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| The Cause Of Rosacea | ||
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Dermatologists are diagnosing more patients with rosacea. This is due to increased recognition of the condition by
patients as well as physicians, and not due to a true increase in rosacea incidence. General practitioners are
recognizing rosacea and referring patients to dermatologists more often. Patients are also becoming more aware
of the symptoms of rosacea. This early awareness makes it easier to control the disease. |
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The dilation of facial blood vessels produces the redness that is the hallmark of rosacea. Leakage of fluid causes
inflammation. Rosacea trigger factors include most things that make the patient blush, such as hot or spicy foods,
exercise, heat or cold, hot beverages, alcohol (particularly red wine), exercise, or stress. If total avoidance of
trigger factors is impossible, rosacea patients should reduce triggering activities until their symptoms are under
control. Rosacea can also be triggered by hormonal components. Flushing is more likely to occur in women as they
approach menapause. Over time, scarring and permanent skin changes can occur. |
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| Common Symptoms | ||
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Rosacea symptoms consist of three components: Usually the first sign of rosacea. Intially, it is intermittent, and then becomes more persistent, affecting the cheeks, nose and central forehead. Usually the next symptom of rosacea, these gradually become more prominent. |
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A classic diagnosis has all three symptoms, but patients may only exhibit one or two of the above symptoms during the
early stages of the disorder. |
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| Unusual Presentations | ||
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Other symptoms that are also associated with the disease include rhinophyma, and eye manifestations such as redness,
sties, and conjunctivitis. Rhinophyma is more common in men. Rhinophyma can be treated by resculpting the nose with a CO2 laser. Aggressive treatment with systemic antibiotics may be effective. Occasionally, treatment with isotretinoin (Accutane) is necessary. Central facial edema occurs when recurrent episodes of inflammation damage the lymphatics, producing persistent and long lasting swelling. Central facial edema can be treated with a course of antibiotics and topical treatment. In its mildest form, it appears as irritable eyes, dry eyes, a mild discharge, or a stye. Lesions on the conjunctiva may also occur with rosaca. |
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| Home Treatment | ||
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Some home measures can be taken to help reduce the severity of rosacea: |
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| Professional Treatment | ||
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There are two standards of therapy: oral antibiotics and topical treatment. A very effective treatment consists of
oral tetracycline (or a derivative of tetracycline) with a topical treatment, such as metronidazole (MetroGel or
Noritate). Both these products have anti-inflammatory effects. Patients with early rosacea can sometimes be
successfully treated with only topical medications. While a weak topical steroid may benefit some patients on rare
occasions, patients should avoid using strong topical steroids on their face, as this can make rosacea worse. In more
severe or resistant cases, Accutane (isotretoin) may be very helpful. |
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It is important to understand that this condition is easy to treat, but difficult to cure. Most patients need to be
on treatment for a long time, sometimes even years. If patients do not want to take oral antibiotics, topical
treatments alone may be effective. Rosacea will recur, however, if the patient completely discontinues treatments,
even if they avoid aggravating factors. As rosacea gets under control, the triggering factors may become less of a
problem. Many people can go back to their standard routines. Still, the patient needs to know what factors make their
rosacea worse, and try to cut back on those factors. |
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In general, most insurance companies cover the treatment of rosacea. This usually includes costs of antibiotics and
topical products, though certain brand names of products may not be covered, but instead substituted with generic
products. |
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WebMaster Shirley J Gee 
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Copyright © Stuart H. Kaplan, M.D. All rights reserved. |
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