Rosacea

Rosacea (also known as 'acne rosacea'), which means 'rose coloured' in Latin, is a long term and chronic inflammatory skin condition affecting the face where a persistent pink to red coloured flush appears on the cheeks, nose and forehead (although it can also occur on the neck and ears and on the chest and the scalp).

It affects both men and women, with around 5% of the population having rosacea, but it is more than three times more common in women than in men. Onset is normally between the ages of 30 and 60.

It is also more common in fair skinned, blue eyed people and people with sensitive skin. Although women are affected more than men, in men the symptoms can be more severe, where the flush is more pronounced due to a greater number of broken or enlarged capillaries (blood vessels) and often accompanied by an associated condition called rhinophyma, where the skin on the nose becomes very red, swollen and misshapen.

In some cases the skin may develop small red bumps and pustules with a burning or stinging feeling and the eyes may also become dry and red.

What causes rosacea is not known, however some research findings point to a possible sensitivity in sufferers to a microscopic mite - the Demodex Folliculorum mite - that lives in the pores of the skin. Other theories suggest the condition is primarily genetic and linked to higher than normal levels of specific enzymes and peptides in the facial skin of sufferers. Rosacea, like many skin conditions, has environmental 'triggers' associated with flare ups. Some of these include things that make many non-sufferers flush in the face a little, eg

  • temperature extremes, such as moving from a warm environment to a cold one or vice versa (eg in winter going out of a warm building into the outdoors or the other way around)
  • strenuous exercise or any overheating (eg when asleep in a warm bed)
  • ingredients of some cosmetics
  • some topical medications (ie medicated skin creams)
  • heat from sunlight and/or sunburn
  • stress or anxiety
  • cold wind on the face
  • alcohol consumption
  • drinks containing caffeine (and particularly if hot eg tea, coffee)
  • foods with a high histamine content (eg fermented foods like yoghurt, sauerkraut and foods containing vinegar)

Treatments for rosacea

In addition to avoiding the triggers above, there are a number of medical treatments available for rosacea...

Medication

  • oral antibiotics (to relieve inflammation)
  • topical antibiotics
  • azelaic acid (to reduce lesions)
  • brimondine gel (which reduces the redness)
  • salycilic acid (anti inflammatory)
  • beta blockers

Light treatment

Lasers or 'intense pulsed light' devices can be used to lessen the red discolouration caused by the blood vessels under the skin by damaging them so that they are absorbed by the surrounding tissue.

Light treatments are needed every 4-6 weeks to start with and once the treatment starts to take effect, annual re-treatment is generally required.