Rosacea

What causes rosacea?

Rosacea is a common skin condition causing facial redness, with or without pustules, across the facial skin of the cheeks and nose. The redness in this skin disease is caused by dilated blood vessels close to the skin surface. The pustules — often confused with acne — result from chronic inflammation of the skin and blood vessels in the areas where the rosacea occurs.

In its most severe form, rosacea can cause the formation of rhinophyma or a bulbous nose. This only occurs in severe rosacea cases lasting multiple years, and is significantly more common in men.

While the exact cause is unknown, rosacea can be correlated to family history, diet (especially hot drinks and spicy foods), exercise, alcohol, smoking, medications, emotional situations, changes in temperature, and cosmetic products.

It is most commonly seen in middle-aged women with fair skin, however, it can affect individuals of any age, ethnicity, or gender. Not all cases of rosacea are permanent, and some will spontaneously self resolve. There is no single rosacea treatment or ‘cure.’

What are the main concerns related to rosacea?

Within the umbrella term ‘rosacea’ there are a few distinctions between the different variations of symptom appearance and distribution. The American Academy of Dermatology has categorized the four types of rosacea as follows:

• Erythematotelangiectatic Rosacea: The most common and simple form of rosacea-redness across the cheeks and nose.
• Papulopustular Rosacea: This is redness of the skin with the addition of pus-filled papules.
• Phymatous Rosacea: A form of rosacea causing thickened, bumpy skin texture.
• Ocular Rosacea: Rosacea occuring in and around the eyes leading irritation, redness, and stinging. Can cause more severe eye conditions.

Who may wish to seek treatment for rosacea?

Rosacea is not curable, but it is manageable. For light-skinned men and women whose symptoms may be more easily noticed, pursuing at-home and professional treatment can be very effective. In more severe forms of rosacea, seeking treatment can mitigate severity and help prevent long term issues. Regardless of the underlying cause, treatment for rosacea can be a liberating and empowering choice.

How can someone get help for rosacea?

Given how common the condition is, there are a myriad of treatment options ranging from DIYs to professional interventions. An excellent first step in managing rosacea is to identify your triggers. Spicy foods, alcohol, hot baths, and certain personal care products can all contribute to the appearance of rosacea and are easily modifiable. If at-home treatments are not successful, consultation with your medical provider can help determine exactly what is causing your symptoms and the best course of treatment.

Erythematotelangiectatic, Papulopustular, and Phymatous Rosacea

• Laser Skin Resurfacing: Ablative Fractional Laser Skin Resurfacing, Ablative Non-Fractional Laser Skin Resurfacing, Non-Ablative Fractional Laser Skin Resurfacing, excel® V, LED Light Therapy, and Non-Ablative Non-Fractional Laser Skin Resurfacing can be used to collapse the small blood vessels causing the redness under the skin. The patient can expect new, brighter skin.
• Facials: Gently cleansing and exfoliating facial treatments, like Hydrafacial and SilkPeel Facial, can soothe skin and quell inflammation.
• Chemical Peels: Depending on the severity of the rosacea, gentle peels such Superficial Chemical Peels, Glycolic Peels, and Salicylic Acid Peels can refresh and rejuvenate skin. For more severe forms, a medium-depth peel, like a Jessner’s Peel, may be needed for better penetration of the dermal layers.

For Papulopustular and Phymatous Rosacea

• Isotretinoin (Accutane): Although predominantly used for acne, isotretinoin can also be used to lessen pustule formation and overactive sebaceous (oil) glands that contribute to this type of rosacea.

For Ocular Rosacea

• Antibiotics: Depending on severity, home eye care can be used. In some cases of ocular rosacea, to avoid permanent eye problems antibiotics will be used to heal and treat the area.

For more information on the treatment options outlined above, check out our guide to Rosacea Solutions.