What are the primary symptoms of rosacea. How is rosacea diagnosed and treated. What triggers can exacerbate rosacea symptoms. How does rosacea impact quality of life. What self-help measures can alleviate rosacea symptoms.

Understanding Rosacea: A Complex Skin Condition

Rosacea is a chronic skin condition that primarily affects the face. While its exact cause remains elusive, this persistent disorder can significantly impact an individual’s appearance and self-esteem. Characterized by periods of flare-ups and remissions, rosacea requires long-term management to control symptoms effectively.

Is rosacea a rare condition? Contrary to popular belief, rosacea is quite common, affecting millions of people worldwide. However, its prevalence and severity can vary among different populations and skin types.

Recognizing the Telltale Signs of Rosacea

Identifying rosacea early can lead to more effective management. The condition typically manifests through a range of distinctive symptoms:

• Facial flushing and persistent redness
• Visible blood vessels (telangiectasia)
• Bumps and pimples (papules and pustules)
• Burning or stinging sensations
• Skin thickening, particularly on the nose (rhinophyma)
• Eye irritation (ocular rosacea)

Can rosacea symptoms vary from person to person? Indeed, the presentation of rosacea can differ significantly among individuals. Some may experience only a few symptoms, while others may contend with a broader range of issues.

Unraveling the Mysteries Behind Rosacea Causes

While the exact cause of rosacea remains unknown, researchers have identified several factors that may contribute to its development:

1. Genetic predisposition
2. Abnormalities in facial blood vessels
3. Microscopic skin mites (Demodex folliculorum)
4. Helicobacter pylori bacteria
5. Immune system dysfunction

Do environmental factors play a role in rosacea development? Environmental triggers can certainly exacerbate rosacea symptoms, but they are not considered primary causes. Instead, they act as catalysts that can initiate or worsen flare-ups in individuals predisposed to the condition.

Navigating the Diagnosis Process for Rosacea

Diagnosing rosacea can be challenging due to its similarity to other skin conditions. Healthcare providers typically follow a comprehensive approach:

• Visual examination of the skin
• Detailed medical history
• Discussion of symptoms and potential triggers
• Exclusion of other conditions with similar presentations

Are there specific tests to diagnose rosacea? While there is no definitive test for rosacea, healthcare providers may sometimes order additional tests, such as skin biopsies or blood tests, to rule out other conditions that may mimic rosacea symptoms.

Exploring Effective Treatment Strategies for Rosacea

Managing rosacea often requires a multifaceted approach tailored to each individual’s specific symptoms and triggers. Treatment options may include:

Topical Medications

• Metronidazole
• Azelaic acid
• Ivermectin
• Brimonidine

Oral Medications

• Antibiotics (e.g., doxycycline, minocycline)
• Isotretinoin (for severe cases)

Light-Based Therapies

• Intense Pulsed Light (IPL)
• Laser therapy

How long does it take to see improvements with rosacea treatment? The timeline for improvement can vary depending on the individual and the chosen treatment. Some people may notice changes within a few weeks, while others may require several months of consistent therapy to achieve significant results.

Identifying and Managing Rosacea Triggers

Recognizing and avoiding personal triggers is crucial for managing rosacea effectively. Common triggers include:

• Sun exposure
• Extreme temperatures
• Spicy foods and hot beverages
• Alcohol consumption
• Stress and anxiety
• Certain skincare products
• Strenuous exercise

Can trigger factors change over time? Yes, rosacea triggers can evolve throughout an individual’s life. Keeping a symptom diary can help identify new triggers and track the effectiveness of avoidance strategies.

Implementing Effective Self-Help Measures for Rosacea

In addition to medical treatments, several self-help strategies can complement rosacea management:

1. Gentle skincare routine with non-irritating products
2. Daily use of broad-spectrum sunscreen
3. Stress reduction techniques (e.g., meditation, yoga)
4. Dietary modifications to avoid trigger foods
5. Use of green-tinted makeup to neutralize redness
6. Avoiding extreme temperature changes
7. Protecting the face from harsh weather conditions

Is it possible to completely prevent rosacea flare-ups through lifestyle changes? While lifestyle modifications can significantly reduce the frequency and severity of flare-ups, complete prevention may not be achievable for all individuals. Consistent management and adaptation of strategies are key to long-term success.

The Psychological Impact of Rosacea: Beyond Skin Deep

Living with rosacea can have profound effects on an individual’s emotional well-being and quality of life. Common psychological challenges include:

• Low self-esteem and poor body image
• Social anxiety and avoidance behaviors
• Depression and feelings of frustration
• Work-related stress and performance issues
• Relationship difficulties

How can individuals cope with the emotional impact of rosacea? Seeking support through therapy, support groups, or online communities can provide valuable coping strategies and emotional validation. Additionally, working closely with healthcare providers to achieve optimal symptom control can significantly improve quality of life.

Rosacea and Comorbid Conditions

Research has identified potential associations between rosacea and other health conditions. These comorbidities may include:

• Cardiovascular diseases
• Gastrointestinal disorders (e.g., inflammatory bowel disease)
• Neurological conditions (e.g., migraines)
• Autoimmune disorders
• Mental health issues (e.g., anxiety, depression)

Does having rosacea increase the risk of developing other health problems? While associations have been observed, it’s important to note that correlation does not imply causation. Individuals with rosacea should work closely with their healthcare providers to monitor overall health and address any concerns promptly.

Navigating Rosacea Care: Finding the Right Healthcare Team

Managing rosacea often requires a multidisciplinary approach. Key healthcare professionals who may be involved in rosacea care include:

1. Dermatologists
2. Primary care physicians
3. Ophthalmologists (for ocular rosacea)
4. Mental health professionals
5. Nutritionists

How can patients ensure they receive comprehensive care for their rosacea? Open communication with healthcare providers, regular follow-up appointments, and proactive discussion of concerns are essential for optimal management. Patients should feel empowered to ask questions and seek second opinions when necessary.

The Role of Diet in Rosacea Management

While dietary triggers can vary among individuals, some general dietary guidelines may help manage rosacea symptoms:

• Avoiding spicy foods and hot beverages
• Limiting alcohol consumption, particularly red wine
• Reducing caffeine intake
• Incorporating anti-inflammatory foods (e.g., omega-3 fatty acids, fruits, vegetables)
• Staying hydrated with water and non-caffeinated beverages

Can specific diets cure rosacea? No single diet has been proven to cure rosacea. However, identifying personal dietary triggers and making appropriate modifications can significantly reduce symptom frequency and severity.

Emerging Therapies and Future Directions in Rosacea Research

The field of rosacea research continues to evolve, with several promising avenues under investigation:

1. Novel topical agents targeting specific inflammatory pathways
2. Advanced light-based therapies with improved precision and efficacy
3. Microbiome-based treatments addressing skin flora imbalances
4. Gene therapy approaches for individuals with genetic predispositions
5. Personalized medicine strategies tailored to individual rosacea subtypes

When might new rosacea treatments become available? The timeline for new treatment approvals can vary. While some therapies may become available in the near future, others may require several years of clinical trials and regulatory review before reaching patients.

Rosacea in Special Populations

Rosacea can affect individuals across various demographics, but certain populations may face unique challenges:

• Pregnant women: Medication restrictions and hormonal influences
• Children: Rare cases of pediatric rosacea requiring specialized care
• Elderly individuals: Increased skin sensitivity and potential drug interactions
• People with skin of color: Diagnostic challenges and tailored treatment approaches

How does rosacea management differ in special populations? Healthcare providers must consider factors such as medication safety, age-related skin changes, and potential comorbidities when developing treatment plans for these groups. Individualized care and close monitoring are essential for optimal outcomes.

The Global Impact of Rosacea: Prevalence and Socioeconomic Factors

Rosacea affects millions of people worldwide, but its prevalence and impact can vary across different regions and populations:

• Higher prevalence in fair-skinned individuals of Northern European descent
• Increasing recognition in people with skin of color
• Variations in healthcare access and treatment options between countries
• Economic burden of long-term management and potential work-related impacts
• Cultural differences in perceptions of skin conditions and seeking medical care

How can global awareness of rosacea be improved? Initiatives focused on public education, healthcare provider training, and research collaborations can help bridge gaps in rosacea awareness and care across diverse populations.

Rosacea and Environmental Factors

Environmental influences can play a significant role in rosacea symptom exacerbation:

1. Climate changes and extreme weather conditions
2. Air pollution and particulate matter exposure
3. Occupational hazards (e.g., heat, chemicals)
4. Indoor air quality and humidity levels
5. UV radiation from natural and artificial sources

Can environmental modifications help manage rosacea symptoms? Implementing strategies such as using air purifiers, maintaining optimal indoor humidity, and protecting the skin from environmental stressors can complement medical treatments and improve overall symptom control.

Rosacea and Skincare: Navigating the Product Landscape

Choosing appropriate skincare products is crucial for individuals with rosacea. Key considerations include:

• Gentle, fragrance-free cleansers
• Non-comedogenic and hypoallergenic moisturizers
• Mineral-based sunscreens with broad-spectrum protection
• Avoiding products containing potential irritants (e.g., alcohol, menthol, witch hazel)
• Patch-testing new products before full facial application

Are natural or organic skincare products better for rosacea-prone skin? While some natural ingredients can be beneficial, not all natural or organic products are suitable for rosacea-prone skin. It’s essential to focus on product formulations and individual skin reactions rather than relying solely on “natural” labels.

The Role of Stress Management in Rosacea Care

Stress is a common trigger for rosacea flare-ups. Implementing effective stress management techniques can complement medical treatments:

1. Mindfulness meditation and deep breathing exercises
2. Regular physical activity and yoga
3. Adequate sleep and consistent sleep patterns
4. Time management and prioritization strategies
5. Seeking professional support through counseling or therapy

Can stress reduction alone control rosacea symptoms? While stress management is an important component of rosacea care, it is typically most effective when combined with appropriate medical treatments and lifestyle modifications tailored to individual needs.

Rosacea and Cosmetic Procedures: Weighing the Risks and Benefits

Individuals with rosacea may consider cosmetic procedures to address persistent symptoms or improve their appearance. Common procedures include:

• Laser therapy for visible blood vessels
• Chemical peels for skin texture improvement
• Microneedling for collagen stimulation
• Botulinum toxin injections for facial flushing
• Dermal fillers for volume restoration

Are cosmetic procedures safe for individuals with rosacea? While many procedures can be safely performed on rosacea-prone skin, it’s crucial to work with experienced practitioners who understand the unique considerations for rosacea patients. Careful pre-procedure preparation and post-procedure care are essential for optimal results and minimizing potential complications.

Rosacea and Hormonal Influences

Hormonal fluctuations can impact rosacea symptoms in some individuals. Key hormonal factors to consider include:

1. Menstrual cycle variations
2. Pregnancy and postpartum changes
3. Menopause and hormone replacement therapy
4. Thyroid disorders
5. Androgen imbalances

How can hormonal influences on rosacea be managed? Working closely with healthcare providers to address underlying hormonal imbalances and adjusting rosacea treatment plans during periods of hormonal fluctuation can help maintain symptom control. In some cases, hormonal therapies may be considered as part of a comprehensive management approach.

Rosacea | NHS inform

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About rosacea

Rosacea is a common but poorly understood long-term skin condition that mainly affects the face.

It can be controlled to some degree with long-term treatment, but sometimes the changes in physical appearance can have a significant psychological impact.

Symptoms of rosacea

Symptoms often begin with episodes of flushing, where the skin turns red for a short period, but other symptoms can develop as the condition progresses, such as:

• burning and stinging sensations
• permanent redness
• spots (papules and pustules)
• small blood vessels in the skin becoming visible

Rosacea is a relapsing condition, which means there are periods when symptoms are particularly bad, but less severe at others.

Read about the symptoms of rosacea

Rosacea symptoms include redness and flushing, as well as stinging and spots.

Source: https://dermnetnz.org/

When to see your GP

See your GP if you have persistent symptoms that could be caused by rosacea. Early diagnosis and treatment can help stop the condition getting worse.

There’s no specific test for rosacea, but your GP will often be able to diagnose the condition by:

• examining your skin
• asking about your symptoms
• asking about possible triggers you may have

In some circumstances your GP may arrange further tests to rule out other conditions with similar symptoms, such as lupus or the menopause. For example, these could be a blood test or skin biopsy, where a small scraping of skin is removed and examined.

Causes of rosacea

The exact cause of rosacea is unknown, although a number of possible factors have been suggested, including abnormalities in the blood vessels of the face and a reaction to microscopic mites commonly found on the face.

Although they’re not thought to be direct causes of the condition, several triggers have been identified that may make rosacea worse.

These include:

• exposure to sunlight
• stress
• strenuous exercise
• hot or cold weather
• hot drinks
• alcohol and caffeine
• certain foods, such as spicy foods

Read about causes of rosacea

Treating rosacea

There’s currently no cure for rosacea, but treatment can help control the symptoms.

Long-term treatment is usually necessary, although there may be periods when your symptoms improve and you can stop treatment temporarily.

For most people, treatment involves a combination of self-help measures and medication, such as:

• avoiding known triggers – for example, avoiding drinks containing alcohol or caffeine
• creams and gels – medications applied directly to the skin to reduce spots and redness
• oral medications – tablets or capsules that can help clear up more severe spots, such as oral antibiotics

In some cases procedures such as laser and intense pulsed light (IPL) treatment may be helpful.  These involve beams of light being aimed at the visible blood vessels in the skin to shrink them and make them less visible.

Read about more about treating rosacea and self-help measures for rosacea

Living with rosacea

Any long-term (chronic) condition can have an adverse psychological effect, but rosacea can be particularly troublesome as it affects your appearance. This can change how you feel about yourself and how you interact with others.

Many people with rosacea have reported feelings of low self-esteem, embarrassment and frustration.

It’s important to try to come to terms with the fact you have a chronic condition that, although incurable, is controllable.

Persevering with your treatment plan and avoiding your individual triggers are the best ways of controlling your symptoms.

As your physical symptoms improve, you may start to feel better psychologically and emotionally.

If you have rosacea, take comfort in knowing you’re not alone. There are millions of people living with the condition in the UK and across the world.

You can find support and information from organisations like:

• Changing Faces – a charity for people with a visible difference or facial disfigurement, who can be contacted on 0300 012 0275 for counselling and advice

Speak to your GP if you’re feeling depressed as a result of your condition. They may recommend further treatment if necessary.

Ocular rosacea

Rosacea that affects your eyes (ocular rosacea) can lead to a number of eye problems, some of which can be serious.

Symptoms of ocular rosacea can include:

• feeling like there is something in your eyes
• dry eyes
• irritated and bloodshot eyes
• inflammation of the eyelids (blepharitis)

Rosacea can sometimes cause the cornea, the transparent layer at the front of the eyeball, to become inflamed and damaged. This is known as keratitis.

This damage can make the cornea vulnerable to ulceration and infection, which could potentially threaten your sight.

Symptoms of serious problems with your corneas include:

• eye pain
• sensitivity to light (photophobia)
• deterioration in your vision

Contact your GP immediately if you think you may have a problem with your corneas. If this isn’t possible, visit your nearest accident and emergency (A&E) department.

If keratitis isn’t treated promptly by an ophthalmologist, a doctor who specialises in treating eye conditions, there’s a risk of permanent vision loss.

Symptoms of rosacea

Rosacea causes a range of symptoms, although not everyone will experience them all.

Most people with rosacea have periods when their symptoms are particularly troublesome, followed by periods when their symptoms are less so.

The main symptoms of rosacea include:

• flushing
• persistent facial redness
• visible blood vessels
• papules and pustules
• thickened skin

These are discussed in more detail below.

Other symptoms associated with rosacea include:

• sensitive skin – burning, itching, stinging and pain
• dry, rough skin
• raised red patches (plaques) on your skin
• facial swelling (lymphoedema)

Rosacea can cause different symptoms, including facial redness and flushing.

Source: https://dermnetnz.org/

Permanent damage to the face (scarring) almost never occurs in rosacea.

Flushing

Flushing is when your skin turns red for a short period – usually a few minutes. It tends to mainly affect the face, although it can spread to your neck and chest.

In some cases the redness may be accompanied by an unpleasant feeling of heat.

In rosacea flushing is often caused by a certain trigger, such as sun exposure, hot drinks or exercise. See causes of rosacea for more information about possible triggers.

Persistent facial redness

Persistent facial redness (erythema) is like a blush or a patch of sunburn that doesn’t go away, or the sort of blotchy skin often associated with drinking too much alcohol.

This can be upsetting for those with rosacea as people can mistakenly assume they are heavy drinkers.

The redness usually affects the cheeks, nose and chin, but may spread to other areas, such as the forehead, neck and chest.

Visible blood vessels

Over time the blood vessels in the skin may become permanently widened (dilated) and visible. The medical name for visible blood vessels is telangiectasia.

Papules and pustules

If you have rosacea, you may develop round red bumps that rise from your skin (papules) and pus-filled swellings (pustules).

These spots appear on your face and are similar to acne. Rosacea used to be called acne rosacea, but the 2 conditions are quite different.

In rosacea there are no blackheads and the skin is not greasy, but dry and peeling. Rosacea spots also don’t cause scarring.

Thickened skin

In the most serious cases of rosacea the skin can thicken and form excess tissue, usually around the nose. This causes the nose to take on a large, bulbous appearance (rhinophyma).

Rhinophyma is an uncommon, severe symptom of rosacea and takes several years to develop. It almost exclusively affects men.

Causes of rosacea

The exact cause of rosacea is unknown, although a number of potential factors have been suggested.

It’s possible a combination of these factors may be responsible for the condition, although there isn’t enough evidence to say this for certain.

Some of the main factors that have been suggested are outlined below.

Blood vessel abnormalities

Some experts believe abnormalities in the blood vessels of the face may be a major contributing factor for rosacea. This may explain symptoms of flushing, persistent redness and visible blood vessels.

It’s not known what causes these abnormalities. But sun damage may be responsible for degeneration of the elastic tissue of the skin and the dilation of blood vessels.

Skin peptides

Recent research has shown external triggers such as ultraviolet (UV) light, spicy food, alcohol (particularly red wine), exercise, stress, heat and cold can lead to the activation of certain molecules within the skin called peptides.

Increased levels of these peptides may in turn affect the immune system or nerves and blood vessels (neurovascular system) of the skin. Activation of these systems can cause dilation of blood vessels, redness and inflammation.

Microscopic mites

Microscopic mites called demodex folliculorum usually live harmlessly on human skin, but people with rosacea have particularly large numbers, which may play a role in the condition.

It is currently uncertain whether the mite is a cause or an effect of rosacea, although some researchers have suggested the symptoms may be caused by the skin reacting to bacteria in the mites’ faeces.

Helicobacter pylori bacteria

Helicobacter pylori bacteria are bacteria found in the digestive system. It’s been suggested these bacteria may be a possible cause of rosacea, although a link hasn’t been proven.

One theory is the bacteria may stimulate the production of a protein called bradykinin, which is known to cause blood vessels to expand.

Genetics

Rosacea seems to be more common in families, although it’s not clear which genes – if any – are involved or how they’re passed on.

Triggers of rosacea

Although they’re not thought to be direct causes of the condition, many people with rosacea find certain triggers make their symptoms worse.

Different people can have different triggers, but triggers that have been commonly reported include:

• exposure to sunlight
• stress
• hot or cold weather
• strong winds
• strenuous exercise
• alcohol
• hot baths
• spicy foods
• hot drinks
• humidity
• caffeine – found in tea, coffee and cola
• the menopause
• dairy products
• other medical conditions
• certain medicines – such as amiodarone, corticosteroids and high doses of vitamins B6 and B12

Treating rosacea

Although rosacea can’t be cured, treatment can help keep the symptoms under control.

Long-term treatment is usually necessary, although there may be periods where your symptoms improve and you can stop treatment temporarily.

Treatment choices depend on which type of symptom is most troublesome, but usually involves a combination of self-help measures and medication, and are outlined below. 

Self-help measures

There are a number of things you can do yourself to help keep the symptoms of rosacea under control, including:

• avoiding things that trigger your symptoms – for example, by using sun cream and covering yourself up if direct sunlight makes your symptoms worse
• taking good care of your skin – for example, by using products suitable for sensitive skin
• using make-up – patches of persistent red skin can be disguised using specially designed camouflage make-up
• keeping your eyelids clean – if rosacea is causing your eyelids to become inflamed (blepharitis)

Treating papules and pustules

If you have round red bumps that rise from your skin (papules) and pus-filled swellings (pustules) caused by rosacea, there are a number of different medications that can be effective.

These can be divided into topical treatments that are applied to the skin, or oral treatments, which are taken by mouth.

Topical treatments

Topical medications are usually prescribed first. These include:

• metronidazole cream or gel
• azelaic acid cream or gel
• ivermectin cream

Ivermectin is a relatively new medicine. There’s some evidence to suggest it may be more effective and perhaps less irritating to the skin than metronidazole, although it’s not currently available on the NHS everywhere and may only be recommended if the other treatments don’t work.

You’ll usually need to apply these topical treatments once or twice a day, taking care not to get them in your eyes or mouth. It may be several weeks before you notice any significant improvement in your symptoms.

Side effects of these treatments can include a burning or stinging sensation, itchiness and dry skin.

Oral antibiotics

If your symptoms are more severe, an oral antibiotic medication may be recommended as these can help reduce inflammation of the skin.

Antibiotics often used to treat rosacea include tetracycline, oxytetracycline, doxycycline and erythromycin. 

These medications are usually taken for 4 to 6 weeks, but longer courses may be necessary if the spots are persistent.

For example, a low-dose doxycycline capsule is available if oral antibiotics need to be taken long term.

Common side effects of these medications include:

• feeling and being sick
• diarrhoea
• bloating and indigestion
• tummy (abdominal) pain
• loss of appetite

Some of the medications used can also make your skin sensitive to sunlight and artificial sources of light, such as sun lamps and sunbeds.

As with the topical treatments mentioned above, these medications usually need to be taken once or twice a day and you may not notice a significant improvement in your symptoms for several weeks.

Oral isotretinoin

Isotretinoin is a medicine often used to treat severe acne, but at lower doses it’s also occasionally used to treat rosacea.

As isotretinoin is a strong medication that can cause a range of side effects, it can only be prescribed by a specialist in treating skin conditions (dermatologist) and not your GP.

Common side effects of isotretinoin include:

• dryness and cracking of the skin, lips and nostrils
• inflammation of your eyelids (blepharitis) or eyes (conjunctivitis)
• headaches
• muscle or joint pain
• back pain
• blood in your urine (haematuria)
• mood changes

Isotretinion can also cause birth defects if taken during pregnancy.

Treating facial redness

Treating facial redness and flushing caused by rosacea is generally more difficult than treating papules and pustules caused by the condition. 

But as well as the self-help measures mentioned above, there are some medications that can help.

Brimonidine tartrate

Brimonidine tartrate is a relatively new medication for facial redness caused by rosacea. It comes in the form of a gel that’s applied to the face once a day.

The medication works by restricting the widening (dilation) of the blood vessels in your face. Research has shown it can start to have an effect about 30 minutes after it’s first used, and this can last for around 12 hours.

Common side effects of brimonidine tartrate include itchiness and a burning sensation where the gel is applied.

Less common side effects can include:

• a dry mouth
• headaches
• pins and needles
• dry skin

A rebound effect, where flushing becomes worse, has also been reported with this medication.

Oral treatments

Alternatively, there are a number of oral medications that may help improve redness caused by rosacea.

These include:

• clonidine – a medication that relaxes the blood vessels
• beta-blockers – medications that decrease the activity of the heart
• anxiety medications – medications sometimes used to help calm the person and reduce blushing 

It’s not clear how effective these medications are at treating redness caused by rosacea, but they may sometimes be prescribed under the supervision of a dermatologist.

Laser and intense pulsed light (IPL) treatment

Redness and visible blood vessels (telangiectasia) can also sometimes be successfully improved with vascular laser or intense pulsed light (IPL) treatment. These treatments may also improve flushing.

A referral to a dermatologist is usually required before having these treatments and they’re not usually available on the NHS, so you may need to pay for them privately. Around 2 to 4 treatments may be needed, so the overall cost may be significant.

Laser and IPL machines produce narrow beams of light that are aimed at the visible blood vessels in the skin. The heat from the lasers damages the dilated veins and causes them to shrink so they’re no longer visible, with minimal scarring or damage to the surrounding area.

Laser treatment can cause pain, but most people don’t need an anaesthetic. Side effects of laser treatment are usually mild and can include:

• bruising
• crusting of the skin
• swelling and redness of the skin
• blisters (in rare cases)
• infection (in very rare cases)

These side effects usually only last a few days and are rarely permanent.

Treating thickened skin

In some people with rosacea the skin of the nose can become thickened. This is known as rhinophyma.

If you have severe rhinophyma, your GP may refer you to a dermatologist or plastic surgeon to discuss ways the appearance of your skin can be improved.

A number of surgical treatments are available to remove any excess tissue and remodel the nose into a more pleasing shape.

This may be done with a laser, a scalpel or specially designed abrasive instruments using a technique called dermabrasion.

Treating eye problems

If rosacea is affecting your eyes (ocular rosacea), you may require further treatment. 

For example, you may need to use lubricating eye drops or ointment if you have dry eyes, or oral antibiotics if you have blepharitis.

If initial treatment isn’t effective or you develop any further problems with your eyes, you’ll need to be referred to an eye specialist called an ophthalmologist for further assessment and treatment.

Preventing rosacea

If you have rosacea, there are a number of things you can do to help keep the condition under control.

Avoid triggers

Many people with rosacea notice certain triggers make their symptoms worse. Although it’s not always practical or possible, taking steps to avoid these triggers can help reduce the severity and frequency of your symptoms.

If you’re not sure whether your symptoms have a specific trigger, it may be useful to keep a diary to identify whether your symptoms get worse depending on things like the activities you do and foods or drinks you have.

Advice about how to avoid some common triggers can be found below.

Sunlight

As sunlight is the most commonly reported trigger of rosacea, you should use sun cream whenever possible, even when it’s overcast.

A sun cream with a sun protection factor (SPF) of at least 30 is recommended. A broad-spectrum sun cream that protects against UVA and UVB light should be used.

Using sun creams specifically designed for children may help reduce skin irritation. Covering exposed skin with clothes or a sun hat may also help.

Try to minimise your exposure to the sun during the summer months, particularly in the middle of the day when the sun is at its hottest. 

But remember, sun can also be strong in the morning and evening, so take adequate precautions at these times as well.

Stress

Stress is also a commonly reported trigger of rosacea. Successfully managing your stress levels can help control your symptoms.

Ways you can reduce stress include:

• learning relaxation techniques, such as deep breathing exercises, meditation and yoga
• taking regular exercise

As strenuous exercise can sometimes make rosacea symptoms worse, a low-intensity exercise programme, such as walking or swimming, may be better than high-intensity activities, such as running or aerobics.

Read about stress management.

Food and drink

Some of the most commonly reported food- and drink-related triggers are alcohol and spicy foods. You may want to try completely removing these from your diet to see if your rosacea improves.

But there are many other dietary triggers that can also affect some people with rosacea.

It’s a good idea to include information about how your diet affects your rosacea symptoms in your rosacea diary.

Cold weather

Covering your face and nose with a scarf can help protect your skin from cold temperatures and wind.

If you need to spend considerable time outside during cold weather, protect your face with a balaclava.

Skincare techniques

The advice below about skincare techniques may also help control your rosacea symptoms.

• Clean your skin every morning and evening using a gentle, non-abrasive cleanser. Use soap-free cleansers with non-alkaline or neutral pH. Avoid scented soaps and alcohol-based skin cleansers
• Rinse your face with lukewarm water and allow skin to dry thoroughly before you apply medication or make-up
• Look for products suitable for sensitive skin. These are usually described as mild, hypoallergenic, fragrance-free and non-comedogenic (will not block pores)
• Use a moisturiser to soothe skin if it feels sore
• Avoid oil-based or waterproof cosmetics requiring solvents for removal. Use water-based make-up and skin products instead
• Avoid astringents, toners and other facial or hair products that contain ingredients that might irritate your skin, such as fragrances, alcohol, menthol, witch hazel, eucalyptus oil, camphor, clove oil, peppermint, sodium lauryl sulphate and lanolin
• You may want to avoid using anything on your skin that you aren’t sure of. You can then gradually reintroduce products once your symptoms have been treated and cleared to see if you can use them again without any problems
• Men may find that using an electric razor, rather than a blade, helps reduce skin irritation
• Some people find regular gentle facial massage reduces swelling (lymphoedema)
• Don’t use steroid cream unless you’re specifically instructed to by your GP, as it may make your symptoms worse

Skin camouflage 

It may be possible to disguise patches of persistent red skin using specially designed camouflage make-up.

The charity Changing Faces offers a skin camouflage service, available nationally and free of charge, to help with the use of these creams.

Your GP or dermatologist can refer you to the skin camouflage service and prescribe skin camouflage make-up.

Eyelid hygiene

If your eyelids are inflamed as a result of rosacea (blepharitis), cleaning your eyelids every day with warm water and a small amount of cleaning solution can help ease your symptoms.

Avoiding eye make-up can also help reduce your symptoms, but if you do choose to wear eye make-up, make sure it is a type that washes off easily so you can still clean your eyelids.

Soothing Rosacea Itch – Rosacea Center

Although rosacea is not always an itchy condition, some people with rosacea do experience itchiness. Rosacea itself is usually not the cause of the itching — and the appropriate anti-itch treatment depends on its underlying cause. Rosacea itch usually results from these culprits:

Folliculitis: This inflammation of the hair follicles is sometimes caused by ingrown hairs. Infection from the bacteria Staphylococcus can develop in inflamed hair follicles on the face of someone with rosacea. Folliculitis is treated with both topical and oral antibiotics, or topical antifungals if a fungal infection is present. Men with rosacea who are prone to folliculitis may want to forego shaving, or use a new razor with every shave, to prevent a recurrence of folliculitis.

Dry skin: If dry skin is causing your rosacea itch, you may need to make changes in your home environment. For example, in the colder months, put your thermostat on a lower setting because heat dries out the air. Don’t sit close to a fireplace or other heat source, as these can contribute to dry skin. Using a humidifier may offer some anti-itch relief. Also, avoid wearing wool or tight-fitting clothing in the winter months because this may exacerbate dry skin and itchiness.

Topical medications or skin care products. Certain skin care product ingredients may irritate and dry out your skin and contribute to rosacea itch. These ingredients include alcohol, witch hazel, menthol, and eucalyptus. “Active inflammation on the face from any cause results in tiny little breaks in the skin,” says Elise Brantley, MD, of the dermatology department at University of Cincinnati. “Because of this breakdown in your natural skin barrier, many things can further irritate the skin, including topical moisturizers with numerous chemicals or fragrances, sunscreens, or even your own natural body sweat.” But regardless of a product’s ingredients, if it causes itching, stop using it immediately.

Treatments for Rosacea Itch

To help get your rosacea itch under control, your dermatologist may prescribe a topical antibiotic such as metronidazole, erythromycin, or clindamycin. Topical antibiotics reduce inflammation associated with rosacea and are most effective in relieving rosacea itch caused by skin care products.

Strontium Calming Lotion, an over-the-counter product, not only relieves rosacea itch, but can also reduce the irritation that men with rosacea may get from shaving. Cool, moist compresses can often soothe itchy skin or you may find relief from rosacea itch using an over-the-counter antihistamine such as diphenhydramine (Benadryl and other brands).

Apply moisturizer often, particularly after bathing, but make sure the product doesn’t contain any irritating ingredients. Avoid using topical corticosteroids, such as hydrocortisone, because they only treat the itch, not the underlying cause. Additionally, long-term use of corticosteroids can have side effects, such as thinning of the skin, and may actually make your rosacea worse.

It’s important to avoid excess touching, rubbing, and scratching of your skin to prevent spreading staph infection associated with Folliculitis. Keep fingernails short and clean to reduce damage to skin caused by scratching.

How Your Dermatologist Can Help

Consult with your dermatologist as soon as you experience any itching associated with rosacea. After determining the cause of your rosacea itch, your dermatologist may prescribe anti-itch medications or make other recommendations for relief. If your current rosacea medication is irritating your skin, a different product may be available.

Let your dermatologists know about all of the skin care products and cosmetics you use, including prescriptions and over-the-counter treatments. It may help to actually bring these products with you to your appointment, so that your doctor can help identify any irritating, itch-inducing ingredients. Work as a team with your dermatologist to develop the ultimate plan for relief from rosacea itch.

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description, symptoms, diagnosis and treatment.

Scientific section of the clinic IAKI

Description

Rosacea is a chronic skin disease that is characterized by reddening of the skin, the presence of pustular rashes, thickening of the dermis and impaired epithelial detachment. Previously, the development of rosacea was prescribed for the presence of demodicosis, but these two diseases are different in their etiology, although each of them complicates the course of the other. In the pathogenesis of the development of rosacea lies the increased sensitivity of the vessels of the skin. If there is a genetic predisposition or the vessels are fragile and brittle, then in response to such irritants as sudden changes in temperature, dry and hot air, the vessels expand, which is not observed in the majority of people.

The incidence of rosacea in people with a history of gastritis is much higher than in those who do not have Helicobacter pylori, the bacterium that causes gastritis. Rosacea of ​​a medicinal nature is observed with prolonged use of corticosteroid ointments, skin arteries become thinner, more brittle and sensitive to minor temperature changes.

Symptoms

If, after contact with cold or hot water, after drinking hot drinks and alcohol, or with a sharp change in ambient temperature, the face instantly becomes covered with red spots that do not disappear for a long time.

Redness is localized in the T-zone of the face (forehead, nose, chin and cheeks). The first stages of rosacea, in which the main clinical manifestation is reddening of the skin, often go unnoticed, since they do not cause any discomfort and are easily masked by cosmetics.

Rashes on the face with rosacea begin to appear with persistent expansion of capillaries, blood flow causes a local increase in temperature, which makes it possible for the saprophytic microflora to actively multiply. The next stage of rosacea is manifested by the presence of bumps and bumps on the skin, which after a while turn into small pustules.

The skin becomes dense, rough to the touch, seals in rosacea are most intense in the T-zone. At this stage of rosacea, a persistent expansion of the vascular network (telangiectasia) appears, and therefore redness and swelling of the skin is already observed without any connection with provoking factors.

The lupoid form of rosacea is characterized by the presence of periorbital and perioral rashes in the form of brownish-red papules and nodules, the elements tend to merge and form an uneven, bumpy surface. Facial skin in unaffected areas, as a rule, is not changed and has a healthy appearance.

Rosacea can take a fulminant course during pregnancy, after childbirth, with appropriate therapy, rosacea disappears without a trace, but each subsequent pregnancy is associated with a relapse of rosacea.

If rosacea is diagnosed in men, then there is persistent redness and thickening of the skin on the nose. Rosacea in men is very often complicated by rhinophyma. With the progression of rosacea, the area around the eyes and eyelids is affected. There is discomfort during blinking, a feeling of pain, dryness and sand in the eyes. With rosacea in the later stages, profuse lacrimation is noted. In this case, ocular rosacea is diagnosed, but it should be borne in mind that clinical manifestations may be several years ahead of skin lesions. In some cases, ocular rosacea is complicated by rosaceakeratitis, leading to loss of vision. Itching, burning, a feeling of tightness of the skin and “goosebumps” are observed in almost all patients with rosacea.

Diagnosis

• History taking and complaints in dermatology
• Visual examination in dermatology
• Palpation in dermatology
• Definition of dermographism
• Microscopy of skin scrapings

Diagnosing rosacea is not difficult, usually a visual examination by a dermatologist is more than enough to make a diagnosis. But in view of the fact that demodex is activated in rosacea and relapses of demodicosis are most likely, often, having discovered demodex, they begin to treat not rosacea, but complications of the disease. Such treatment only aggravates the condition of the patient with rosacea, and the disease progresses further.

If rosacea is complicated by the presence of pustules and vesicles with purulent contents, then a bacteriological culture is performed to study the skin microflora.

Attention! The volume of the diagnostic examination is selected by the doctor for each patient individually!

Do not self-medicate. If you suspect any symptoms, be sure to consult a doctor!

Rosacea ❌Treatment of Rosacea or rosacea in Kyiv 2023

What rosacea looks like in different stages

Rosacea – is a progressive skin disease that affects the central part of the face, ie the cheeks, forehead, chin and nose. Dermatologists distinguish four stages.

Areas of facial redness associated with rosacea

STAGE 1: Early stage rosacea

Early stage rosacea is characterized by flushing of the face due to various triggers, including:

• intense exercise;
• spicy or spicy food;
• hot drinks;
• alcoholic beverages
• excessive exposure to sunlight.

Initial facial flushing may come and go over a period of time, weeks to months. Often the redness looks like a sunburn.

STAGE 2: Mild rosacea

In this stage, the blood vessels of the face, which have dilated to cope with the increased blood flow through them, remain open further.

The redness becomes persistent, lasting longer than before before disappearing indefinitely. The skin of the face becomes sensitive to the point that when trying to apply makeup or lotion, an unpleasant burning sensation can occur.

Mild rosacea, sourced at https://dermnetnz.org/

STAGE 3: Moderate rosacea

At this stage, rosacea persists for several days or weeks. Structural damage to the vessels of the face occurs to varying degrees. Blood vessels can become chronically inflamed and dilated, appearing on the face, especially the cheeks, as red lines called telangiectasias.

Moderate rosacea, sourced from https://dermnetnz. org/

STAGE 4: Severe rosacea

This is the most clinically advanced stage of the disease, presenting the patient with many problems, including facial pain, burning, severe flushing, swelling, and inflammation due to accumulations of papules and pustules.

The skin of the face became dark red, and the blood vessels were severely damaged. By stage 4 rosacea, approximately 50% of patients develop eye involvement, dryness and irritation.

One potential serious problem that severe rosacea can cause is rhinophyma, or “bulging nose”

Rosacea rhinophyma, https://dermnetnz.org/

Symptoms of rosacea

The most common symptoms of rosacea are :

• dilated capillaries (telangiectasias)
• Permanent blush on nose and cheeks
• pimples with yellow head on forehead, cheeks and chin
• painless nodules under the skin
• slightly swollen cheeks and nose
• frequent and persistent reddening of the skin
• burning or tingling sensation
• small punctate rash limited to the face.

Diagnostic signs of rosacea

The presence of any of these signs is diagnostic of rosacea.

• Persistent redness
  Persistent redness of the face is the most common individual sign of rosacea and may resemble a blush or sunburn that does not last long.
• Skin thickening

The skin may thicken and enlarge, most often on the nose (rhinophyma). This condition is less common, but in severe cases can lead to facial disfigurement and nasal breathing problems.

The main signs of rosacea

The presence of at least two of these signs is a diagnostic sign of rosacea.

• Flushing
  This flushing of the face may be accompanied by a feeling of heat, warmth or burning that comes and goes and is often an early sign of rosacea.
• Appearance of papules and pustules.

Facial papulo-pustular rosacea sourced from https://dermnetnz. org/

• Visible blood vessels
  Many people with rosacea have prominent and visible small blood vessels called telangiectasias appear on the cheeks ah, back of the nose and other areas of the central part of the face.

Telangiectasias, dermoscopy image, https://dermnetnz.org/

• Eye irritation
  In many patients with rosacea, the eyes may be permanently irritated and appear watery or bloodshot. The eyelids may also become red and swollen, and recurrent stye is common.

Scabs and scales may accumulate around the eyelids or eyelashes, and patients may notice visible blood vessels around the edges of the eyelids. Severe cases can lead to corneal damage and decreased visual acuity

Eye redness in rosacea, ocular form, https://dermnetnz.org/

Types of rosacea

The clinical manifestations of rosacea are extremely numerous and varied, therefore the type of rosacea is assessed by the majority of symptoms in a given patient belonging to one of the four main types of rosacea

A description of each type of rosacea includes the minimum signs and symptoms necessary for diagnostics.

Patients may have characteristics of more than one rosacea subtype at the same time.

Type 1: Erythematous telangiectatic rosacea

The erythematous type of rosacea is characterized by flushing of the cheeks and persistent central erythema of the face. Telangiectasias are common but are not the main symptom for diagnosis.

Erythematous-telangiectatic rosacea, stages of disease severity

Erythematous-telangiectatic rosacea on the cheeks iectatic rosacea on the cheeks and nose, source https://dermnetnz. org/

Erythematous telangiectatic rosacea, source https://dermnetnz.org/

Type 2: Papulopustular rosacea

Includes persistent central facial erythema with transient papules ah, pustules. Burning and tingling may also be noted.

As with other types of rosacea, these spots appear mainly in the center of the face. In very severe, untreated cases, the chest and shoulders may also be affected. Unlike acne, which usually appears during adolescence, papulopustular rosacea is more common in adults, especially middle-aged women.

Papulopustular rosacea, nasal rash, source https://dermnetnz.org/

Papulopustular rosacea, forehead rash, source https://dermnetnz.org/

9 0004 Papulo- pustular rosacea, eruptions on the cheeks and nose, source https://dermnetnz.org/

Type 3: Phymatous rosacea

This type of rosacea includes thickening of the skin, uneven nodules (papules) on the surface of the skin, and thickening of the skin.

Phymatous rosacea most commonly presents as rhinophyma, but may appear elsewhere, including the chin, forehead, cheeks, and ears. Bulging, prominent follicles may appear in the phymatous area, and telangiectasias may be present.

This condition occurs when thickening of the skin due to phymatous rosacea causes skin growth around the nose. This condition is significantly more common in men than women and is almost always the result of poorly controlled or untreated rosacea

Phymatous rosacea and the development of rhinophyma

Phymatous rosacea, source https://dermnetnz.org/

Phymatous rosacea, source https://dermnetnz.org/

Phymatous rosacea, rhynphyma formation, source https://dermnetnz.org/

Type 4: Ocular rosacea

Ocular rosacea may present with:

• hyperemia of the conjunctiva
• foreign body sensation,
• burning or stinging,
• dry,
• itching,
• photosensitivity,
• blurred vision,
• telangiectasias of the conjunctiva and eyelid margins,
• Blepharitis, conjunctivitis, and uneven eyelid margins may occur.

Meibomian gland dysfunction manifesting as chalazion or chronic infection manifesting as stye (stye) are common in patients with ocular rosacea.

Some patients may experience loss of vision due to corneal complications (punctate keratitis, corneal infiltrates, ulcers or marginal keratitis).

Ocular rosacea – redness of the conjunctiva, skin around the eyes, telangiectasia of the conjunctiva and the rim of the eyelids or eyelids

The symptoms of rosacea can vary greatly from person to person, and people often have a combination of the above types. The approach to treatment will always be determined mainly by your individual symptoms and skin changes.

Rosacea in children and adolescents

Very few children and adolescents develop rosacea.

Signs to look out for and suspect rosacea:

• Red, irritated eyes
• Styes or frequent conjunctivitis
• Red, swollen eyelids, which may itch and appear greasy or crusty
• Long blush on the face

In children, prolonged redness may progress to permanent redness in the middle of the face. Some children develop pimple-like rashes.