International Academy of Cosmetic Dermatology

ROSACEA

Rosacea is a common skin condition which is sometimes called “The Curse of the Celts,”  due to its tendency to affect mostly fair skinned people.  Patients who develop rosacea often have an unpleasant redness of the face.  This can be associated with flushing, and in its typical form, there is an outbreak of red spots, both bumps and pustules which are found on the center of the forehead, around the nose, and on the chin.  In men who have lost some of their scalp hair, these spots can even occur on scalp in areas where the hairline has receded.  About a third of the patients who develop rosacea also develop an uncomfortable sensation of itching.  There may be watering of their eyes.  Rarely, a serious inflammation of the eyes can accompany the skin disorder – ocular rosacea.

Rosacea tends to be a chronic or persistent skin condition.  It fluctuates in severity, and it may be worse at times of stress.  Some people find that hot liquids, alcohol, and spicy foods increase their tendency to flushing, if this is present.  Most patients also find that sun light, by making the surrounding skin slightly redder, disguises the rosacea but does not tend to affect it otherwise.

Treatment of rosacea consists of using a high SPF sunscreen to prevent the potential damage.  If rosacea is characterized by the presence of bumps and pustules, then antimicrobials are indicated:  topical – metronidazole or azeliac acid and systemic doxycycline or minocyclinecan be applied to the skin.  Telangiectasia, the broken blood vesselsare treated by electrodestruction or lasersurgery.

There is no cure, and relapses are common.  Contrary to popular belief rosacea is not caused by alcohol excess.  Rhinophyma, or a swelling or distortion of the nose, rarely accompanies rosacea; it is seems almost exclusively in men.

Frank Powell, MD
Dublin, Ireland