Rosacea is a skin condition that causes red rashes on the face and may also affect the eyes. The rashes may feature multiple pimples or bumps. Fair skinned women between the ages of 30 and 60 are most affected. People who blush a lot are more prone to get rosacea. Though it is a chronic condition, it can go into remission.

Causes

The exact cause of rosacea is not known, though many hereditary and environmental factors are blamed for it.

Skin affected by rosacea is said to overreact to germs. People with rosacea have been known to carry larger numbers of a bacteria called Helicobacter pylori in the stomach, and hair follicle mites called Demodex folliculorum. Almost everyone carries these mites, though the role of these organisms in causing of rosacea is unclear.

Some factors that increase the blood flow to the skin can worsen rosacea. These include:

• Exposure to sunlight
• Extreme temperatures
• Hot baths
• Saunas
• Consumption of alcohol
• Hot foods or beverages
• Spicy foods
• Stress
• Exercise
• Strong emotions
• Topical steroids that treat skin diseases, like corticosteroids
• Blood pressure lowering medicines

These can aggravate rosacea, but they are not a cause of the condition.
 

Rosacea causes red patches, sometimes with pimples, on the nose, cheeks, forehead, and chin. Tiny red threadlike blood vessels, known as telangiectesia, may be visible as well. The nose may become large, bulbous, and ruddy, a condition known as rhinophyma. Ocular rosacea, which affects the eyes, may lead to a burning and gritty sensation in the eyes.

Rosacea can occur in phases. Pre-rosacea is the tendency to flush and may be due to dilated blood vessels. It is followed by vascular rosacea, when telangiectasia appears on the nose and cheeks. In the last phase, inflammatory rosacea, pimples appear on the affected skin.

Early treatment is important in rosacea. Topical medicines applied locally to the inflamed areas include antibiotics such as metronidazole, vitamin A preparations like tretinoin, and others medicines such as benzoyl peroxide and azelaic acid. These may be used once or twice a day depending upon the severity of symptoms.

Oral medicines may be co-prescribed with these topical medicines. These include antibiotics such as doxycycline, minocycline, and erythromycin. Oral isotretinoin, a retinoid that inhibits oil production by the sebaceous glands, may be given for severe cases. If the eyes are affected, eye drops containing corticosteroids may be prescribed. 

When enlarged blood vessels, redness, or changes in the size and shape of the nose from rhinophyma become permanent, surgery is an option. Laser or electrosurgery can reduce redness, remove tissue build-up around the nose, and improve the face's appearance.

Besides medical intervention, other treatment should be given to help control rosacea. the face should be protected from extremes of temperature. Sunscreens should be applied before going out in the sun, while in winter the face should be protected by a scarf or mask.

The skin should not be touched or rubbed. Any friction with clothing should be avoided. Only clean water and gentle cleansers should be applied to the face. Facial creams with alcohol should be avoided. If the face feels dry after application of topical medicines, a gentle moisturizer can be used.

Women should wear only water-based makeup. Drinking alcohol should be avoided, since alcohol dilates blood vessels and makes the face look redder. L-Lysine, an amino acid that strengthens the skin’s elasticity and helps it fight flare-ups, has been known to assist in clearing the symptoms of rosacea and may be taken as a supplement.

Outlook

Rosacea cannot be completely cured, but it is important to begin early and maintain proper treatment. Gentle care of the skin and avoiding triggers that can worsen the condition are simple steps that can benefit those who suffer from rosacea.