Rosacea is a chronic skin condition that affects millions of people worldwide, primarily appearing on the face and causing persistent redness, visible blood vessels, and sometimes small, pus-filled bumps.
In this ultimate guide by e-Surgery, we will explore the intricacies of rosacea, including its types, symptoms, triggers, diagnosis, and treatment options. Whether you’re newly diagnosed or looking to better manage your condition, this comprehensive guide aims to provide valuable insights and practical advice for living with rosacea.
Understanding Rosacea
Rosacea is a complex skin disorder than can significantly impact an individual’s quality of life. It typically appears on the cheeks, nose, chin, and forehead, but can also affect the neck, chest, and ears. The exact cause of rosacea remains unknown, but researchers believe it involves a combination of genetic and environmental factors.
A few key facts about the condition include:
- It affects an estimated one in 20 people in the UK
- It is most common in people ages 30 to 50, especially people of Irish and Northern European descent
- While there is no cure, various treatments can help manage symptoms
Rosacea is characterised by periods of flare-ups and remissions. During flare-ups, the skin may become extremely sensitive, and symptoms can worsen. By understanding the nature of rosacea, it can help with effective management and treatment.
Types Of Rosacea
Rosacea is typically categorised into four subtypes, each with distinct characteristics:
- Erythematotelangiectatic Rosacea (ETR): ERT is marked by persistent redness in the central face and visible blood vessels (telangiectasia). The skin may be sensitive and prone to flushing. This subtype is often the initial stage of rosacea.
- Papulopustular Rosacea: This subtype includes persistent facial redness with acne-like breakouts, such as papules and pustules. It can resemble adult acne and may occur alongside or after ETR.
- Phymatous Rosacea: Phymatous rosacea involves thickened skin, particularly on the nose (rhinophyma), giving it a bumpy or bulbous appearance. It is more common in men and usually develops after other rosacea subtypes.
- Ocular Rosacea: Ocular rosacea affects the eyes, causing redness, dryness, burning, and itching. It may also lead to light sensitivity and blurred vision, occurring before or after skin symptoms.
It’s important to note that individuals may experience symptoms from multiple subtypes simultaneously or progress from one subtype to another over time. Identifying the specific subtype(s) is crucial for determining the most effective treatment approach.
Symptoms & Triggers
The symptoms of rosacea can vary greatly between individuals, but the common signs of the condition include:
- Facial redness (erythema): A persistent flush or sunburn-like appearance
- Visible blood vessels (telangiectasia): Small, red lines visible on the skin
- Swollen, red bumps (papules and pustules): Often mistaken for acne
- Burning or stinging sensations: Especially when applying skincare products
- Dry, rough, or scaly skin: Often accompanied by increased sensitivity
- Skin thickening, especially around the nose: Known as rhinophyma
- Eye irritation (in ocular rosacea): Including dryness, redness, and styes
There are several factors that can trigger or exacerbate rosacea flare-ups. These include sun exposure, extreme temperatures (hot or cold), spicy foods, alcohol consumption, hot drinks, stress and anxiety, certain skincare products, exercise, or some medications that dilate blood vessels.
By identifying and avoiding personal triggers, it can significantly help in managing rosacea symptoms.
Diagnosing Rosacea
Rosacea is typically diagnosed through a visual examination by a dermatologist or general practitioner. Although there is no specific test for rosacea, your doctor may perform tests to rule out other conditions with similar symptoms, such as lupus, acne, or allergic reactions.
If you experience persistent redness in the central face lasting more than a few weeks, visible blood vessels on the face, bumps or pimples that don’t respond to over-the-counter acne treatments, burning or stinging sensations when applying skincare products, or eye irritation or vision problems potentially related to ocular rosacea, it may be time to see a doctor. These symptoms could indicate a more serious condition that requires professional medical evaluation and treatment.
During your appointment, the doctor will likely examine your skin closely, ask about your symptoms and how long you’ve had them, inquire about potential triggers or factors that worsen your symptoms, and rule out other conditions that might mimic rosacea.
Early diagnosing and treatment can help prevent the condition from worsening and reduce the risk of complications, such as permanent skin damage or eye problems. If you’re unsure whether your symptoms warrant a doctor’s visit, it’s always better to err on the side of caution and seek professional advice.
Treatment Options
While there is no cure for rosacea, various treatments can help manage symptoms and prevent flare-ups. The treatment plans are typically tailored to the individual based on their specific symptoms and subtype of rosacea.
Topical Medications
Topical medications are commonly prescribed to manage the symptoms of rosacea. Metronidazole, an antibiotic cream, is often used to reduce inflammation and redness. Another option is Azelaic Acid, which helps clear bumps and lessens redness by normalising skin cell turnover. Additionally, Brimonidine is a gel that works by constricting blood vessels, providing temporary relief from redness.
Oral Medications
For more persistent or severe cases, oral medications may be recommended. Antibiotics such as doxycycline are frequently prescribed at anti-inflammatory doses to reduce redness and bumps.
Laser & Light Therapies
Laser and light therapies are also effective in treating rosacea, particularly when other treatments are insufficient. Pulsed dye laser therapy targets visible blood vessels, helping to reduce their appearance. Intense pulsed light (IPL) is another option that reduces redness and flushing by targeting blood vessels. For more severe cases, especially those involving rhinophyma, a CO2 laser may be used.
Lifestyle Changes & Skincare
In additional to medical treatments, certain lifestyle changes and skincare practices can help manage rosacea. It’s important to use gentle, fragrance-free skincare products to avoid irritation. Wearing a broad-spectrum sunscreen with SPF 30 or higher is crucial to protect the skin against UV rays. Identifying and avoiding known triggers can also help prevent flare-ups.
Eye Care For Ocular Rosacea
For those with ocular rosacea, proper eye care is essential. Artificial tears can be used to relieve dryness, while gentle eyelid cleansing helps manage blepharitis. In some cases, prescription eye medications may be necessary to manage symptoms effectively.
It’s crucial that you consult with a healthcare professional before starting any new treatment regimen for rosacea. They can help determine the most appropriate treatment based on your specific symptoms, subtype, and overall health.
Living With Rosacea
It’s important to note that managing rosacea extends beyond medical treatments. Here are some of our top tips for living with the condition:
- Keep a trigger diary: Identify and avoid personal triggers by tracking your symptoms and potential causes.
- Practice stress-free management techniques: Stress can exacerbate rosacea, so techniques like meditation, yoga, or deep breathing exercises can be beneficial.
- Use cool compresses: Soothe irritated skin and reduce redness with gentle, cool compresses.
- Stay hydrated and maintain a balanced diet: Proper hydration and nutrition can support overall skin health.
- Be gentle when cleansing or applying skincare products: Use your fingertips and avoid rubbing or scrubbing the skin.
- Protect your skin from sun and extreme temperatures: Wear protective clothing, use umbrellas, and avoid overheating.
- Considering joining a support group: Connect with others who have rosacea to share experiences and coping strategies.
- Communicate with loved ones: Help friends and family understand your condition and how it affects you.
- Be patient with treatments: It may take several weeks or months to see significant improvements from new treatments.
- Stay informed: Keep up with the latest research and treatment options for rosacea.
Next Steps
Living with rosacea can be challenging, but with the right knowledge and tools, it is possible to effectively manage the condition and maintain a good quality of life. By understanding the different types of rosacea, recognising your symptoms and triggers, and working with healthcare professionals to find the right treatment plan, you can take control of your skin health.
Remember that rosacea is a chronic condition that requires ongoing management, so early diagnosis and treatment are crucial to prevent symptoms from worsening. A combination of medical treatments and lifestyle changes often provides the best results, but it’s important to be patient and consistent with your treatment plan.
If you’re concerned about rosacea or any other skin condition, we encourage you to speak to a healthcare professional who will be able to provide you with personalised advice, treatment options, and support to help you achieve healthier, more comfortable skin
Additionally, our ‘Ask-a-Pharmacist‘ service allows you to consult with trained UK healthcare pharmacists who can provide guidance on managing your condition and answer any questions you may have about your treatment options or prescribed medications.
