Symptoms, Causes & Treatments
Rosacea is a common skin condition that causes redness and visible blood vessels in your face. It may also produce small, red, pus-filled bumps. These signs and symptoms may flare up for a period of weeks to months and then diminish for a while. Rosacea can be mistaken for acne, an allergic reaction or other skin problems.
Rosacea can occur in anyone. But it most commonly affects middle-aged women who have fair skin. While there’s no cure for rosacea, treatments can control and reduce the signs and symptoms. If you experience persistent redness of your face, see your doctor for a diagnosis and proper treatment.
Signs and symptoms of rosacea may include:
• Facial redness. Rosacea usually causes a persistent redness in the central part of your face. Small blood vessels on your nose and cheeks often swell and become visible.
• Swollen red bumps. Many people who have rosacea also develop pimples on their face that resemble acne. These bumps sometimes contain pus. Your skin may feel hot and tender.
• Eye problems. About half of the people who have rosacea also experience eye dryness, irritation and swollen, reddened eyelids. In some people, rosacea’s eye symptoms precede the skin symptoms.
• Enlarged nose. Rarely, rosacea can thicken the skin on the nose, causing the nose to appear bulbous (rhinophyma). This occurs more often in men than in women.
The cause of rosacea is unknown, but it could be due to a combination of hereditary and environmental factors. Rosacea is not caused by poor hygiene.
A number of factors can trigger or aggravate rosacea by increasing blood flow to the surface of your skin. Some of these factors include:
• Hot drinks and spicy foods
• Temperature extremes
• Sunlight or wind
• Drugs that dilate blood vessels, including some blood pressure medications
Treatment for rosacea focuses on controlling signs and symptoms. Most often this requires a combination of skin care and prescription treatments.
The duration of your treatment depends on the type and severity of your symptoms. Recurrence is common.
The type of medication your doctor prescribes depends on what signs and symptoms you’re experiencing. Prescription drugs for rosacea include:
Medications that reduce redness.
Recent studies have shown the drug brimonidine (Mirvaso) to be effective in reducing redness. It is applied to the skin as a gel. It works by constricting blood vessels. You may see results within 12 hours after application. The effect on the blood vessels is temporary, so the medication needs to be applied regularly to maintain any improvements seen.
Other topical products that have been shown to reduce redness and the pimples of mild rosacea are azelaic acid and metronidazole. With these drugs, improvements generally don’t appear for three to six weeks.
Antibiotics help reduce some types of bacteria but likely mainly fight inflammation when used for this disease. Doxycycline is an antibiotic taken as a pill for moderate to severe rosacea with bumps and pustules. Other similar oral antibiotics are also sometimes used (tetracycline, minocycline, others), but their effectiveness isn’t as well-supported by studies.
If you have severe rosacea that doesn’t respond to other therapies, your doctor may suggest isotretinoin (Amnesteem, Claravis, others). It’s a powerful oral acne drug that also helps clear up acne-like lesions of rosacea. Don’t use this drug during pregnancy as it can cause serious birth defects.