Drexel University College of Medicine

Diseases and Conditions

Rosacea

Definition

Rosacea is a chronic skin condition involving inflammation of the cheeks, nose, chin, forehead, or eyelids. It may appear as redness, prominent spider-like blood vessels, swelling, or skin eruptions similar to acne.

Alternative Names

Causes, incidence, and risk factors

Although the cause of rosacea is unknown, you are more likely to develop this harmless skin condition if:

• You are fair skinned.
• You blush easily.
• You are a woman. However, men are usually more severely affected.
• You are between the ages of 30 and 50.

Rosacea involves enlargement of the blood vessels just under the skin and may be associated with other skin disorders (acne vulgaris, seborrhea) or eye disorders (blepharitis, keratitis).

Symptoms

• Redness of the face in discrete areas or covering the entire face
• A tendency to flush or blush easily
• Increased vascularity (spider-like blood vessels called telangiectasia) of the face
• A red, bulbous nose
• Acne-like skin eruptions (may ooze or crust)
• A burning or stinging sensation of the face
• Irritated, bloodshot, watery eyes

Signs and tests

Your physician can usually diagnose rosacea with a thorough medical history and physical exam.

Treatment

There is no known cure for rosacea. The goal is to identify and avoid possible triggers, and thus reduce flare-ups. In fact, the National Rosacea Society strongly recommends that you keep a symptom diary to identify the specific triggers you may have. As you keep track of your symptoms, you should start to see a pattern within several weeks of what makes your rosacea worse. Use this information to avoid future flare-ups.

Here are some steps that may help:

• Avoid sun exposure. Use sunscreen every day.
• Avoid prolonged exertion in hot weather.
• Try to reduce stress. Try deep breathing, yoga, or other relaxation techniques.
• Limit spicy foods, alcohol, and hot beverages.

Triggers vary from person to person. Other triggers may include wind, hot baths, cold weather, specific skin products, exercise, or other factors.

Oral antibiotics (such as tetracycline, minocycline, or doxycycline) or topical antibiotics (like metronidazole) applied to your face may control skin eruptions. Other medications (isoretinol or Accutane), which are similar to vitamin A, are stronger alternatives that your doctor or dermatologist might consider.

In severe cases, laser surgery may help reduce the redness. Surgical reduction of enlarged nose tissue may also improve your appearance, if you so choose.

Expectations (prognosis)

Rosacea is not medically dangerous. It is not curable, but can usually be controlled with treatment. It may be persistent and chronic.

Complications

• Permanent changes in appearance (for example, a bulbous nose)
• Psychological damage, loss of self esteem

References

Habif TP. Clinical Dermatology. 4th ed. St. Louis, Mo: Mosby; 2004:198-200.

Noble J, Green HL, Levinsen W, et al. Textbook of Primary Care Medicine. 3rd ed. St. Louis, Mo: Mosby; 2001:760-761.

van Zuuren EJ, et al. Systematic review of rosacea treatments. J Am Acad Dermatol. 2007:56(1):107-115

Physician Reference

International Classification of Diseases, 9^th Revision (ICD9)

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