Acne Rosacea

What is Rosacea?

Rosacea is a common skin disorder characterized by extreme facial redness (flushing) around the nose and cheeks. It is an inflammatory skin disorder with small red blisters or pus filled pimples. It is commonly mistaken for Acne. Rosacea is often called Acne Rosacea but the disorder is distinct from the common acne seen in younger adults. Unlike acne, blackheads are never seen in Rosacea. The red face (flushing) seen in individuals with Rosacea has nothing to do with drinking alcohol or use of other illicit drugs. The other conditions which are often mistaken for Rosacea are skin allergies or dermatitis (itchy dry skin)

Rosacea is a disorder of adults and is more common in Caucasians (or those with fair skin). Both genders are affected and the disorder is more common after the 3rd decade of life. Even though the disorder has no detrimental health affects, it can be emotionally devastating and lead to lack of self confidence and social isolation.

When the disorder is untreated it always progresses. In most cases, flare ups occur every few weeks or months.

What causes Rosacea?

The exact cause of Rosacea is not known but has been linked to be an abnormal hyper-response to flush or blush. The fine blood vessels underneath the skin somehow become hyper responsive and dilate (large). The enlargement of these fine blood vessels results in patches of red (flushed) areas on the face.

Some researchers have postulated that Rosacea may be due to H pylori- the organism that has been associated with peptic ulcer disease. Other researchers think that some tiny mites (Demodex folliculorum) which live on human skin may plug the hair follicles and plug up the pores. However, none of these theories have any scientific data to back them up. Even though alcohol is known to cause facial flushing, it does not cause Rosacea. There are many individuals who do not drink alcohol who have Rosacea.

The individual's diet and life style are two major triggers for Rosacea. Factors which are known to triggers Rosacea attacks are:

- eating hot and spicy foods

- Excessive sun exposure

- Hot beverages

- Excessive steroid use

- Emotional and physical stress

- Hot and cold weather

- Use of harsh creams and soaps

- Use of exfoliating creams and chemical peeling agents

- Hot baths, saunas

- Extreme anger

- Medications used to treat angina and blood pressure

Controlling these triggers can help one control/limit the facial flushing but the condition is very variable and despite strict control, many individuals show no response to the excessive flushing.

How does Rosacea look like?

Rosacea may present with

- Facial redness more prominent around the cheeks and nose

- Red pimples on the nose, forehead and chin

- Large red or deformed nose (rhinophyma)

- Dry and red eyes-individuals usually complain of a gritty feeling in the eyes

- Constant flushing of the face

- Numerous fine blood lines on the face

- Scaly rash or small pimples on the eye lids

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