Rosacea - Causes, Symptoms, Risk Factors, Types, and Treatment

What Is Rosacea?

Rosacea is the chronic inflammatory condition that can cause redness or noticeable blood vessels in the face. Rosacea does not get cured on its own, it can go into remission, and there can be time lapses between the flare-ups. If not treated, it can cause permanent damage to the skin. The damage can be endless, like redness of the skin due to long-lasting blushing, the appearance of spider veins in the cheeks, and may affect the patient's eyes. Rosacea is not a contagious disease. It can persist for an extended period in any individual, but the severity tends to fluctuate. Rosacea can affect the cheeks, chin, forehead, and nose, and it is discriminated by persistent redness caused by dilated blood vessels, pus-filled spots, and small bumps similar to acne. There can also be painful inflammation of the outside of the eyes and eyelids.

What Can Cause Rosacea?

The cause for rosacea is unknown, but it can be a combination of environmental and hereditary factors, not due to poor hygiene. The common factors that can worsen the condition are:

• Hot drinks and spicy foods.

• Sunlight or wind.

• Temperature extremes.

• Red wine and other alcoholic beverages.

• Emotions.

• Exercise.

• Drugs like blood pressure medications can dilate blood vessels.

• Various cosmetic products.

• Microscopic skin mites that carry Bacteria.

What Are the Signs and Symptoms of Rosacea?

The signs and symptoms of rosacea are:

• Bumpy texture to the skin.

• Oily skin.

• Skin begins to thicken, especially widespread on the nose. When the skin on the nose thickens, it is called rhinophyma.

• Pores look large.

• The skin may swell on the chin, forehead, cheeks, and ears.

• Broken blood vessels may be visible on the nose and cheeks.

• Red patches on the face, particularly on the central part of the face.

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• Small, red, and pus-filled bumps.

• A hot and tender feeling of the skin.

• Dryness or irritation in the eyes.

• Reddened and swollen eyelids.

• Enlarged nose, often seen in men.

• Problems with seeing.

What Are the Signs of Ocular Rosacea?

• Watery eyes and blood shots.

• Broken blood vessels on eyelids.

• Eyes that feel gritty.

• Cysts on eyes.

• Dry or itchy eyes.

• Stinging or burning sensation in the eyes.

• Eyes that are sensitive to light.

• Diminished vision.

What Are the Types of Rosacea?

The types of rosacea are:

• Erythematotelangiectatic rosacea is characterized by redness on the face.

• Phymatous Rosacea is associated with the thickening of the skin of the nose.

• Papulopustular rosacea usually occurs in middle-aged women and is associated with acne-like breakouts.

• Ocular rosacea usually shows symptoms in the eye area.

What Are the Risk Factors for Rosacea?

The risk factors for developing rosacea are:

• Age.

• In gender, women can develop rosacea more frequently than men, but men can also develop severe rosacea.

• Sun Exposure.

• History of Acne.

• Family History.

• Fair Skin.

• Blonde hair.

• Blue eyes.

• Ethnic Background.

• Smoking.

• Hairspray.

How to Diagnose Rosacea?

For diagnosis of rosacea, the doctor usually relies on the signs and symptoms of the patient. Skin biopsy can rule out skin conditions like Psoriasis, lupus, or eczema because the signs and symptoms of these conditions are similar to that of rosacea.

What Are the Differential Diagnoses for Rosacea?

The differential diagnosis for rosacea are:

• Acne vulgaris is a common skin condition that occurs due to any block in the hair follicles due to bacteria, dead skin cells, or oil. It can result in blemishes on the skin like blackheads, whiteheads, pimples, or cysts.

• Lupus erythematosus is an autoimmune disease resulting in the joints' erosion, skin rash, and even kidney failure.

• Contact dermatitis is the inflammation of the skin caused due to contact with any substances.

• Seborrheic dermatitis is a condition that affects the scalp and results in scaly skin.

• Perioral dermatitis is the inflammatory rashes occurring on the skin around the mouth.

• An eczema is a group of skin conditions causing red and itchy rashes.

• Carcinoid syndrome occurs in a patient with a carcinoid tumor.

• Psoriasis is a chronic skin condition resulting in scaly, itchy areas in patches.

• Natural ruddiness.

What Are the Treatment Methods for Rosacea?

The treatment for rosacea mainly focuses on controlling the signs and symptoms. It can be the combination of prescription drugs and good skincare. Drugs like Metronidazole, Azelaic acid, and Ivermectin may have less effect on skin color, but they will control pimples.

Topical treatment:

• Metronidazole.

• Azelaic acid.

• Ivermectin 1 % for mild to moderate rosacea, which has an anti-inflammatory effect, kills the Demodex mites that produce pustules to activate the local immune response.

• Dapsone.

• Cream or gel such as Brimonidine and Oxymetazoline reduces redness by constricting the blood vessels. The patient may see the results within 12 hours of use.

Oral Antibiotics:

Oral antibiotics like Doxycycline for moderate to severe rosacea, which has pimples and bumps.

Oral Acne Drugs:

Isotretinoin is a powerful drug that acts against acne and cleans up all the rosacea's acne-like lesions.

Therapies:

Laser or other light-based therapies may decrease the skin's redness due to enlarged blood vessels. Repeated treatments are required to get a better result.

Alternative Medicine:

The alternative method of treating rosacea are:

• Facial massage to reduce the swelling and inflammation of the face.

• Having caffeine reduces the risk of developing rosacea.

• Laurelwood, emu oil, and oregano oil are used to treat rosacea.

How to Prevent Rosacea?

Rosacea cannot be prevented, but we can avoid the triggering factors to maintain the remission by improving the lifestyle and environmental factors. The triggering factors may include:

1. Protect your skin from the sun.

2. Minimize stress.

3. Avoid overheating even during exercise.

4. Simplify your skincare routine.

5. Use a mild cleanser for washing the face.

6. Choose mild foods.

7. Choose for cold beverages.

8. Limit alcohol.

9. Protect your face from wind and cold.

10. Avoid menthol.

11. Witch hazel.

12. Exfoliating agents.

What Diet to Be Followed in Rosacea?

Foods to be avoided when you have rosacea are:

• In any form, heat is a common triggering factor of rosacea outbreaks; therefore, eliminating heated up beverages such as tea, hot cider, coffee, and hot chocolate is essential.

• Spicy foods.

• Foods that contain histamine.

• Alcohol.

• Dairy.