Acne rosacea, or rosacea as it’s commonly known, is a condition that causes redness of the nose, cheeks, chin and forehead. Sometimes it may also affect the eyes and eyelids, making them sore and swollen and causing an unpleasant eye irritation. The redness, often accompanied by a skin rash, may come and go and is believed to be triggered by a number of factors including diet, environmental conditions and even stress. There is no known cure for rosacea, but effective treatments are widely available to help control the symptoms.
What are the symptoms?
When rosacea first manifests, the face may simply appear flushed. However, later on, symptoms can include a permanent reddening of the skin, pus-filled spots, visible blood vessels or a burning sensation.
Rosacea symptoms vary greatly from one sufferer to another and not all will experience the full spectrum of symptoms. That said, rosacea nearly always includes at least one of the primary signs below. Some secondary signs and symptoms may also develop over time and may even develop beyond the face, affecting the neck, chest, scalp or ears.
Many sufferers will have a history of frequent blushing or flushing. The facial redness, which often comes and goes, is often one of the earliest indicators of rosacea.
Longer-lasting redness which resembles sunburn and that does not subside over time.
Spots and pimples
Some people develop small, pus-filled pimples or solid red bumps with rosacea. They may be accompanied by a burning or stinging sensation.
Visible blood vessels
Small blood vessels that become permanently visible on the skin’s surface can also indicate the onset of the condition.
Watery, bloodshot or irritated eyes can also occur, indicating a condition called ocular rosacea. Sufferers may also be more prone to styes as well as swelling on the eyelids.
Burning or stinging
Tingling or tight sensations, even itching, can be a sign of rosacea.
The skin in the centre of the face can sometimes become rough and take on a very dry texture.
Isolated raised red patches can often develop.
In some cases, excess tissue may cause the skin to thicken – a condition known as rhinophyma, which often affects the nose, causing it to appear enlarged and bulbous.
Swelling may occur independently or in tandem with any of the other signs of rosacea.
Who is affected?
Rosacea affects around 1 in 10 people. Those with fair skin who tend to blush more easily may be at a higher risk, though it can also affect people of Asian or African origin. Women are more commonly affected than men, with the condition usually manifesting around middle age (between age 40 to 60), however when men do get rosacea it tends to be more severe.
While the cause of rosacea is still unknown, there are several different theories as to why it occurs. One being that the condition may be the result of a disorder linked to blood vessels, while others believe that the condition is a reaction to microscopic skin mites, fungus, physiological factors or an irregularity in the connective tissue.
Although nobody can say definitely what causes rosacea, particular circumstances and conditions appear to trigger the symptoms.
The most commonly cited are:
Getting hot and sweaty, for example during exercise
Extremes of weather, either very hot or very cold
Eating spicy foods
Treatment will depend largely on the type of rosacea you have.
In papulopustular rosacea (the kind typified by pimples, raised bumps, flushing and broken blood vessels in the cheeks), ointments and oral medicines will usually be prescribed by your GP. For mild cases, an antibiotic cream or topical treatment may be advised, usually combined with oral antibiotics in more severe cases.
Other treatment options are available for more persistent and extreme cases – please speak to your GP for the best recommendation for you.
UV exposure is often a trigger so adequate sun protection plays a large part in lessening rosacea symptoms. However some SPFs may irritate already sensitised skin, so choose your formula carefully – mineral sunscreens are often recommended as the best option.
Use a gentle cleanser and light cream moisturiser to avoid overloading the skin. Scent-free products that are hypo-allergenic and contain simple ingredients are recommended.
Consistency is key – avoid changing your skincare too often and stick to a regular routine.
Identify your triggers
Take the time to notice what your natural triggers are and make a note of any recurring patterns in a symptom diary, so you can avoid them in the future. In many cases reducing the consumption of alcohol and spicy food can help.
Be sun smart
Avoid exposure to very strong sunlight and always wear a big hat and sunglasses in warm weather to protect rosacea-prone skin.
Seek out support
Rosacea can have a considerable impact on psychological wellbeing, often affecting mood or self-esteem. Many sufferers feel embarrassed about their appearance while some avoid social or professional situations entirely. If rosacea is causing you to feel anxious or depressed, you may also benefit from counselling or confiding in your doctor.
Avoid strenuous exercise and sweating
While it’s important for your mental and physical wellbeing to keep active, avoid strenuous exercise that causes excessive sweating which can trigger rosacea symptoms. Instead, stick to gentle, moderate exercise like walking, yoga or pilates.
For further information
The National Rosacea Society (US)