Rosacea

What is rosacea?

Rosacea is a common condition that predominantly affects middle aged fair-skinned people. It usually affects the cheeks, forehead, nose and chin and is characterised by small red spots, pustules and flushing or redness. Although rosacea is more common in women, it is often more severe in men.

Although rosacea is often referred to as "acne rosacea" it is now felt to be a different entity and is not directly related to acne.

What causes rosacea?

The cause of rosacea is not known. There are a number of factors that may contribute to the development of rosacea including genetics, environmental factors, inflammation and blood vessel formation.

Current research is focussing on the role of the immune system, specifically the role of cathelicidins and matrix metalloproteinases in the formation of rosacea.

How does rosacea present?

 There are 2 key components to rosacea:

Papulopustular component

  • Red papules and pustules, typically affecting the cheeks, nose and forehead.

Erythrotelangiectatic (vascular) component

  • Flushing or blushing of the face
  • Fine blood vessels (telangiectasia) that are present all the time
  • Flushing may be exacerbated by sun exposure, alcohol, hot or spicy foods

In some cases, rosacea can involve the eyes (ocular rosacea) and present with sore or gritty eyes.

Rosacea may also cause fibrous thickening of the nose and prominence of the oil glands. This is known as rhinophyma and usually only affects men.

What is the treatment for rosacea?

Although there is no cure for rosacea, there are a number of treatment options that can significantly improve both the appearance of the skin and the symptoms of rosacea.

General measures are very important when treating rosacea (see the "Rosacea Do's and Don'ts" section below)

Prescription treatment options include:

  • Topical creams
  • Antibiotic tablets
  • Isotretinoin (in severe cases)
  • Medications to reduce flushing
  • Vascular laser for blood vessels and redness
  • Brimonidine gel (recently approved for the topical treatment of facial redness)

Rosacea Do's and Don'ts

Do:

  • Use a soap free cleanser
  • Apply products gently with the fingers
  • Choose a broad spectrum sunscreen
  • Choose cosmetics that contain protective silicones (esp dimethicone or cyclomethicone)
  • Choose a light foundation and set with powder if necessary
  • Use green tinted makeup for the redness
  • Avoid waterproof cosmetics and heavy foundations

Don't:

  • Wash your face in a hot shower
  • Rub your face (especially with a facecloth)
  • Use harsh products (eg toners, chemical peels etc)
  • Use products containing acetone, alcohol or benxoyl peroxide
  • Use steroid based creams (unless prescribed by your doctor)
  • Use greasy moisturisers
  • Have aggressive facials or microdermabrasion