ROSACEA

Rosacea is a papular inflammatory eruption of the face in adults. It is not acne and this author prefers to avoid the term "acne rosacea." Red, inflamed papules and pustules develop on the nose and cheeks. Often there is a background of redness, superficial blood vessels (telangiectasias) and flushing. Hot foods or liquids, sun, and wind may trigger the flushing. Redness or blood vessels alone, without papules and pustules, is not rosacea.

• Rosacea seems to represent a mild surface infection or overgrowth by normal flora--particularly Demodex.
  
• Fair-skinned adults are preferentially affected.
• Patients with rosacea often have sensitive skin.
  
• Mask wearing aggravates all aspects of rosacea in the covered areas.
  
• Ocular rosacea may accompany rosacea. Signs include red or dry eyes. Symptoms include burning, stinging, light sensitivity, and foreign-body sensation.
  
• Woman with rosacea are more likely to have migraines.
• Chronic topical steroid use on the face may induce a rosacea-like eruption, so called steroid-rosacea.
  

General Measures

• Use a gentle skin care routine with unscented cleansers and moisturizers (e.g., Cetaphil, Dove Sensitive Skin, Cerave)
• Avoid cleansers with abrasive or exfoliating agents, alcohol, acetone, and scents.
• Allow skin to dry before applying any medication (or moisturizer).
• Always apply any prescription medication first, before any moisturizer or makeup.
• A green-tinted makeup can help reduce the appearance of redness.
• If flushing is a problem, triggers (e.g. hot foods or liquids) should be avoided as much as possible.

Treatment

There are various approaches to the treatment of rosacea. You and your doctor will decide which is best for you. Often, a combination of a pill (e.g. doxycycline) and a topical medication (e.g. Triple cream containing ivermectin, azelaic acid and metronidazole) is used initially to control the rosacea. Once control is achieved, the pills are stopped and the skin kept clear with just the topical medication.

As always, let your doctor know of any problems, side effects of the medications, or if the rosacea fails to improve.

See rosacea for more information and pictures.

RegionalDerm

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