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Rosacea: Symptoms, Diagnosis and Treatment

Rosacea is a chronic disease characterized by cyclical flare-ups of redness and pimples around the face. These symptoms, occasionally accompanied by watery and bloodshot eyes (known as ocular rosacea), are usually limited to the facial area and rarely appear in other parts of the upper body.

Rosacea affects approximately 14 million people in the United States, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMSD). The disorder is most often seen in adults between the ages of 30 and 60, and it appears more frequently in women (particularly those going through menopause) than men.

face in mirror, woman, skin, looking at skin
Credit: Yuri Arcurs | Dreamstime

Signs & Symptoms

Rosacea's signs and symptoms can vary from person to person. However, as its name implies, outward symptoms of rosacea often include frequent flushing or blushing around the central area of the face (cheeks, chin, nose and central forehead). Some patients may also experience persistent redness around the face; small, red, solid bumps or pus-filled pimples somewhat different than common acne; or visible blood vessels around the face, according to 2006 classification guidelines in the Journal of the American Academy of Dermatology. In some cases, symptoms may also include burning or stinging sensations, dry and thickened skin, swelling and eye irritation.

Some patients may develop rhinophyma, a condition characterized by an enlarged, bulbous nose.This is caused by enlarged sebaceous glands beneath the surface of the skin, according to the NIAMSD. Rhinophyma is more likely to occur in men than in women.

Diagnosis & Tests

Since there are no specific diagnostic tests that test for rosacea, physicians or dermatologists have to rely on the patient's physical appearance and family and medical history to diagnose the disorder. Knowledge of onset and variety of symptoms and frequency of flare-ups can assist the diagnosis by narrowing down and eliminating other possible skin disorders, according to the Mayo Clinic.

 

Treatments & Medication

There is currently no cure for rosacea. It rarely reverses itself spontaneously and may last for years, according to the American Academy of Dermatology. The symptoms can worsen without treatment.

However, there are ways to control the symptoms and improve the appearance of the patient's skin. According to the NIAMSD, dermatologists may prescribe topical antibiotics such as metronidazole, for mild cases or oral antibiotics such as tetracycline, minocycline, erythromycin, and doxycycline for more severe cases of skin problems and ocular rosacea. The pimples and pustules should quickly respond to these treatments, but the redness and flushing are less likely to improve.

For those who wish to diminish the appearance of blood vessels around the face and tissue build-up around the nose, laser surgery and electrosurgery may provide cosmetic improvement with little scarring or damage, according to the Mayo Clinic.

Coping Tips

A number of environmental factors and habits can aggravate rosacea or make the symptoms worse by increasing blood flow to the surface of the skin. These triggers can vary among patients, and patients should be aware them and learn to avoid them, according to the Mayo Clinic. For some, simple things such as hot beverages, spicy food, alcohol and hot baths can lead to flushing of the skin and can worsen rosacea. People whose skin is sensitive to sunlight should wear broad-spectrum sunscreen, and those with overly dry skin should stick to mild cleansers and oil-free moisturizers.

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