Red patches of skin on your face, and tiny visible blood vessels and spots – these can be quite common symptoms. They may be caused by rosacea, a common facial skin inflammation.
Skin diseases can be difficult to cope with, and they often affect people’s self-confidence and wellbeing. But if you have rosacea, there is a lot you can do on your own.
Rosacea is a non-contagious inflammation of the skin on the face which can last for many years. It often develops into a rash, with papules and pustules (red and yellow pimples) and spidery red veins. It comes and goes in bouts. Sometimes the symptoms get worse and sometimes they get better or go away on their own.
The exact cause of rosacea is not clear. Some types of rosacea seem to run in families, and it is more common in people who have fair hair and fair skin.
Although the symptoms include pimples, rosacea is not acne. Acne is caused by too much sebum (oil) in the skin, and this is not what causes rosacea.
Rosacea is believed to be caused by several things: problems in the blood vessels in the skin, sun damage of the connective tissue, and an abnormal inflammatory reaction. Rosacea might also be a side effect of medication.
Rosacea usually starts over the age of 20. In Germany it affects about 2 to 5 out of 100 adults, and is more common in fair-skinned people and women. Many do not realize that they have a skin condition.
Rosacea has four different stages:
- Stage 1: Mostly skin redness
- Stage 2: Papules, pustules and spots
- Stage 3: Edemas (swelling due to fluid retention) and inflammatory bumps on the nose
- Stage 4: Symptoms affecting the eyes
Rosacea does not necessarily always get worse. The symptoms often stay the same over long periods of time.
The lumps and swelling are often particularly unpleasant, and can lead to a swollen and bulbous nose (a condition called rhinophyma). This is more common in men.
Rosacea can be especially problematic if it affects the eyelids or eyes. Inflammation around the eyelids and in the corneas, and dryness in the eyes can be painful. In very rare cases, rosacea can cause serious damage to the eyes if they are severely affected on a regular basis.
Over time, people often learn that certain things trigger their outbreaks. The triggers can vary from person to person, but anything that makes your face flush might make rosacea worse. Some people react to certain foods or alcohol, while others react to cosmetics or particular medications. Getting to know what these triggers are and avoiding them may help. It is not known if any particular dietary changes work.
There are a lot of creams, lotions and gels recommended for the treatment of rosacea. Creams and gels with either azelaic acid or the antibiotic metronidazole in them are used most commonly. Antibiotics can also be taken as tablets, but then the entire body is affected.
Although rosacea is normally harmless, facial redness can be very difficult to handle emotionally. Many people with the condition will have experienced unpleasant situations, like being stared at or realizing that others suspect that their nose is red because they drink too much alcohol. This usually happens because many people do not know much about rosacea. Other common skin conditions like acne are much better known. Some people find it helpful to be open about their skin condition and explain it to their family, friends and colleagues.
If the redness in your face is obvious and makes you self-conscious, cosmetics can help make the problem less obvious. You need to be careful, though, that the cosmetics that you use do not themselves make the rosacea worse. A dermatologist can help you choose the right products.
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National Rosacea Society (USA). Patients’ perspectives: living with rosacea. Dermatology Nursing 2007; 19: 274-275.
Rebora A. Papulopustular rosacea. In: Williams H, Bigby M, Diepgen T, Herxheimer A, Naldi L, Rzany B (Red.) Evidence-based Dermatology. London: Blackwell Publishing und BMJ Books. 2. Auflage 2008: 105-110.
Van Zuuren EJ, Kramer S, Carter B, Graber MA, Fedorowicz Z. Interventions for rosacea. Cochrane Database Sys Rev: Version 2011, Issue 3. CD003262.
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