Keywords: Rosacea, Facial Redness, Visible Blood Vessels, Enlarged Nose
What Is Rosacea?
Rosacea (pronounced "roh-ZAY-sha") is a chronic, relapsing and potentially life-disruptive disorder of the facial skin that affects an estimated 14 million Americans. Many have observed that it typically begins any time after age 30 as a redness on the cheeks, nose, chin or forehead that may come and go. In some cases, rosacea may also occur on the neck, chest, scalp or ears. Over time, the redness becomes ruddier and more persistent, and visible blood vessels may appear. Left untreated, bumps and pimples often develop, and in severe cases the nose may grow swollen and bumpy from excess tissue. This is the condition, called rhinophyma (pronounced "rhi-no-FY-muh"), that gave the late comedian W.C. Fields his trademark bulbous nose. In many rosacea patients, the eyes are also affected, feeling irritated and appearing watery or bloodshot.
Although rosacea can affect all segments of the population, individuals with fair skin who tend to flush or blush easily are believed to be at greatest risk. The disease is more frequently diagnosed in women, but more severe symptoms tend to be seen in men -- perhaps because they often delay seeking medical help until the disorder reaches advanced stages.
While there is no cure for rosacea, medical therapy is available to control or reverse its signs and symptoms. Individuals who suspect they may have rosacea are urged to see a dermatologist for diagnosis and appropriate treatment.
What Should I Look For?
Facial redness from rosacea may appear similar to a blush or sunburn, and may be caused by flushing -- when a large amount of blood flows through vessels quickly and the vessels expand under the skin to handle the flow. The redness tends to become ruddier and more persistent over time. Burning and stinging are common in many with rosacea, and swelling may also occur. In some patients the facial skin may appear to be very dry.
Visible Blood Vessels
Visible blood vessels called telangiectasia (pronounced "tell-an-jek-TAY-zha") may appear on the surface of the skin in some patients. The small blood vessels on the face may grow permanently larger from flushing and eventually show through the skin. These enlarged blood vessels look like thin red lines on the face, usually on the cheeks or nose. These lines may be hidden by facial redness, but become more noticeable when the redness is cleared up.
Bumps and Pimples
Rosacea sufferers often develop small, red, solid bumps known as papules, and/or pus-filled pimples known as pustules. These bumps and pimples may be inflamed and look similar to teenage acne. However, rosacea does not normally involve follicular plugging (blackheads, comedones) as seen in acne. Rosacea may also cause raised red patches known as plaque.
In about half of rosacea patients, the eyes may be irritated and appear watery or bloodshot. In many cases, the eyes may feel as if a foreign object is present or feel "gritty." The eyelids may also become red and swollen, and styes are common. Symptoms are typically mild, but severe cases can result in vision loss without medical help.
In severe cases, the nose may become swollen from excess tissue, and small knobby bumps may appear. Known as rhinophyma, this condition affects more men than women. In rare cases, skin thickening or excess tissue may develop in facial areas other than the nose.
Please see the Faces of Rosacea page for photographs showing the signs and symptoms of rosacea.
How Is Rosacea Treated?
The signs and symptoms of rosacea vary substantially from one patient to another, and treatment must therefore be tailored by a physician for each individual case.
Various oral and topical medications may be prescribed to treat the bumps, pimples and redness often associated with the disorder. Dermatologists usually prescribe initial treatment with oral antibiotics and topical therapy to bring the condition under immediate control, followed by long-term use of the topical therapy alone to maintain remission.
When appropriate, treatments with lasers, intense pulsed light sources or other medical and surgical devices may be used to remove visible blood vessels, reduce extensive redness or correct disfigurement of the nose. Ocular rosacea may be treated with oral antibiotics and other therapy.
In addition to medical treatment, rosacea sufferers can improve their chances of maintaining remission by identifying and avoiding lifestyle and environmental factors that trigger rosacea flare-ups or aggravate their individual conditions. The National Rosacea Society offers a free Patient Diary Checklist to assist patients in identifying factors that may affect their individual cases, as well as a booklet called "Coping with Rosacea" that provides tips on lifestyle management.
Acknowledgments: This section was reviewed and edited by Dr. Larry Millikan, chairman of Dermatology, Tulane University; Dr. Guy Webster, professor of Dermatology, Thomas Jefferson University; and Dr. Diane Thiboutot, associate professor of Dermatology, Pennsylvania State University.
This Article is taken from National Rosacea Society and is used with permission