Rosacea

Clinical description

Rosacea is an acne-like condition. It usually begins with a history of easy facial flushing & blushing. This frequently evolves into red bumps and pustules that look like pimples, and may be painful or itch. It tends to involve the convex surfaces of the face. The intermittent redness of the central face eventually becomes more persistent, and dilated blood vessels may be seen. Rosacea also may result in dry, easily irritated eyes, that may also become persistently red, and the eyelids may be afflicted by styes. The typical rosacea patient is usually fair-complected ( rosacea is also called "curse of the Celts"). Longstanding rosacea may result in a bulbous nose called rhinophyma; this is quite uncommon in women.

Cause

Unknown! There are many theories about what can cause rosacea:

Bacteria
Blood vessel abnormality
Neurologic abnormality
Demodex (follicle mite)

Trigger factors

Trigger factors are things that make rosacea worse in some people. There are a great many potential trigger factors, but they do not affect all people with rosacea. Each individual has to figure out for himself which factors are important, if any. Here are the most common ones:

Alcohol
Spicy foods
Stress
Exercise
Extremes of heat or cold
Some fruits, including tomatoes, citrus, bananas
Irritants applied to facial skin (soaps, astringents)

Treatment

Avoidance of triggers, when reasonable
Topical antibiotics: metronidazole, sodium sulfacetamide
Oral antibiotics: usually a tetracycline derivative, but many others may work
Accutane (low dose)
Laser ablation of dilated blood vessels

Resources

For more sources of information, go to www.rosacea.org.