Rosacea (rose-AY-sha) is a chronic inflammation of the skin of the face that causes redness and swelling. Characterized by enlargement of blood vessels in the skin, the conditionwhich affects 13 million Americanstypically affects the forehead, chin, cheeks and nose.
It often begins with brief periods of facial flushing that may not even be noticed. In time, rosacea leads to the appearance of small spidery blood vessels (telangiectasia) and tiny pimples in and around the reddened area (which is why it was once known as adult acne). In some cases rosacea may be accompanied by oily skin and dandruff.
In more advanced cases, thick red bumps may develop on the lower half of the nose and spread to the cheek. This condition, called rhinophyma, is more common in men than women, with its victims often mistaken for alcoholics, thanks to the comedian W.C. Fields, who had rhinophyma and rosacea and regularly referred to his nose bumps as "gin blossoms." But teetotalers can certainly get rosacea.
Rosacea is sometimes called the curse of the Celts because so many people who develop it are of Irish ancestry. In fact, it can also afflict other ethnic groups. Still, those most likely to develop rosacea are adults with fair hair and skin, typically women between the ages of 30 and 60. When it strikes men, rosacea is often more severe.
Symptoms of Rosacea
- Areas of the face appear to blush for a few minutes to a few hours
- In some cases, outbreaks can leave a permanent sunburned appearance
- Blood vessels in areas with rosacea enlarge and become more visible through the skin
- Pimples appear in some cases
- Small, red lines under the skin
- In about half of the cases a burning, gritty sensation and itching are experienced in the eyes
- Vision problems
What Causes Rosacea?
Some experts believe a vascular disorder is the cause. Since rosacea can affect several family members, researchers think there is a genetic component to the disease. The actual cause of rosacea is still unknown, but a number of diverse factors can aggravate the condition, including stress, spicy foods, smoking, alcohol, temperature extremes, humidity, strenuous exercise, hot drinks, wind, excessive sunlight, and skin products that contain irritating ingredients.
What If You Do Nothing?
Rosacea rarely reverses itself and may last for years, worsening without treatment.
Home Remedies for Rosacea
Rosacea can’t be cured, but it can be treated with several medications prescribed by your physician. In addition, the following measures may help.
- Try to avoid direct sun. Sunlight is a common aggravating factor. When you must be in the sun, wear a hat and be sure to apply sunscreen.
- Keep a trigger diary. One way to help control rosacea is to avoid anything that you think makes your face flush. Keeping a diary of such triggers may help. These might include alcoholic beverages, alcohol applied to the skin, hydrocortisone creams, sun exposure, hot baths, hot or very cold weather, vigorous exercise, heavy lifting, straining on the toilet, chronic cough, menopause, or emotional upset. Hot spices and peppers, hot drinks, chocolate, yogurt, and tomatoes may aggravate rosacea. So can certain drugs, such as niacin in large doses (for lowering cholesterol) and blood pressure medications. Most over-the-counter “remedies” aggravate rosacea rather than help it.
- Check your cosmetics and medications. Certain medications may dilate blood vessels and worsen rosacea. Instead of using oil-based products, switch to less irritating water-based cosmetics.
- Reduce stress in your life. Do your best not to suppress anger, fear, or other strong emotions.
- Avoid rubbing your face. This can irritate your skin.
- Gently wash your face with a non-abrasive soap. Use lukewarm water when washing your face. Avoid using hot water because it may inflame or irritate the skin.
- Switch to an electric shaver. Razor blades can irritate the skin. Avoid aftershave lotions containing alcohol, menthol, witch hazel, or peppermint.
- Apply a cold compress. Soak a cloth in ice-cold water and apply it to the flushed areas of your face for 10 minutes. This will help constrict dilated blood vessels and slow down the inflammatory process.
- Avoid extremes of temperature. When it’s very hot or cold, rosacea symptoms can intensify.
There are no specific preventive measures for rosacea, but you can help control it by avoiding anything that makes your face flush.
Beyond Home Remedies: When To Call Your Doctor
Rosacea can be treated and controlled if it is diagnosed early and treatment begins immediately. At first, rosacea usually appears, disappears, and then reappears a short time later. When you notice that the skin doesn’t return to its normal color after an outbreak, and when you develop other symptoms such as pimples and enlarged blood vessels, you should contact your physician, who may refer you to a dermatologist. You may also see an ophthalmologist if your eyes and eyelids are involved.
What Your Doctor Will Do
After a careful examination and diagnosis, your physician may prescribe topical medications or oral antibiotics to reduce the facial redness and inflammation and to heal the bumps—a process that requires patience, since it can take weeks or even months. For severe cases laser treatment and/or surgery may be recommended. Rosacea can recur for years or even over a lifetime, and each recurrence should be treated.
The Complete Home Wellness Handbook
John Edward Swartzberg, M.D., F.A.C.P., Sheldon Margen, M.D., and the editors of the UC Berkeley Wellness Letter
Updated by Remedy Health Media