Rosacea

What is rosacea?

Rosacea is a common skin inflammatory condition that mainly affects the face. It is more common in women and people with fair skin, and there may be a family history.

What causes rosacea?

The exact cause is unknown. There may be a genetic predisposition. Possible theories include immune reactions to skin mites or bacteria, abnormally sensitive blood vessels or stimulation of nerves.

There are often triggers for rosacea such as heat, exercise, humidity, change of climate, stress, contact with certain skin care products and even food/ beverages e.g. spicy food, alcohol, coffee.

What are the types rosacea?

Erythematotelangiectatic rosacea:
Features of early rosacea include facial redness, easy flushing on the face, neck and chest and telangiectasia (small blood capillaries). There is often a burning or stinging feeling when using skincare products.

Papulopustular rosacea:
This is characterised by persistent facial redness and recurrent acne-like spots, usually around the central part of the face around the nose and chin.

Phymatous rosacea:
This is characterised by skin thickening, often resulting in an enlargement of the nose (rhinophyma).

How to treat rosacea?

Treatment involves avoidance of triggers and the following options:

Topical medication such as topical antibiotics (e.g. metronidazole), azelaic acid, immunomodulators (pimecrolimus, tacrolimus), brimonidine, ivermectin are often prescribed for reducing redness, inflammation and control.

Oral medication are prescribed for inflammation and flare-ups. These include oral antibiotics (doxycycline, minocycline, erythromycin) amd isotretinoin. Oral antibiotics and isotretinoin are usually taken for several months. Repeated courses or low maintenance doses may be necessary for patients with frequent recurrences.

Light and laser treatments such as intense pulsed light and pulsed dye laser are often helpful to reduce redness, blood vessels and stabilising the rosacea. Carbon dioxide laser ablation is used to improve the appearance of the nose in rhinophymas.

Your dermatologist will need to assess the severity of rosacea and discussed the options with you.