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Acne Help (Home) > Common Skin Disorders > Rosacea

Rosacea: Cause, Symptom, Medication and Treatment

Rosacea is a skin disease that causes redness, pimples, and red lines on the nose, cheeks, chin, and forehead. A rash over the cheeks, nose, forehead, and chin often occurs. People sometimes call it "adult acne" because it can cause pimple-like outbreaks. Rosacea can also cause burning and soreness in the eyes and eyelids.

You may control rosacea with medication and by avoiding triggers that lead to flare-ups. Left untreated, rosacea can get worse. Large, disfiguring bumps on the nose and face and serious eye problems are signs of severe rosacea.

Fair-skinned people between the ages of 30 and 60 are most likely to develop rosacea. Women are more likely to have rosacea, but men usually have more severe symptoms.

Causes of rosacea

The exact cause of rosacea is unknown. One theory is that some people have blood vessels that are easily irritated. Another possible cause is tiny mites that normally live on our skin. People with rosacea have more of these mites on their faces than those who don't have the disease.

Pimples may result when a flare-up of rosacea heats the skin, causing bacteria to grow. Flare-ups often start when certain triggers cause the blood vessels in the face to dilate, or expand, which causes redness. Common triggers are exercise, hot weather, stress, spicy foods, alcohol, and hot baths. Swings in temperature from hot to cold or cold to hot can also trigger a flare of rosacea.

Symptoms of rosacea

Rosacea symptoms may include flushing of the face, and pimples or bumps on or around the cheeks, nose, mouth, and forehead. Sometimes the flushing or redness on the face can last for days. Some people say their skin burns or stings, especially when they apply lotions or medications.

You may notice tiny, red veins on your face that look like spiderwebs. You may also develop patches of rosacea on your ears, neck, chest, or back. Your face may feel increasingly dry, sensitive, or sunburned. Over time, some cases of rosacea that aren't treated can cause knobby bumps on your nose and cheeks that can multiply. This is advanced rosacea, known as rhinophyma. It can give your nose a bulbous (swollen), waxy look. Most cases of rosacea don't progress this far.

Rosacea can also affect the eyes. Your eyes may become dry, red, and irritated. Your vision may blur. Without treatment, rosacea can cause serious eye problems.

How is rosacea treated?

One of the first actions in caring for rosacea is to discover what triggers a flare-up of the disease. Triggers can include alcohol, stress, spicy foods, sun exposure, and extremes in surrounding temperature. It may be helpful to keep a diary of what you eat, drink, and do during the day. Make notes on the days that the rosacea appears. Then you can take the diary to your next doctor's appointment and discuss lifestyle changes and actions that can help you control the disease.

Doctors sometimes prescribe antibiotic creams and oral antibiotics to treat the pimples that develop. Antibiotic creams, however, may cause burning and stinging for some people. These people may find that oral antibiotics, such as tetracycline, are a better option. Women who are pregnant should not use some antibiotic creams or tetracycline.

If antibiotics don't control your rosacea, your doctor may try other medications, such as isotretinoin (Accutane) or tretinoin cream (Retin-A), unless you are pregnant. Laser therapy may reduce the red lines (telangiectasia) of rosacea, but it is usually used only in advanced cases. Treatment options for advanced cases of rhinophyma are dermabrasion, cryosurgery, or laser surgery.

About half of the people who have rosacea also have eye irritation. It may feel like you have something in your eye. Your eyelids may look red and swollen. Oral antibiotics may help treat eye problems.

When you are outdoors, always wear sunscreen to control flare-ups. Also avoid heavy cosmetics and skin care products that irritate the skin, such as harsh soaps or cleansers that contain alcohol.

Can rosacea be cured?

There is no cure for rosacea. But early treatment can help you manage the symptoms with medications and by making lifestyle changes to avoid triggers for the disease.

Medications

You can use antibiotic creams to relieve the redness on your face or any eye symptoms that result from rosacea. Antibiotic pills may help clear the pimples, and reduce any swelling or irritation in your eyes. Mild cases often respond to treatment with antibiotic creams. Symptoms usually improve faster, however, with oral medication. Long-term use of oral antibiotic medication may cause side effects, such as stomach upset and yeast infections. Therefore, oral medication may be used first, then tapered off and followed by antibiotic cream.

With antibiotic treatment, symptoms usually improve in 3 to 4 weeks, with greater improvement in 2 months.

Swollen bumps on the nose (rhinophyma) do not respond well to antibiotic treatment.

Medication Choices

Medications used to treat rosacea include:

  • Antibiotics: Used alone or with another medication, antibiotics are the most common medicines doctors prescribe to treat rosacea.
  • Isotretinoin (Accutane): Doctors usually prescribe isotretinoin only for severe rosacea or rosacea that does not respond to antibiotics.
  • Note: Women who are pregnant or may become pregnant should not take isotretinoin, because of the risk of serious side effects such as miscarriage and birth defects.
  • Tretinoin (Retin-A, Avita, Renova): Tretinoin is a topical medication most often used to treat acne. You may use it to treat the pimples that develop from rosacea. It is not useful for treating red lines (telangiectasia) or facial redness.

Doctors may prescribe other medications, including imidazoles or azelaic acid gel (such as Finacea).



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