ROSACEA

Rosacea is a chronic skin disorder of the face in middle-aged and older people (usually between 30 and 60), which affects especially those with fair skin, blue eyes and of Celtic origin (Caucasians). Rosacea (roz-ay-sha) is a very common red, acne-like benign skin condition which includes red or pink patches, visible tiny broken blood vessels, small red bumps, red cysts, and pink or irritated eyes.

Common locations for rosacea are mainly the forehead, the chin, and the lower half of the nose. Sometimes rosacea can occur on the neck and upper chest. About 50 percent of the time it involves the eye area as well.

Approximately 45 million people worldwide are affected by rosacea. Rosacea is not considered contagious or infectious. There is no evidence that rosacea can be spread by contact with the skin, sharing towels, or through inhalation.

Some people confuse rosacea with acne. Rosacea is basically different than acne, although the two can coexist. It is also sometimes called "adult acne."

Rosacea Causes

Unfortunately the modern medicine does not know the real cause of rosacea. There are several theories regarding the origin of overactive facial blood vessels and inflammation, including genetic, environmental, vascular, inflammatory factors.

Skin is the main factor in rosacea development - the skin's innate immune response appears to be important in rosacea, as antimicrobial peptides such as cathelicidins have been observed actively promoting the inflammatory reaction.

Some scientists discovered the increased incidence of rosacea in patients who carry the stomach bacterium – so called “Helicobacter pylori”. This theory was criticized by several dermatologists.

It is well known that rosacea can be aggravated by facial creams or oils, and especially by topical steroids.

Hair follicle mites are sometimes found in greater numbers within rosacea papules but their role is unclear.

Several scientists suggested that suspected causes of rosacea include but are not limited to genetic factors - genetics plus sun exposure. They consider also other additional factors such as hair follicle mites sometimes found in hair follicles, the bacteria Helicobacter pylori (that is associated with stomach ulcers), gastrointestinal disease, and medications that cause blood vessels to widen.

There seems to be a hereditary component to rosacea in a large number of people. Often people have close family members with rosacea.

Rosacea symptoms

Specific signs and symptoms of rosacea include facial flushing, blushing, redness, burning, red bumps, and small cysts. These symptoms could come and go. Sometimes skin can be clear for weeks, months, or years and then erupt again. Rosacea tends to evolve in stages and typically causes inflammation of the skin of the face, particularly the forehead, cheeks, nose, and chin.

It is very typical for rosacea to affect the "blush" areas of the face. It is more common in people who flush easily especially if triggered by following factors:

• emotional factors (stress, fear, anxiety, embarrassment, excitements, etc.),
• changes in the weather like strong winds or a change in the humidity,
• sun exposure (especially in cases with sun-damaged skin),
• alcohol consumption,
• spicy food.

Most typical rocasea symptoms include:

	Red papules and sometimes pustules on the nose, forehead, cheeks and chin.
	Frequent blushing or flushing
	Red face due to persistent redness and/or prominent blood vessels – telangiectasia
	Dry and flaky facial skin
	Aggravation by sun exposure and hot and spicy food or drink (anything that reddens the face)
	Sensitive skin: burning and stinging, especially with make-up, sunscreens and other facial creams
	Red, sore or gritty eyelid margins including papules and styes (blepharitis and/or conjunctivitis) – ocular rosacea
	Enlarged unshapely nose with prominent pores (sebaceous hyperplasia) and fibrous thickening – rhinophyma
	Firm swelling of other facial areas including the eyelids – blepharophyma
	Persistent redness and swelling or solid oedema of the upper face due to lymphatic obstruction – Morbihan disease.

Rosacea Risk Factors

• Fair skin,
• Sun-damaged skin,
• Rosacea family history,
• Caucasian race,
• Menopause,
• Age factor (30-60 year old)

Rosacea Prevention Measures

• Where possible, reduce factors causing facial flushing.
• Avoid oil-based facial creams. Use water-based make-up.
• Never apply a topical steroid to the rosacea.
• Protect yourself from the sun. Use light oil-free facial sunscreens.
• Keep your face cool: minimize your exposure to hot or spicy foods, alcohol, hot showers and baths and warm rooms.
• Sun protection. Sun exposure is a well known flare for many rosacea sufferers. Sun protection using a wide-brimmed hat (at least 6 inches) and physical sunscreens (like zinc or titanium) are generally encouraged. Because rosacea tends to occur in mostly fair-skinned adults, the use of an appropriate daily sunscreen lotion and overall sun avoidance is recommended. Zinc-based sunscreens (SPF 30 or higher) provide superior sun protection.

Rosacea At A Glance

	Rosacea is a common, chronic, incurable, adult, acne-like skin condition.
	Rosacea has periodic ups and downs (flares and remissions).
	Rosacea symptoms tend to come and go.
	Rosacea is easily controllable and medically manageable.
	Rosacea may begin with easy facial blushing or flushing.
	Rosacea commonly affects the central third of the face, especially the nose.
	Rosacea causes tiny red pimples and fine red lines on the facial skin.
	Rosacea may be mistaken for rosy cheeks, sunburn, or quite often, acne.
	Rosacea triggers include alcohol, hot or spicy foods, emotional stress, and heat.
	Rosacea can be a very bothersome and embarrassing condition.
	Untreated rosacea tends to worsen over the time and be a progressive disease. Rosacea untreated can cause a bulbous red nose (like W.C. Fields).
	Prompt recognition and proper treatment permit people with rosacea to enjoy life.

Rosacea Treatment (see on next page)