If you have rosacea, read this guide to rosacea – knowledge is your best defence against this distressing skin condition

Rosacea is a persistent or recurring inflammatory skin condition affecting the centre of the face. Rosacea causes facial redness and can also produce cysts (small, pus-filled bumps).

If you have rosacea, it will get worse if you do not seek treatment. If you have any red rash, red blotches or red spots on your face, consult your doctor for a professional diagnosis. Sufferers are known to mistake their rosacea for acne, eczema or a skin allergy.

If a GP or dermatologist diagnoses you as having rosacea, there is reassuring news: treatment can control and prevent further damage.

Rosacea diagnosis and treatment – an overview

The rosacea skin condition is common among fair-skinned people, and many sufferers are of English, Irish or Scottish backgrounds. However, the occurrence of rosacea in Asia, including China, is growing.

The disorder is also common in those who blush easily, have sun-damaged skin or are related to sufferers. The condition tends to come and go. In some cases, the skin can be clear for years – and then the rosacea erupts again.

While rosacea affects more women than men, rosacea symptoms in men are usually more severe, perhaps because men are often slower to seek treatment. Rosacea is typically diagnosed when the sufferer is between 30 and 50, although an important indicator – blushing – can begin in the teenage years.

Experts believe rosacea affects about 10 per cent of Australians. Sadly, they also believe that most minor to moderate cases are never diagnosed, which of course means they are never treated.

While no one knows what causes rosacea, many of its triggers are known. We list them below to help you keep this troubling skin condition at bay.

There is no clinical test for rosacea. If your GP suspects you might have rosacea, he or she will examine your skin and ask about symptoms and triggers. Your doctor will look for enlarged blood vessels, a particular distinguishing factor, before coming to a diagnosis. He or she may refer you to a dermatologist.

Because the signs and symptoms of rosacea vary so dramatically, treatment must be tailored to each individual.

Skincare is an increasingly important component of rosacea treatment. Many doctors will recommend you use an appropriate rosacea sunscreen daily. They may also prescribe antibiotics you apply directly to the skin, or oral antibiotics (which you swallow).

Laser treatment is usually recommended for the more resistant or established rosacea symptoms, such as broken capillaries and thickened skin.

Rosacea and facial redness – the emotional and psychological effects.

For many rosacea sufferers, this skin disorder causes great distress. While there is no suggestion rosacea can be life-threatening, its persistence or a return bout can cause the sufferer embarrassment and great misery.

In the US, studies indicate more than three-quarters of rosacea patients are affected psychologically and emotionally. One American study found 42 per cent of its respondents felt sad or depressed over their rosacea, and nearly one in six stayed home from work or from social occasions to hide it.

If you are feeling distressed or intensely embarrassed by your rosacea, talk to your doctor or arrange an appointment with a counsellor or a social worker.

Help! I have red skin on my face! Is this one of the signs of rosacea?

Rosacea primarily affects the face and can be hard to manage. It often becomes more aggressive if left untreated. Symptoms of rosacea may include one or more of the following:

Frequent flushing of the face, similar to blushing. This is often the first symptom and maybe the only symptom for months or years before others develop.
Red marks on the face (erythema), which can look similar to a sunburn.
‘Skin’ sensitivity – blood vessels below the surface of the skin can dilate in reaction to touch or sunlight. This often feels like stinging or burning on the skin’s surface.
Small lumpy red spots on the face (papules) and small cysts on the face (pustules). The spots and cysts look similar to acne. These may come and go in some cases but, in others, remain long term unless treated.
Telangiectasia, or ‘spider veins’, on the face. Tiny blood vessels under the skin swell and become visible.
Thickening of the skin occurs in some cases, although this is uncommon.

No one knows what causes rosacea – but what are the risk factors?

Experts are not sure just what causes rosacea. Contributing factors are believed to include:

Abnormal facial blood vessels
A light skin colour
Mites patients with rosacea have much higher numbers of the microscopic, skin-dwelling mites
Demodex folliculorum than do others. It is possible the rosacea itself causes this overpopulation.
H. pylori bacteria Several experts link this bacteria, which lives in the gut, to the development of rosacea.
Family history Some 30 to 40 per cent of patients with rosacea have a close relative with the condition.

How can I manage this skin condition? What are the rosacea triggers?

Many factors can worsen rosacea by increasing blood flow to the surface of the skin. These include:

Hot foods and drinks
Coffee and caffeine soft drinks
Spicy foods and condiments
Dairy products
Extremes of temperature & fluctuations in ambient temperature
Sunlight (even through glass)
Humidity and wind
Stress (see below) and negative emotions
Vigorous exercise, saunas and hot baths – overheating can cause your capillaries to swell
Steroids
Medication for high blood pressure; other medications
Alcohol – while drinking does not cause rosacea, it can be a trigger for people with the condition.

What are my rosacea treatment options?

There is no cure for rosacea. However, various treatments can relieve the signs and symptoms. A combination of medications and lifestyle changes gives the best results.

Treatment may involve a combination of medications, in two forms. The first are medications you apply to your skin, known as topical medications. The second are pills, tablets or capsules you swallow (oral medications). Both topical and oral medications may include antibiotics.

Laser treatment is often recommended for patients with visible blood vessels (telangiectasia). Rosacea laser treatment is an effective telangiectasia treatment as it removes visible blood vessels, fades facial redness and can correct a disfigured nose.

Ocular rosacea may be treated with oral antibiotics and other therapy.

Your doctor may prescribe camouflage creams for the blemishes on your skin – for more, see the section on skincare below.

Lifestyle and home remedies for rosacea

These measures will help you to manage your rosacea:

Consult a medical professional about which sunscreen is best for you.
Wear a scarf or balaclava to protect your face during winter.
Don’t touch the skin of your face.
When washing, use a gentle cleanser.
Do not use any products that contain alcohol or skin irritants on your face.
Use non-comedogenic creams only. These do not block gland openings.
Don’t get too hot. When sleeping, keep blankets and covers to a minimum
Cut back or cut out alcohol
Switch from wet shaving to shaving with an electric razor.
Avoid spicy foods and condiments.

Unless your doctor has advised you otherwise, do not use over-the-counter (non-prescription) steroid creams. They may worsen your symptoms.

Rosacea and stress – what you can do

Stress triggers rosacea. Reducing the stress in your life will help prevent flare-ups and existing rosacea symptoms from worsening. Exercise regularly (low-intensity exercise is best – you should avoid rigorous exercise), aim to get at least seven hours of sleep per night, and be sensible with your diet.

What is the best skincare for rosacea?

If you suffer from rosacea, ask a medical professional for advice on skincare. A gentle skin-care routine will help you to keep your rosacea at bay. Patients are advised to clean their face with a gentle cleanser, rinse with tepid water and blot the face dry with a non-abrasive towel. Avoid any product that includes a fragrance, alcohol or other irritating or abrasive substance in its ingredients list.

Take careful note of your medical professional’s advice about sunscreen and follow it.

Make-up can conceal some forms of rosacea. Green make-up or green-tinted foundations can counter redness.

True Skin’s clinicians can advise you about the best rosacea treatment and the best skincare routine for you. Give us a call on 0415 620 008 or email us. Your initial appointment is free.

Your guide to rosacea & how to treat it