Posted on 11 Feb 2016
Rosacea is a chronic and potentially life-disruptive disorder primarily of the facial skin, often characterized by flare-ups and remissions. It often begins after the age of 30, and most commonly affects the nose, cheeks, forehead and chin, but some people can experience symptoms on their neck, back, scalp, arms and legs. Antibiotics are the primary treatment, while changes to skin care regimens may help prevent reoccurences.
Over time, the redness tends to become worse and more persistent, and visible blood vessels may appear. Left untreated, bumps and pimples often develop, and in severe cases the nose may grow swollen and bumpy from excess tissue. In many rosacea patients, the eyes are also affected, feeling irritated and appearing watery or bloodshot.
Rosacea can have a similar appearance to acne, but the two conditions are unrelated. Rosacea does not produce the blackheads, deep cysts or lumps that are symptomatic of acne. Although rosacea can affect all segments of the population, Caucasian people with fair skin, who tend to flush or blush easily, are believed to be at greatest risk.
The disease is more frequently diagnosed in women, but more severe symptoms tend to be seen in men – perhaps because they often delay seeking medical help until the disorder reaches advanced stages.
- Pimples that may be hard (papules) or puss filled (pustules).
- Dry and flaky facial skin.
- Burning and stinging of the skin.
- Red, sore eyelids and a tendency to develop styes and conjunctivitis.
- Swelling of the face and eyelids.
- In advanced cases, the pores of the skin may become prominent and the nose may become enlarged and unshapely (rhinophyma).
- Excess alcohol
- Hot drinks and spicy foods
- Application of topical steroids
- Excessive exposure to sunlight or extreme hot or cold temperatures
- Rubbing or massaging the face
- Some facial creams and cosmetics
While there is no cure for rosacea and the cause is unknown, treatments are available to control its signs and symptoms. Once the symptoms are under control, an antibiotic ointment may be prescribed on a long-term basis. Other treatments that may be used include:
- Isotretinoin – a vitamin A derivative that may be recommended in cases of rosacea that have not responded to antibiotics, or where antibiotic treatment is not well tolerated. Taken orally, isotretinoin can help to reduce the papules and pustules that occur with rosacea.
- Azelaic acid – a topical cream or lotion, often used to treat acne, which has proven effective in treating rosacea (This medication must not be used by pregnant women, as it can cause birth defects).
- Vascular laser treatment – this can be effective in treating persistent telangiectasia
- Other medications – Non-steroidal anti-inflammatory drugs (NSAIDs), such as diclofenac, can help to reduce redness and discomfort of the skin. Medications, such as clonidine, can help to reduce flushing of the skin
- Surgery – this can help to treat rhinophyma by reshaping the nose.
When treatment is followed correctly, there is gradual improvement. In some cases rosacea can recur and in others it can clear up completely. If left untreated, rosacea will worsen and become more difficult to treat. The success of treatment depends upon how early rosacea was diagnosed and if the full course of treatment is followed correctly. Call Neaman Plastic Surgery today for a consultation.
Dr. Keith Neaman
Dr. Neaman is a board-certified plastic surgeon that specializes in surgical body contouring. He prides himself on being on the cutting edge of plastic surgery. He takes an informative approach to each consultation, and through open dialogue and communication, he helps his patients decide on a treatment plan that meets their needs.