Rosacea – Types, causes, symptoms and treatment

What is rosacea?

• Rosacea is a chronic skin disease that is characterized by small, red, pus filled bumps on the skin that are present during flare-ups. Rosacea may affect your nose, cheeks and forehead. 
• In rosacea, flare-ups often occur in cycles. It means that you can experience symptoms of rosacea for some weeks or months then after taking treatment symptoms will subside and then return. The exact cause of rosacea is still unknown yet and there is no permanent cure for this.

Types of rosacea

There mainly four subtypes of rosacea. Each subtype has its own symptoms. Sometimes more than one subtype of rosacea can be present in one patient at a time.

These four types of rosacea that include

1. Erythematotelangiectatic rosacea (ETR), is associated with redness on face, flushing and visible blood vessels.
2. Papulopustular (or acne) rosacea is characterized by acne-like appearances on skin and commonly affects women in middle-age.
3. Rhinophyma, is a rare form of rosacea that is associated with thickening of the skin commonly on your nose. It affects men mostly and is often accompanied by other subtype of rosacea.
4. Ocular rosacea and its symptoms commonly affect the eye area.

Symptoms of rosacea

Symptoms of rosacea are different for each subtype.

Signs of rosacea ETR

• Flushing and redness on your face
• Visible broken blood vessels
• Swollen and sensitive skin
• Burning sensation on skin
• Dry, rough and scaly skin

Signs of acne rosacea

• Acne-like appearance and very red skin
• Sensitive and oily skin
• Broken blood vessels that are visible
• Formation of patches on skin that may be raised

Signs of thickening skin

• Thick skin on nose , chin, forehead, cheeks, and ears
• Bumpy skin texture
• Visible broken blood vessels
• Large pores

Signs of ocular rosacea

• Watery eyes
• Burning sensation in the eyes
• Cysts on eyes
• Dry, itchy eyes
• Diminished vision
• Eyes those are sensitive to light
• Broken blood vessels on eyelids

What causes rosacea?

The cause of rosacea is not known yet. It   may occur due to combination of hereditary and environmental factors. There are some factors that may trigger the condition and make symptoms worse. These include:

• Drinking hot coffee or tea frequently
• Taking spicy foods
• Consuming items that contain the compound cinnamaldehyde, that include citrus food items, tomatoes, cinnamon, chocolate
• Having infection of Helicobacter pylori

Risk factors for rosacea

There are some risk factors that will make you more prone   to develop rosacea than others. 

• Age – Rosacea commonly affect the age group of 30 and 50. 
• Sex– This condition is more commonly seen in women than men.
• Race – It is also more commonly affect the people who are fair-skinned and having blue eyes and blond hairs.
• Genetics – Genetic history may also play a role in causing   rosacea. You are more likely to develop rosacea if there is family history of the condition.

How to diagnose rosacea?

Your doctor can diagnose rosacea by doing physical examination of your skin. Other tests like blood investigations can help to exclude other conditions. Skin biopsy may help to confirm the diagnosis.

How can I control my symptoms?

Rosacea cannot be cured permanently, but you can follow some steps to manage your symptoms.

• Always use oil-free facial creams and moisturizers.
• Take care of your skin using cleansers and oil-free, water-based skin-care products.
• Avoid skin care products that contain:

1. Witch hazel
2. Alcohol
3. Menthol
4. Exfoliating agents

These ingredients may irritate your symptoms.

• Keep a check on the foods that you take and the cosmetics you apply on your skin. This will help you to figure out what triggers your symptoms.

Other management steps include:

• Avoid drinking alcohol
• Avoid direct contact with sunlight and apply sunscreen
• Use of lasers and light treatment should be done to help with some severe cases of rosacea
• Microdermabrasion treatments to reduce thickening skin
• Taking medicines for eye and antibiotics for ocular rosacea

Treatment options for rosacea

• Treatment for rosacea mainly focuses on controlling signs and symptoms. Most often this requires a combination of good skin care and prescription drugs.
• The duration treatment prescribed depends on the type and severity of your signs and symptoms. Reoccurrence of rosacea is common.

Medications used

Medication depends upon the signs and symptoms you’re experiencing. Your doctor may use different options or may prescribe combination of medicines to find a treatment that works for you.

• Topical use of drugs – To the treatment of mild to moderate cases of rosacea, your doctor may prescribe a cream or gel for local application to the affected skin. Oxymetazoline (Rhofade) , Brimonidine (Mirvaso) help in reduction of  flushing by constricting blood vessels. 
• Oral antibiotics – Oral antibiotic such as doxycycline (Oracea) are helpful to treat moderate to severe cases of rosacea with bumps and pimples.
• Oral acne drug – If severe rosacea doesn’t respond to other treatment options, then doctor may suggest isotretinoin (like Amnesteem, Claravis. Avoid use of this drug during pregnancy as it can cause serious birth defects.

Laser therapy

Laser therapy can be helpful to make enlarged blood vessels less visible. Because the laser targets visible veining on the skin.

Lifestyle changes for rosacea

In addition to these treatment options there are certain lifestyle changes that can be effective for managing your rosacea and avoiding rosacea’s most common triggers.

• Taking more anti-inflammatory foods such as kale, ginger, and avocados that are high in antioxidants and vitamins such as niacinamide are helpful
• Create a daily routine to manage your stress and anxiety that can trigger rosacea flare-ups.
• Wear sunscreen regularly whenever you go outside, to prevent rosacea flare-ups from sun exposure and UV rays.
• Avoid certain kind of medications, like topical steroids, vasodilators etc. that may increase the rosacea or lead to flushing.

Long-term outlook for rosacea

As symptoms of rosacea are seen differently in everyone, so it takes time to figure out how to manage the condition. The best way to manage this condition is to work with your doctor to develop a treatment plan and follow his advice and avoid the trigger factors.