Rosacea and It's Treatment

Rosacea (say "rose-ay-shah") is a disease that affects the skin on the face. It often begins as redness that looks like a blush across the nose, cheeks, chin or forehead. As time goes on, red pimples and pus-filled bumps may appear. Some people also notice small blood vessels across their nose and cheeks. In some people, the skin of the nose may become red and thick. This is called rhinophyma (say "rye-no-fie-muh").

A chronic skin eruption, rosacea produces flushing and dilation of the small blood vessels in the face, especially the nose and cheeks. Papules and pustules may also occur but without the characteristic comedones of acne vulgaris. Rosacea is most common in white women between ages 30 and so. When it occurs in men, however, it's usually more severe and commonly associated with rhinophyma, which is characterized by dilated follicles and reddened, thickened, and bulbous skin on the nose. Ocular involvement may result in blepharitis, conjunctivitis, uveitis, or keratitis. Rosacea usually spreads slowly and rarely subsides spontaneously.

What causes Rosacea?

Although the cause of rosacea is unknown, stress, infection, vitamin deficiency, menopause, and endocrine abnormalities can aggravate it. Anything that produces flushing - for example, hot beverages, such as tea or coffee; tobacco; alcohol; spicy foods; physical activity; sunlight; and extreme heat or cold - can also aggravate rosacea.

Rosacea may be aggravated by facial creams or oils, and especially by topical steroids .

Signs and symptoms of Rosacea

Rosacea generally begins with periodic flushing across the central oval of the face, accompanied later by telangiectasia, papules, pustules, and nodules. Rhinophyma is commonly associated with severe rosacea but may occur alone. Rhinophyma usually appears first on the lower half of the nose, and produces red, thickened skin and follicular enlargement. It's found almost exclusively in men over age 40. Related ocular lesions are uncommon.

Characteristics of rosacea include:

• Red papules and sometimes pustules on the nose, forehead, cheeks and chin. Rarely it involves the trunk and upper limbs.
• Frequent blushing or flushing
• A red face due to persistent redness and/or telangiectasia ('broken capillaries')
• Dry and flaky facial skin
• Aggravation by sun exposure and hot and spicy food or drink (anything that reddens the face)
• Sensitive skin: burning and stinging, especially with make-up, sunscreens and other facial creams
• Red, sore or gritty eyelids including papules and styes (blepharitis and/or conjunctivitis)
• Enlarged unshapely nose with prominent pores ( sebaceous hyperplasia ) and fibrous thickening (rhinophyma)
• Firm swelling of other facial areas including the eyelids (blepharophyma)

Diagnosis information

Typical vascular and acneiform lesions - without the comedones characteristically associated with acne vulgaris - and rhinophyma in severe cases confirm rosacea.

Treatment of Rosacea

Treatment of the acneiform component of rosacea consists of oral tetracycline (Sumycin) or erythromycin (Erythocin) in gradually decreasing doses as symptoms subside. Resistant cases can be treated with oral metronidazole (Flagyl). Isotretinoin (Accutane) is also effective. Topical metronidazole gel (Metro Gel) helps resolve papules, pustules, and erythema.
Combination acne products, including over-the-counter and prescription products (such as Sulfacet-R Lotion and Clearasil) are available in flesh tones, control pustules, and hide redness. They can be used alone or with oral antibiotics. Topical application of 1 % hydrocortisone cream reduces erythema and inflammation. Other treatments include electrolysis to destroy
large, dilated blood vessels and removal of excess tissue in patients with rhinophyma.

Home remedies to cure Rosacea

• Alfalfa is a good source of chlorophyll, which has detoxifying properties. It also supplies many needed vitamins and minerals. Helps to cure rosacea.
• Apply aloe vera gel, garlic oil, and comfrey and goldenseal tea.
• In severe cases, a laser or electrical device can be used to remove the excess tissue. Dermabrasion also has helped some people with rosacea.

Special considerations and Prevention

• Instruct the patient to avoid hot beverages, alcohol, extended sun exposure, and other possible causes of flushing.
• Assess the effect of rosacea on body image. Because it's always apparent on the face, your support is essential.
• Refer your patient to a dermatologist, as necessary.