Rosacea


What is Rosacea?
Rosacea is a chronic and often progressive skin disease characterised by facial redness and swelling. It usually starts as an increase in skin sensitivity and a tendency to flush or blush easily, then progress to persistent redness in the centre of the face that may gradually involve the cheeks, forehead, chin and nose. In rare cases it may even spread to the ears, scalp, neck, chest, back and upper limbs.

Rosacea affects mostly fair-skinned between the ages of 30 and 60. Rosacea often runs in families and women are more often affected; however, men are more likely to be affected by its severe forms. Those with a personal or family history of acne also have a higher incidence of rosacea.

he characteristics of rosacea fall into four types, although some patients experience symptoms of more than one rosacea type at the same time. While rosacea may or may not evolve from one type to another, each individual sign or symptom may progress from mild to moderate to severe. The condition rarely reverses itself and may last for years. Rosacea can become worse without treatment so early diagnosis and treatment is recommended.

The four types of rosacea are:

Type 1: Flushing and persistent redness; may also include visible blood vessels
Usually the least severe, this type is often accompanied by enlarged sweat glands as well as oily or dry, flaky skin, or both. The skin may become sensitive with a burning and stinging effect when it comes into contact with make-up, sunscreens and other facial creams or by exposure to sun or hot and spicy food.

Type 2: Persistent redness with transient bumps and pimples
Characterised by raised red patches with pimples or whiteheads on and around the reddened area, some of which may contain pus, this type has some similarities with acne but is actually quite different. There are red spots and sometimes pus-filled pimples in both conditions, but in rosacea there are no blackheads, whiteheads, deep cysts, or lumps.

Type 3: Skin thickening, often resulting in an enlargement of the nose
This condition is a more advanced type of rosacea, called rhinophyma. Although relatively uncommon, it more often affects men and is characterised by a bulbous, enlarged red nose and puffy cheeks. Thick bumps can also develop on the lower half of the nose and cheeks.

Type 4: Eye irritation
Many with this condition mistake the symptoms for allergies as it is characterised by a reddening of the eyes, a feeling of 'grit' in the eyes, crusting on the lashes and sometimes a clear discharge. The eyes may also become dry or teary with a burning sensation. Other symptoms can include swollen eyelids, recurrent styes and potential vision impairment from corneal damage if no treatment is undergone.

Available treatments

Laser therapy or light treatment can also improve the appearance of broken veins, redness and flushing; symptoms that are common to all types of rosacea.

Maintaining a good skin care regime can also improve the condition.

The type of treatment depends upon the type of rosacea.

Lifestyle modification
Rosacea is often provoked by excessive exposure to the sun. Use a broad-spectrum sunscreen, wear a wide-brimmed hat or remain sheltered and avoid temperature extremes.

Topical treatments
Rosacea patients often have very sensitive skin and need to be especially careful with their skin care. Skin care products to avoid include astringents, toners, menthols, camphor and sodium lauryl sulphate products. Heavy foundations and cosmetics that are hard to remove such as oil-based facial creams must also be avoided. Topical steroids must not be used to treat rosacea.

Other topical treatments include:



Oral medications
Your medical practitioner may discuss with you the following oral medications as treatment: