Rosacea & Flushing
What Is Rosacea?
Rosacea is a chronic (long-term) disease that affects the skin and sometimes the eyes. The disorder is characterized by redness, flushing, pimples, and, in advanced stages, thickened skin. Rosacea usually affects the face; other parts of the upper body are only rarely involved.
Who Gets Rosacea?
Rosacea most often affects adults between the ages of 30 and 60. It is more common in women (particularly during menopause) than men. Although rosacea can develop in people of any skin color, it tends to occur most frequently and is most apparent in people with fair skin.
What Does Rosacea Look Like?
There are several symptoms and conditions associated with rosacea. These include frequent flushing, vascular rosacea, inflammatory rosacea, and several other conditions involving the skin, eyes, and nose.
Frequent flushing of the center of the face--which may include the forehead, nose, cheeks, and chin--occurs in the earliest stage of rosacea. The flushing is often accompanied by a burning sensation, particularly when creams or cosmetics are applied to the face. Sometimes the face is swollen slightly.
A condition called vascular rosacea causes persistent flushing and redness. Blood vessels under the skin of the face may dilate (enlarge), showing through the skin as small red lines. This is called telangiectasia (tel-AN-je-ek-tay-ze-ah). The affected skin may be swollen slightly and feel warm. A condition called inflammatory rosacea causes persistent redness and papules (pink bumps) and pustules (bumps containing pus) on the skin. Eye inflammation and sensitivity as well as telangiectasia also may occur.
In the most advanced stage of rosacea, the skin becomes a deep shade of red and inflammation of the eye is more apparent. Numerous telangiectases are often present, and nodules in the skin may become painful. A condition called rhinophyma also may develop in some men; it is rare in women. Rhinophyma is characterized by an enlarged, bulbous, and red nose resulting from enlargement of the sebaceous (oil-producing) glands beneath the surface of the skin on the nose. People who have rosacea also may develop a thickening of the skin on the forehead, chin, cheeks, or other areas.
How Is the Eye Affected?
In addition to skin problems, up to 50% of people who have rosacea also have eye problems caused by the condition. Typical symptoms include redness, dryness, itching, burning, tearing, and the sensation of having sand in the eye. The eyelids may become inflamed and swollen. Some people say their eyes are sensitive to light and their vision is blurred or otherwise impaired.
What Causes Rosacea?
Doctors do not know the exact cause of rosacea but believe that some people may inherit a tendency to develop the disorder. People who blush frequently may be more likely to develop rosacea. Some researchers believe that rosacea is a disorder where blood vessels dilate too easily, resulting in flushing and redness.
Factors that cause rosacea to flare up in one person may have no effect on another person. Although the following factors have not been well-researched, some people claim that one or more of them have aggravated their rosacea: heat (including hot baths), strenuous exercise, sunlight, wind, very cold temperatures, hot or spicy foods and drinks, alcohol consumption, menopause, emotional stress, and long-term use of topical steroids on the face. Patients affected by pustules may assume they are caused by bacteria, but researchers have not established a link between rosacea and bacteria or other organisms on the skin, in the hair follicles, or elsewhere in the body.
Can Rosacea Be Cured?
Although there is no cure for rosacea, it can be treated and controlled. The goals of treatment are to control the condition and improve the appearance of the patient's skin. It may take several weeks or months of treatment before a person notices an improvement of the skin.
Some doctors will prescribe a topical antibiotic which is applied directly to the affected skin. For people with more severe cases, doctors often prescribe an oral (taken by mouth) antibiotic. The papules and pustules symptomatic of rosacea may respond quickly to treatment, but the redness and flushing are less likely to improve with topical or oral medications.
Doctors usually treat the eye problems of rosacea with oral antibiotics. People who develop infections of the eyelids must practice frequent eyelid hygiene. The doctor may recommend scrubbing the eyelids gently with diluted baby shampoo or an over-the-counter eyelid cleaner and applying warm (but not hot) compresses several times a day. When eyes are severely affected, doctors may prescribe steroid eye drops.
Laser surgery and Intense Pulsed Light (IPL) therapy are treatment options if red lines caused by dilated blood vessels appear in the skin or if rhinophyma develops. For some patients, laser surgery may improve the skin's appearance with little scarring or damage. For patients with rhinophyma, surgical removal or laser resurfacing of the excess tissue to reduce the size of the nose usually will improve the patient's appearance.
At Reviva Medical Laser and Vein Clinic, we offer two revolutionary treatments for rosacea/flushing. The first is Laser Genesis and the second is intense pulsed light (IPL) with or without the use of photosensitizing agent. Both modalities are effective. Patients with a more inflammatory component may respond better to the IPL and those with more flushing might respond better to the Gentle Yag laser. Medications, both topical and sometimes oral, are used to help the control the condition. Since rosacea is a chronic condition, maintenance therapy might be needed periodically to maintain good result.
