determine the severity and extent of your condition. You will collaborate to develop the best treatment plan to control your condition and manage flare-ups.
