Rosacea

Rosacea is a facial rash that occurs in middle-aged men and women. The cause of rosacea is unknown. It affects people mainly in the 30s and 40s, especially those with fair-skin, blue eyes and of Celtic origin.

Rosacea used to be called "acne rosacea" but it is quite different from acne. The red spots and pustules are dome-shaped rather than pointed and there are no blackheads, whiteheads, deep cysts, or lumps.

Sometimes the affected skin is swollen and hot. Rosacea affects the cheeks, nose and forehead - rarely does it involve the trunk and upper limbs.

Rosacea is often accompanied by other features:

  • A red face due to flushing and telangiectasia (persistent red veins).
  • Red, sore or gritty eyelids.
  • Symptoms are often aggravated by sun exposure and hot and spicy food or drink.
  • The skin may be very sensitive i.e. make-up, sunscreens and so on sting.
  • The nose may slowly enlarge (rhinophyma).

Treatment of rosacea

  • Reduce factors causing facial flu.
  • Avoid oil-based facial creams. Use a water-based make-up and sunscreen.
  • Never apply a topical steroid to the Rosacea.
  • Keep your face cool: minimize your exposure to hot or spicy foods, alcohol, hot showers and baths and warm rooms.
  • Protect yourself from the sun.

Oral antibiotics

Antibiotics reduce inflammation. They lessen papules, pustules and eye symptoms of Rosacea.

Topical antibiotics

Topical antibiotic cream or gel can be used intermittently or long term on its own for mild cases and in combination with oral antibiotics for more severe cases.

Topical treatments

Topical treatments such as vitamin A (retinaldehyde) , beta hydroxyacids (eg. Salicylic acid) and niacinamide (vitamin B3) are all highly effective in rosacea.

Vascular laser

Persistent telangiectasia can be successfully improved with vascular laser treatment. Where this is unavailable, cautery or diathermy may be helpful.

Surgery

Rhinophyma can be treated successfully surgically or with carbon dioxide laser by a plastic surgeon.

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