Rosacea is an inflammatory condition mainly affecting the face. It is hall-marked by episodic flushing of the skin, often lasting for several hours. Some people will periodically develop multiple spots in the affected areas which often become pustular. It is an under-diagnosed condition which may affect up to 10% of the population. There are two peak incidences of rosacea, one in the 20s and one in the 50s, although people of any age may develop the condition.
Rosacea can be hereditary and may run in those with Celtic skin types. The flushing attacks may be triggered by a number of different factors. Often these trigger factors will vary considerably from individual to individual. No exclusion list exists that is suitable for everyone. There are, however, many common triggers including:
dairy products food and drinks
After a period of intermittent flushing, the skin becomes persistently red with the development of multiple telangiectasia (tiny broken veins) over the affected area. Experiencing these flushing attacks can be extremely uncomfortable. Attacks can vary from burning to intense pain. Rosacea also causes considerable embarrassment itself. For example, 23% of members of the Acne Support Group with rosacea, who have taken part in public surveys, said that they have been asked whether they had a drinking problem.
Many people believe their facial redness is purely a cosmetic problem and do not seek advice about it. However, it is important to treat this condition early to prevent long term side effects which include: telangiectasia; rhinophyma (enlargement of the nose); persistent oedema of the face (swelling) or eye problems. Treatment should start with identifying possible trigger factors. It could be helpful to keep a diary over a few weeks to help to identify foods which might make the flushing worse. In mild rosacea, topical antibiotics are commonly used. In general, metronidazole is used and needs to be applied sparingly to the whole affected area. In those who fail to respond to topical antibiotics, or those with a more severe disease, systemic antibiotics can be used. Systemic antibiotics tend to have their major impact on the inflammatory lesions, with the flushing tending to respond less quickly. Roaccutane, a hospital-only drug, can also be prescribed to some people, but there are many reported side effects of this treatment, so it should be considered carefully before using. If flushing is a major problem, Clonidine can help to reduce flushing attacks.
Rosacea can be confused with acne or seborrhoeic dermatitis, although some people have both rosacea and seborrhoeic dermatitis. Therefore it is important that the condition is diagnosed correctly, so that the most appropriate treatment is administered.
It is considered that rosacea is often self-limiting, but it is impossible to predict how long it may last. Many people affected by this skin condition can feel embarrassed and ashamed by their appearance. There are some excellent camouflage creams available from the British Red Cross Skin Camouflage Service, which can help to tone down facial redness and are suitable for both men and women.
The key to managing rosacea is to be the one in control of the skin condition, and not the other way around.
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