Rosacea
I. Definition:
Rosacea is a common face rash of adults. Rosacea is only a skin
condition and is not related to your general health. Rosacea has three stages. In the
first stage the face gets red. This redness sometimes merges into the normal variants of
ruddy or blushy complexion types. The redness often persists after cold exposure or after
exposure to irritants like soap. With time, small blood vessels develop making the redness
more noticeable. Many patients will develop stinging or burning sensations and the skin
will often feel tight. The skin feels like a mild sunburn with smiling, frowning, or
squinting. Sometimes this progresses to the point that everything the patient puts on his
or her face stings, burns, and irritates.
In the second stage of rosacea, the redness covers a larger area of the
face. Slight swelling, pimples, and pustules develop. This is especially noticeable on the
nose, mid-forehead, and chin. As the condition progresses, prominent facial pores can
develop.
The third stage is characterized by swelling and growth of the nose and
central facial areas. At times the ears may be involved as well. This can be very
disfiguring. This stage is known as rhinophyma. Most patients do not
progress to the third stage of rosacea.
II. Causes:
- The cause of rosacea is unknown. Rosacea is stubborn and often the
condition will last for years.
- Foods or beverages that cause facial flushing, such as alcohol, spicy
foods, hot soups, coffee, and tea, may make rosacea temporarily more noticeable.
- Sunlight is a major trigger factor for rosacea and may be a cause of this
condition.
III. Treatment:
- Antibiotics such as MetroGel, MetroCream and sulfur preparations applied
to the skin one to two times a day work well for many people with rosacea.
- Retin-A is an effective
treatment for Rosacea and can decrease the number of small blood vessels.
- Topical vitamin C creams such as SkinC Skin Firming Cream
will lessen the redness that is caused by rosacea. It should be
applied once a day.
- Use of sunscreen and avoidance of sunlight will help to prevent flares.
- Antibiotics taken by mouth
are usually effective in controlling rosacea, and can be used for people not controlled by
topical antibiotics. Tetracycline is the most common
antibiotic used for treating rosacea.
- Treatment only controls rosacea. There is no cure for this condition.
Most people with this condition need to continue applying Metrogel and
Retin-A or taking antibiotics for months to years.
- Accutane is a drug taken by mouth which
is reserved for severe rosacea. Accutane has many side effects and if taken during
pregnancy will cause birth defects. Patients taking Accutane must have periodic blood
tests and checkups.
- The red face of rosacea can often be improved with tunable dye laser
treatments. This type of treatment is time consuming and expensive. It is not covered by
insurance.
- Rhinophyma (nose swelling and tissue over growth) can be
treated with the CO2 laser. This is
often covered by insurance because it is so disfiguring.
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