What is Rosacea?

Rosacea on cheekRosacea is a very common condition that leads to redness and pimples on the face. It can often be confused with acne. What makes it different is that rosacea tends to occur in older patients and also involves flushing, broken blood vessels, and sensitive skin. Rosacea can sometimes affect the eyes in addition to the skin. This can lead to stinging or burning of the eyes or irritation with light. If eye symptoms occur, it is important to be seen by an ophthalmologist.

You may have rosacea if you have the following:

  • Flushing
  • Papules
  • Pustules
  • Telangiectasias (broken blood vessels)
What is the cause of Rosacea?

The cause of rosacea is not yet known but there are many theories that exist. We know that certain factors can aggravate or trigger rosacea and these include sunlight, menopause, topical anti-inflammatory creams, spicy foods, and also alcohol.

How is Rosacea diagnosed?

Rosacea is usually diagnosed by the dermatologist clinically. This is because it presents with classic features with redness, broken blood vessels, and spots. These are red bumps but also pustules. Sometimes if there is confusion about the diagnosis or another diagnosis needs to be excluded such as lupus or sarcoidosis then a biopsy may be taken.

How is Rosacea treated?

Rosacea treatment varies depending on the severity of the condition. However, for all rosacea suffers, there are some very important general measures that should be adhered to. These include sun avoidance, the use of oil-free products, and the avoidance of hot spicy foods, long hot showers, and hot beverages.

Medical treatment of Rosacea

Rosacea can be treated both topically and also with oral tablets.

Topical creams: These include metronidazole (Rozex) and also azelaic acid (Finacia). A new product available this year in Australia is ivermectin (Soolantra). These help with the papules and pustules. For inflammation, tacrolimus or pimecrolimus may also be used.

Oral tablets: These are also available for rosacea and include antibiotics. Usually, tetracyclines are used and this is to reduce inflammation and papule and pustule formation. If your rosacea is very severe or is resistant to this treatment, then you may require a course of isotretinoin. This is used at a very low dose over a longer period of time to enable side-effects to be dramatically reduced but also allowing for improvement of rosacea.

Vascular laser: Medical treatment helps with the papules and pustules but cannot help with the redness or dilated blood vessels. This requires treatment with a vascular or red laser. Two to five treatments are usually required with ongoing treatment on a yearly basis as well to maintain effect. Your dermatologist will discuss this with you further if you are appropriate for this option of treatment.