Facts About Rosacea
Rosacea affects 1 in 10 people
Rosacea is a chronic inflammatory skin disease that predominantly involves the central face and tends to progress with time. It affects approximately 10% of the total UK population Rosacea can also affect the neck, scalp, and eyes and is characterized by flushing, erythema (redness), papules and pustules (raised red or pus filled spots) and dilated blood vessels in the skin known as telangiectasias. In some cases it can result in thickening of the skin leading to disfigurements e.g. a bulbous nose.
Rosacea is more common in women than men
Rosacea is three times more common in women than men, although men seem to suffer more severe disease. There is a genetic tendency as rosacea can run through families and although it is seen more commonly in fair-skinned people and is sometimes referred to as the “Curse of the Celts”, it is also seen in Asian skin.
Rosacea peaks between 40-60 years
Rosacea peaks at the age of 40-60 years, but may occur in teenagers and early 20s. The condition may coincide with acne and a form of eczema called seborrhoeic dermatitis. It is important for a doctor to distinguish these conditions so that the best treatment can be offered.
Diagnosis of Rosacea requires clinical assessment
There are no specific tests for rosacea. Diagnosis relies largely on the clinical assessment based on a thorough history and a visual inspection of the skin. Until fairly recently, rosacea was seen as a progressive disease, beginning with flushing, followed by erythema (redness) and dilated blood vessels (telangiectasia), red inflamed and pus filled spots, as well as skin thickening especially on the nose which is called rhinophyma. This progression is now not considered inevitable. Four individual subtypes of rosacea are now recognised - Erythematotelangiectatic Rosacea, Papulopustular Rosacea, Phymatous Rosacea and Ocular Rosacea. (To learn more about these subtypes read Dr Alison Layton’s Paper ‘Living With Rosacea’ at yinyangskincare.co.uk)
The underlying causes of rosacea are not clearly understood
Underlying causes are a mixture of genetic predisposition and environmental/behavioural influences. Rosacea can run in families and many sufferers think that they have simply inherited “rosy cheeks” not appreciating that there may be some therapy to help modify this appearance.
Alcohol is a recognised trigger for rosacea
A flushed complexion is also associated in people’s minds with high alcohol intake: this stigma can be unfairly applied to rosacea sufferers. However alcohol is a recognised trigger factor for flushing and an attack of rosacea.
Sun exposure will aggravate rosacea
In 70% of cases, sun exposure will aggravate rosacea and can lead to degeneration of the elastic tissue in the skin.
Dietary & other triggers for rosacea
There are a number of trigger factors for flushing which may also aggravate the disease. Because these factors can vary from person to person, it is a good idea for sufferers to keep a detailed daily diary to help establish links between flushing episodes and possible triggers, which may include:
Environmental Triggers:
- temperature extremes
- wind
- ultra violet light
Dietary Triggers:
- hot, spicy foods
- alcohol
- some hot drinks
Medication Triggers:
- vasodilators
- Emotional factors
- Physical exertion
- Hormonal factors
- Skin care products
Topical Treatments for Rosacea
A recently published review examining treatments for rosacea concluded that there was good evidence for the use of the topical treatments, ie. treatments that are directly applied to the skin in the form of metronidazole and azelaic acid.
Systemic Treatments for Rosacea
There is some evidence for the use of the oral antibiotics oxytetracycline and metronidazole.
Surgical Treatments for Rosacea
Surgery, either by conventional surgical dermobrasion or laser ablation, has a role in treating rosacea.
Psychosocial Impact of Rosacea
A link between depression and rosacea has been highlighted in a controlled trial (and other studies have supported this connection . Clinicians need to be aware of the “quality of life” issues and appreciate that sufferers may be highly susceptible to psychological upset.
Information for Rosacea Sufferers
Sufferers need to receive comprehensive information explaining the condition: this can be through a variety of methods, such as leaflets, websites, patient help groups, etc. Trigger factors should be highlighted and lifestyle adjustments suggested where possible. Advice on camouflage should not be underestimated: sufferers find it very beneficial and it can aid them to function more normally during periods of flare-up, again improving their quality of life.
Rosacea Support Groups
Sufferers can be put in touch with support groups, who can provide additional information and help, such as the teaching of cognitive behavioural therapy techniques, which aim to make patients more socially confident. Examples of Rosacea support groups include:
Outlook - http://www.nbt.nhs.uk/services/surgery/outlook/
Changing Faces http://www.changingfaces.org.uk/Home
Caring for Skin with Rosacea
- Wash with body temperature water
- Use very gentle non-alcohol-based cleansers
- Use fingertips and not a flannel to wash
- Blot dry, don’t rub!
- Apply topical agents 30 minutes after cleansing
- Try to avoid anything known to cause stinging, flushing or redness
To learn more read ‘Living With Rosacea’ by Dr Alison Layto