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What Is Rosacea? What Causes Rosacea?

Rosacea is a chronic, inflammatory skin condition which principally affects the face. Rosacea causes facial redness and produces small, red, pus-filled pustules (bumps). Rosacea worsens with time if left untreated. It is often mistaken foracne or eczema, or some other skin allergy.


Approximately 1 in every 20 Americans - 14 million people - are estimated to be affected with rosacea. As it is frequently misdiagnosed the incidence may be a lot higher. A Gallup survey revealed that 78% of Americans do not know anything about rosacea, its symptoms or what to do about it.


Rosacea is more common among fair-skinned people of northern European ancestry. However, studies have revealed that its incidence in many parts of Asia, including the Middle-East, South Asia, and China is growing, especially in regions that have undergone socioeconomic development in recent years. This has triggered speculation that lifestyle may be a risk factor, and not just skin color. Others say incidence has grown in those areas because healthcare and diagnosis techniques have improved.


What are the signs and symptoms of rosacea?

Many signs and symptoms are associated with rosacea, however they may vary considerably from person-to-person. The following signs and symptoms tend to be present in most cases:


  • Flushing (easily blushing)

This is usually the first sign of what many call pre-rosacea. Flushing episodes can last as long as five minutes. The blush can spread from the face down to the neck and chest. Some people say the skin feels unpleasantly hot during flushing episodes.


  • Facial skin hyper-reactivity

Sensitive blood vessels dilate very easily to topical triggers (touch), and some other physical stimuli, such as sunlight. Many mistakenly refer to this as "sensitive skin", but with rosacea it is sensitive blood vessels and not sensitive skin cells which cause this.


  • Persistent redness

Sometimes the flushing episodes may eventually be followed by bouts of persistent facial redness. The redness, like a patch of sunburn, may not go away. This occurs because hundreds of tiny blood vessels near the surface of the facial skin dilate (expand).


  • Spots, papules, and pustules (Inflammatory rosacea)

Small spots, papules and pustules sometimes appear on the face - this is also known as inflammatory rosacea. Misdiagnosis is common because of their teenage acne appearance. However, with rosacea the skin has no blackheads, unlike acne.


  • Inflamed blood vessels (vascular rosacea)

As the signs and symptoms of rosacea progress and get worse, small blood vessels on the nose and cheeks swell and become visible (telangiectasia) - they sometimes look like tiny spiderwebs. The skin on the face can become blotchy, similar to the skin of some alcoholics. However, it is caused by inflammationof tiny blood vessels in the surface of the skin, and not alcohol. People with rosacea may become concerned and distressed at being labeled hardened drinkers because of this. Although alcohol may trigger rosacea flare-ups in patients who already have rosacea, alcohol consumption is never the source of the condition.


  • Rhinophyma - Excess facial skin around the nose

Severe rosacea can result in the thickening of facial skin, especially around the nose. The nose can become bulbous and enlarged (rhinophyma). This is a very rare complication, and tends to affect males much more than females.


  • Ocular rosacea

There is a burning, gritty sensation in the eyes, making them bloodshot. The inside of the eyelid may become inflamed (blepharitis) and appear scaly, causing conjunctivitis. Some people may not tolerate contact lenses and styes may develop. In very rare cases vision may become blurred. Approximately 50% of patients with rosacea experience some kind of eye irritation or symptoms.


  • Facial swelling

Excess fluid and proteins leak out of the blood vessels and eventually overwhelm the lymphatic system that cannot drain the leakage away fast enough. This results in fluid buildup in the facial skin.



How is it treated?

Doctors can prescribe medicines and other treatments for rosacea. There is no cure, but with treatment, most people can control their symptoms and keep the disease from getting worse.


  • Redness and breakouts can be treated with: Pills, such as low-dose antibiotics like doxycycline. Skin creams that contain medicine, such as azelaic acid or metronizadole. In some cases fruit acid.


  • Redness from tiny blood vessels can be treated with lasers and another light treatment called intense pulsed light (IPL).


  • Dry, sensitive skin can be protected with products for sensitive skin, such as moisturizers and sunscreen.


  • Dry, red, and irritated eyes can be treated with artificial tears or prescription eyedrops that contain a medicine such as cyclosporine.


  • Thickened or bumpy skin on the nose or face can be treated with cosmetic surgery.

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