Rosacea

Acne Rosacea is a common skin disorder which affects both men and women. The disorder not only occurs on the face but can also affect the eyes. Acne Rosacea is most common on the sun exposed areas such as the face, upper arms, neck and back.

The classic features of the disorder include

- redness around the middle of the face and nose

- numerous spotty and linear red lines

- acne like pustules of varying size

The disorder can be triggered by many factors which cause a reddish flushing of the face. The common triggers include:

- excessive sun exposure

- spicy foods

- hot beverages

- alcohol consumption

The role of foods as triggers of Rosacea is not well understood. Not all individuals have the same food triggers and even the intensity of symptoms is variable. It is believed that foods that are rich in certain amino acids like histamine and serotonin can trigger Rosacea.

These foods include:

- vinegar

- dry cheese

- certain wines

- yogurt and sour cream

- yeast extract

- fruits like avocados, citrus fruits, plums, raisins

- vegetables like broad-leaf beans, peas, tomatoes, bananas, red plums,

- spicy foods

- Chocolates

Other rare causes of Rosacea include:

Medications like topical corticosteroids, certain blood pressure medications

Menopause

Emotional liability.

Unlike acne, there are no black heads (comedomes) seen. As the disorder progresses, it can cause a severe deformity of the nose (rhinophyma)

The treatment of Rosacea is difficult and many individuals remain unsatisfied.

The most important thing in the treatment is to avoid the triggers. Exposure to very hot weather, warm clothes, saunas and extremes of weather should also be avoided.

There are medications available to day which will partially control the symptoms of Rosacea. But in most cases, the Rosacea is recurrent. Each episodic attack may last a few weeks to months and then resolve.

Antibiotics: The tetracyclines have been the major treatment of Rosacea. The results are variable and not all individuals respond to the drugs. The drug treatment is prolonged. Other antibiotics frequently prescribed for Rosacea include clindamycin, metronidazole and sulphonomides, no one class of drug is better than the other



Accutane: Recently Accutane has been prescribed for moderate episodes of Rosacea. The reports do indicate that the drug is effective but Accutane also has some side effects. In addition, the use of Accutane in females of child bearing age is questionable.

For Rosacea that is triggered during menopause, oral contraceptives have been prescribed for very short periods with good results. However, the prolonged use of hormone replacement therapy following menopause needs physician monitoring