SKIN CONDITIONS
Rosacea
Facial flushing, redness, prominent vessels, sensitive skin and eyes.
- Long-term condition
- Careful skin care; avoid triggers and irritants
- Light-based treatments such as vascular laser and BBL
Rosacea is a skin condition with symptoms of facial redness, flushing, irritation, acne-like lumps and sensitive skin. More advanced rosacea leads to prominent red blood vessels and overgrowth of the skin leading to an enlarged nose.
Rosacea treatments can include laser, intense pulsed light and other light-based treatments, prescription creams or oral antibiotics. These treatments can improve damaged skin, provide optimal skin care, and relieve rosacea symptoms. People with rosacea should avoid triggers for flushing and choose skin care products that help reduce skin inflammation, redness, flushing, and other symptoms.
What is rosacea?
Causes of rosacea
Rosacea appears to be caused by a complex interaction of many factors:
- Rosacea tends to be more common in families, especially those of northern European descent. A genetic change seen in people with rosacea can predispose to inflammation of the blood vessels and skin follicles of the face.
- Environmental factors can trigger inflammation of the blood vessels in the skin and lead to rosacea outbreaks.
- There may be increased numbers of the normal skin mite Demodex folliculorum or an imbalance in the organisms in the gut.
- In rosacea, the skin barrier may not function effectively, leading to water loss and dry skin.
Symptoms of rosacea
Rosacea is more than simply a cosmetic concern. Rosacea has many different combinations of symptoms. For most people with rosacea, the facial skin condition is usually lifelong, and symptoms will come and go over many years, requiring repeated skin care treatments.
For most people with rosacea, the facial skin condition is usually lifelong, and symptoms will come and go over many years, requiring repeated skin care treatments.
There currently isn’t a cure for rosacea, but treatments can be an effective way to relieve symptoms. Treatments are usually effective for months to years, but constant attention to skin care is necessary and occasional maintenance treatment is required to control rosacea symptoms.
Symptoms of rosacea include:
- Facial redness with constantly red cheeks or nose.
- Episodes of increased blood flow in the face, causing uncomfortable and embarrassing flushing.
- Prominent blood vessels on the face, visible as a fine network of overgrown red capillaries (sometimes called “spider veins”).
- Small pimple-like lumps, which may resemble acne.
- Sensitive skin.
- Sore and red eyes.
- The skin may be dry or oily.
- Rosacea over many years can lead to rhinophyma – overgrowth of the skin of the nose – with a bulbous, misshapen appearance. This is more common in older men.
Symptoms of rosacea are commonly caused by triggers such as heat, exercise, alcohol or spicy foods.
MBBS, MA (Virtual Comm), Grad Cert Hlth Info, Grad Dip Comp Inf Sci
Rosacea affecting a man's cheek and nose
Rosacea causing redness, telangiectasia (visible capillaries), small pustules and inflammation around the eyes.
Young woman with rosacea. Vessels, redness and pustules.
Woman with facial rosacea
Close-up view of telangiectasia of the nose, as seen in rosace
Treatment of rosacea
The best treatment for rosacea is a combination of skincare products with low-irritant products, minimising exposure to triggers, using topical or oral medications, and using light-based treatments such as laser or intense pulsed light (IPL).
Laser rosacea treatment
Laser and intense pulsed light (IPL) treatments (we refer to both as “laser” treatments for convenience) can help reduce persistent redness and visible capillaries. Laser treatment uses a very bright light applied directly to the skin to destroy overgrown facial blood vessels. Laser or intense pulsed light (IPL) is the best treatment to remove or reduce the appearance of capillaries on the skin.
Laser or intense pulsed light (IPL) is the best treatment to remove or reduce the appearance of capillaries on the skin.
Laser treatment can also effectively manage other intermittent symptoms such as flushing, redness, skin irritation and sensitivity. In cases where laser does not reduce these symptoms, a course of oral or topical medication is usually recommended.
Laser treatments can also treat sun-damaged skin or cosmetic concerns such as facial freckles and angiomas.
Medications for rosacea
Prescription creams and oral medications help manage flushing, redness and inflammation of the skin but unlike laser treatments, cannot effectively treat facial blood vessels.
Topical creams and gels
Topical skin treatments (creams or ointments) usually must be applied once or twice daily for up to three months. Topical medications commonly prescribed for rosacea include antibiotics, medication to kill skin mites or anti-inflammatory products.
Oral medications
Oral medications are often prescribed if topical rosacea therapy is not effective. These rosacea medications may have side effects and are not always safe to use during pregnancy or breastfeeding, so they are not usually recommended as first-line treatment.
Complications of rosacea
One complication of late stage rosacea is rhinophyma, which involves the thickening of the skin on the nose and the enlargement of the sebaceous glands, often resulting in a bulbous and red appearance. Rosacea can also have significant psychological impacts. Many individuals experience lowered self-esteem and self-confidence due to the visible symptoms, which can lead to social anxiety and isolation.
Before and after
Before and after a rosacea treatment course: BBL treatments and oral medication
Before and 3 months after a single BBL treatment for rosacea
Treatments for rosacea
Managing your rosacea
Controlling rosacea outbreaks on your skin requires more than laser treatment or medications. It’s important to look after the skin carefully and minimise exposure to triggers that make rosacea worse.
Avoid substances that irritate the skin such as fragrances, alcohol-based products, essential oils, harsh and drying soaps, toners and some-mineral make-up.
Use skin products that help settle inflammation and reduce redness. These include moisturisers and cleansers containing nicotinamide, colloidal oatmeal, aloe vera, panthenol, ginkgo biloba and bisabolol (chamomile extract). Anti-oxidant products such as vitamin C and green tea can also reduce rosacea symptoms.
Protect the skin from ultraviolet radiation by using a low-irritant sunscreen on your skin every day.
Know your rosacea triggers. Many different triggers can lead to rosacea facial flare-ups. These can include sun exposure, exercise, alcohol and certain foods and drinks. Once you identify triggers to rosacea, avoid or minimise exposure to them as much as possible.
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