Rosacea is a skin disorder that may affect as many as 45-50 million people worldwide and approximately 14 million people in the United States alone. The condition is primarily characterized by inflammation and reddening of the facial skin. It commonly occurs on and around the nose, cheeks, forehead, chin, eyelids, and occasionally on the neck and upper chest.
The redness sometimes progresses to visible vessels, swollen bumps, called papules, or pus-filled bumps, called pustules that are often mistaken for adult acne, and in some cases, thickened skin that results in a red, bulbous nose. Most people with rosacea don’t even realize they have it and are not treating it. Although the red facial skin is harmless, the red-faced appearance often causes people with rosacea to be unhappy with their appearance.
Those afflicted with rosacea may first notice a tendency to flush or blush easily. The condition progresses to persistent redness, pimples, and visible, threadlike blood vessels (telangiectasias) in the center of the face. These skin changes can eventually spread to the cheeks, forehead, chin, and nose.
How Does Rosacea Occur?
Before learning about rosacea treatment and prevention, it will help to understand a little about your skin and how rosacea occurs. The skin is composed of two main layers, the epidermis and the dermis. The epidermis is the outer layer that acts as the body’s primary defense against the environment. The inner layer, or dermis, is comprised primarily of connective tissue, which is made mostly of collagen and elastin fibers. These fibers form a network that provides your skin with structure, support, and elasticity. Rosacea develops as a result of skin inflammation, changes to the skin’s connective tissue, and dilation of the blood vessels in the dermis.
Rosacea results from a cascade of events starting with skin inflammation that causes blood vessels to dilate. The enlarged vessels also become more permeable and leak white blood cells into the surrounding, inflamed connective tissues. The white blood cells within the connective tissue cause swelling and also stimulate the growth of additional blood vessels, some of which grow near the surface of the skin and become visible. Over time, the new vessels will dilate and become more permeable, continuing the cycle. The dilated vessels cause the telltale redness associated with rosacea.
Although some people describe being able to see broken vessels with certain stages of rosacea, they are generally referring to the visible, enlarged vessels near the skin surface. Scientists do not fully understand what causes rosacea. Rosacea may arise from a single specific trigger, or as a result of a combination of factors and genetics. There is evidence that certain environmental factors, foods, drinks, and medications may trigger rosacea. In addition, some researchers believe that specific living organisms may possibly even play a role in the flushing and blushing that precede rosacea.
Who Does Rosacea Affect?
Rosacea affects people of all ethnicities, skin colors, gender, and age. However, there are patterns in which certain groups of people are more likely to develop rosacea than others. Rosacea tends to occur in fair-skinned people more often than people with darker skin. The onset of rosacea primarily occurs between the ages of thirty and sixty, but it can also first appear in children or the elderly. Rosacea afflicts many more women than men, and it is sometimes occurs around menopause. However, although there are more cases in women, men generally develop far more severe rosacea symptoms.
Rosacea doesn’t always worsen over time but the symptoms often progress when left untreated. As rosacea progresses it may present symptoms from any or all of the different subtypes. Based on genetics, some rosacea sufferers are more susceptible to certain symptoms than others. Early diagnosis and treatment is often effective in preventing the progression of rosacea symptoms. Therefore, if blushing tends to be brought on by your diet, medications, or other environmental factors; or if you notice that periods of flushing last longer and longer, consult your dermatologist.
Rosacea Treatment and Prevention
A dermatologist can help you identify substances or activities that cause flushing and trigger rosacea flare-ups. Keeping a symptom diary may also help to see patterns and identify triggers that make your rosacea worse. The best prevention is to avoid triggers. If you find that you are sensitive to sun exposure, specific skin care products, foods, drinks, alcohol, tobacco products, stressful situations, temperature extremes, or strenuous exercise, do your best to avoid them. Your dermatologist may recommend a regimen that includes using mild cleansers or warm compresses or may even provide prescriptions for various acne products, medications that inhibit immune reactions, antibiotics, anti-inflammatory medications, or cell-growth inhibitors, based on your needs.
Additionally, laser procedures can be effective in removing tissue growth or reducing the redness and visible vessels once rosacea triggers are under control and symptoms subside. Rosacea responds to treatment, but it may take several weeks or months before you notice improvement. Papules and pustules generally respond to treatment quickly; whereas redness and flushing tend to respond slowly. Be patient, as your dermatologist may need to tailor your medication dosages or suggested skin care routines to achieve the desired results for your particular needs. By following the customized treatment plan and avoiding triggers, you can often stop the progression of rosacea over time and even reduce your symptoms and improve your skin’s overall appearance.