Rosacea: Causes, Symptoms & Treatment
What is Rosacea?
Rosacea is a common but chronic skin condition pronounced roh-ZAY-sha and appears as small red bumps on the face. Some of these bumps may contain pus and be accompanied by persistent redness and the development of many tiny blood vessels on the surface of the skin.
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Causes & Symptoms of Rosacea
Medical research has not come up with a definite cause for rosacea but it is strongly believed that genetics and the environment are contributing factors. It is also thought that it may be because of blood vessels that expand too easily. Alcohol is not a cause but can aggravate an existing condition.
Types of Rosacea
This common but often chronic skin condition has four recognized stages and each stage has different signs and symptoms, all of which affect the face. The two stages in this article are the two early stages of Pre-Rosacea and Vascular Rosacea.
As the signs and symptoms of pre-rosacea worsen, vascular rosacea may develop. There will be small blood vessels on the nose and the cheeks which will swell and become visible, showing through the skin as small red lines. This is called telangiectasia. The skin will feel warm and look puffy. The skin may become more sensitive and the rosacea may be accompanied by oily skin and dandruff. Eventually, flushing and redness become persistent and then permanent. If you have telangiectasia, then this can be greatly aggravated by your lifestyle. Rosacea is much more likely in female adults with fair skin between the ages of 30 and 60. If you have a lifestyle which includes a steady diet of hot, spicy food, above average alcohol consumption, smoking cigarettes and eating meals too quickly, then telangiectasia will surely follow.
If telangiectasia is present, those small delicate capillaries in the skin are affected as the elasticity deteriorates, so they remain slightly dilated. The skin gradually becomes congested and eventually the capillaries become visible through the skin’s surface.
Although there is no overnight cure for rosacea, the symptoms can be treated and controlled. The goal is to control the condition and improve the appearance of your skin. Unfortunately, rosacea rarely clears up unaided and it usually worsens over time if left. Avoid any over the counter products that contain ingredients such as acids, alcohol and other irritants as the chances are that they may actually worsen rosacea. It is safer to see your doctor or dermatologist so that they can prescribe a safe treatment for your symptoms or you may want to consider a natural alternative such as a topical homeopathic product which is FDA registered.
Try to avoid anything which you think might trigger a flare up. Keep a diary of such flare ups so that you can identify what might be a cause.
In addition to the triggers we have already described:
- Protect your face from the sun or the cold in winter.
- Avoid touching or rubbing your facial skin
- If using a topical medication, apply any moisturizer once the medication has dried.
- Use products that are labeled non comedogenic.
- If using a natural homeopathic product, look for a topically applied, FDA registered product.
With sensible care and treatment, you can be successful in treating the symptoms of rosacea and the accompanying flare ups.
Inflammatory rosacea is the name given to the third stage in rosacea. In addition to the persistent redness in the central portion of the face (particularly the nose) small, red bumps or pustules (bumps containing pus) may appear and persist. Nodules in the skin may become painful. This can spread across the nose, cheeks, forehead and chin.
In severe and rare cases, the oil glands or sebaceous glands in the nose, and even sometimes the cheeks, become enlarged resulting in a build up of tissue on and around the nose. This complication is more likely to occur in men. The condition can develop very slowly over a period of years so that eventually the nose becomes red, enlarged and bulbous. Thick bumps may also develop on the lower half of the nose and nearby cheeks.
This particular aspect of inflammatory rosacea is called rhinophyma.
Rhinophyma is often treated with surgery when the excess tissue can be carefully removed with a scalpel, laser or through electro surgery. Then dermabrasion, a surgical method that smoothes the top layer of the skin, will help improve the look of the scar tissue. It is not possible to treat Rhinophyma with less invasive methods because the condition will have progressed too far.
How to treat inflammatory Rosacea
Many sufferers of rosacea do not realize what they have and so the condition progresses until they have inflammatory rosacea or worse. Identifying the condition is the first step to controlling it.
If you have the signs and symptoms of inflammatory rosacea, you should see a doctor or dermatologist as soon as possible so that the condition can be positively identified and treatment commenced. Your doctor or dermatologist will often recommend a combination of treatments tailored to suit your individual requirements which can stop the progress and even reverse it. Such treatments will take up to two months for a significant improvement to be apparent so it will take patience and perseverance.
Oral antibiotics often produce faster results than topical medications while cortisone creams can reduce the redness of rosacea but should not be used for longer than two weeks as the downside of such treatment is that they can cause thinning of the skin and even flare ups after discontinuing.
Along with the treatment of your inflammatory rosacea, there is much you can do to help the condition at home:
- Avoid those triggers that may aggravate the condition such as hot and spicy drinks and foods, caffeine and alcoholic beverages.
- Limit your exposure to sunlight and take the necessary precautions.
- Avoid extreme temperatures both hot and cold. Exercise in a cool environment so you do not overheat.
- Avoid unnecessary contact with the skin on your face. Just keep it clean and moisturized with gentle products that do not contain any alcohol, fragrances etc. If you use a hairspray, do not let it come in contact with the skin on your face.
- Keep a diary of when your skin has flare ups or times when it is worse so that you can track possible triggers.
- Investigate using a natural healing product for the treatment of inflammatory rosacea and for the prevention of flare-ups.
The key to successful management of your inflammatory rosacea is early diagnosis and treatment and to do your bit in avoiding those aspects of your life that may worsen the condition. You will feel happier about your condition and you will feel happier about your appearance.
Statistics tell us that between 50 to 60% of all those with rosacea also have ocular rosacea of which some 20% have the ocular problems before the skin problems themselves. However, some 80% will first develop skin problems on the face typical of rosacea symptoms and then go on to experience ocular problems with signs and symptoms such as:
- A burning and gritty sensation in the eyes.
- Chronically inflamed margins of the eyelids even including scales and crusts.
- Pain and abnormal sensitivity to light (photophobia).
- Blepharitis with burning, itching and irritation of the lids. Also sandy, itchy eyes; red or swollen eyelids; crusty, flaky skin on the eyelids. In severe cases, there may be sties, irritation and inflammation of the cornea or conjunctivitis.
- Keratitis is a more serious further condition and is the term used to cover a range of ocular conditions where there is infection or inflammation of the cornea sometimes resulting in severe eye pain, blurry vision and sensitivity to light.
- Iritis is the inflammation of the iris and symptoms include eye pain, sensitivity to light and blurry vision. This is very similar to conjunctivitis.
How to treat the symptoms of Ocular Rosacea
Obviously, the onset of any of these symptoms will ensure that you visit an ophthalmologist for diagnosis and treatment. Doctors usually treat the eye problems of rosacea with oral antibiotics, particularly tetracycline or doxycycline. Some doctors will recommend cleaning the eyelids gently with diluted baby shampoo or an over the counter eyelid cleanser if infections of the eyelids occur. They also suggest applying just warm compresses several times a day. In severe cases, doctors may prescribe steroid eye drops.
In addition here are some helpful hints for caring for the Ocular Rosacea condition:
- Increase your liquid intake so that you increase the moisture in your eyes. Make sure you drink 8 to 10 glasses of water daily and this will ease many of the symptoms of ocular rosacea. Eye cell (and skin) regeneration only takes place through the use of water. It is absolutely essential for new cell regeneration of the eye, skin and all body organs. We cannot overemphasize the importance of an increased water intake.
- The dry eye symptom can also be treated with safe artificial tears or drops (those that do not contain any preservatives) up to 4 times per day.
- A home humidifier is a useful piece of equipment for adding valuable moisture to the air.
- Follow a balanced diet and try to include at least 3 helpings per week of food from the Omega-3 group – oily fish such as pilchards, mackerel or sardines – or you can take an Omega-3 fatty acids supplement on a daily basis.
- Be careful of the makeup you use around your eyes. Eye make up, such as mascara, eye liner or eye shadow, should be replaced every 3 months as these containers can become contaminated with airborne and skin bacteria, and pollutants. Anti-wrinkle creams may have harsh anti-aging ingredients so check on these.
- It is not easy when you suffer from ocular rosacea and you will have to persevere with your treatment and with your homecare. Treatments will definitely be more effective the earlier they are started.
Early Treatment of Rosacea
It is important to treat Rosacea in its early stages so that it does not become worse and more difficult to treat as rosacea rarely clears up on its own. There are certain foods and drinks that can trigger an outbreak or worsening of rosacea and, though these may vary from person to person, frequent trigger foods include hot drinks, spicy foods, caffeine and alcoholic beverages. Reducing the heat in beverages may mean you can keep on enjoying coffee, tea and hot chocolate a couple of times per day.
Stress is also a trigger, so if possible avoid any emotional stress, anger or embarrassment. Learn to relax and manage your stress levels through meditation, gentle exercise, yoga and listening to soothing or classical music. Any exercise should be carried out in a cool environment so you do not overheat. When under stress, try deep-breathing exercises. Inhale and count to 10, then exhale and count to 10. Repeat this exercise several times.
While sunlight is as beneficial as a healing process to many conditions and produces vitamin D in our bodies, keep the area affected by rosacea out of the sun by wearing a wide brimmed hat and use a natural sun block.
Extreme temperatures whether hot or cold can make your symptoms worse so hot baths and saunas should be avoided. Stay in a cool, air-conditioned environment on hot, humid days or sip cold drinks, chew on ice chips or spray the face with cool water. Very cold weather and wind can easily cause flare-ups in the winter months so bundle up by covering your cheeks and nose with a scarf to protect against the cold.
Controlling indoor temperatures and keeping temperatures mild can help in treating Rosacea symptoms.Be careful about cleaning and applying makeup to your face. Clean your face once a day, using a gentle, natural cleanser. Pat the skin dry very gently with a clean, soft towel. Never rub, scrub or massage the face. Check the ingredients in the cosmetics and products you use on your face – these should be natural and free of synthetic chemicals but also avoid any that contain alcohol, menthol or eucalyptus oil.
Check any medications that you may be taking. Avoid drugs that dilate the blood vessels and these include some blood pressure medications. Also steer clear of corticosteroids.