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Red Flush: An Introduction to Rosacea

Dr. Nazia Shakeel

3 min read

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Commonly mistaken for acne, eczema, or a skin allergy due to its characteristic redness and the appearance of small pus-filled bumps, Rosacea is a chronic yet benign skin condition that, unlike mot similar skin diseases, is confined only to the face, commonly affects fair-skinned individuals, and occurs in the form of periodic or unregulated flare-ups lasting anywhere between a few weeks to months. Below we talk in detail about the symptoms and treatment for Rosacea. 

Types

Rosacea is divided into 4 subtypes based on individualized symptoms accompanying a shared trait, i.e. facial redness due to broken and visible blood vessels:

1- Erythematotelangiectatic Rosacea (ETR)

It is characterized by frequent flushing and redness in the center of the face, with other symptoms being:

  • Swollen, sensitive skin
  • Stinging
  • Burning
  • Dry, rough, and scaly skin

2- Papulopustular Rosacea

Acne-like breakouts accompany facial redness and blood vessel breakage in this common form of rosacea. Other signs include:

  • Oily and sensitive skin
  • Raised patches of skin (plaques)

3- Rhinophyma

While commonly affecting the skin on the nose, this rare subtype can also form thickened skin patches on the chin, forehead, cheeks, ears and eyelids (where it is then called ‘phyma’), and usually affects men; with other defining symptoms being:

  • Bumpy skin texture
  • Large pores

4- Ocular Rosacea

Often mistaken for an eye infection, rosacea may sometimes manifest as blood vessel breakage and redness in the eyes and eyelids. It can happen before or after facial redness. Ocular rosacea can damage and expose the eyes to potentially sight-threatening infections if left untreated. Other definitive symptoms include:

  • Bloodshot, watery and gritty eyes
  • Burning or stinging
  • Dryness
  • Itchiness
  • Eye cysts
  • Reduced vision
  • Inflammation on the insides of the eyelids (blepharitis)

Causes

The exact causes of Rosacea are not known to doctors, yet. However, they have singled out some things that might be to blame. These are: 

  • Genetics: Research has found that usually Rosacea patients have family members that have it as well. 
  • Bacteria: The bacterium H. pylori that is found in the stomach might cause Rosacea. Studies have found that H. pylori increases the quantity of certain hormones that leads to this problem. 
  • Mites: These microscopic insects reside on your skin and are not harmful. However, if you are hyper-sensitive to them, they might cause Rosacea in the form of irritation. 

Also, you are likely to contract Rosacea if you have these characteristics: are a female; middle-aged ( in your 30s or 40s); have a lighter skin tone; and/or indulge in smoking. Some things about you may make you more likely to get rosacea.

Triggers

Although varying from person to person, following are the most common flare-up triggers that work by increasing blood flow to the face:

  • Hot drinks
  • Spicy foods
  • Temperature extremes
  • Sunlight or wind
  • Anxiety
  • Stress
  • Cosmetics
  • Blood pressure medication
  • Vigorous exercise
  • Hot baths

Treatment

Since rosacea cannot be cured, treatment usually comprises of symptom control via the following methods:

1- Skincare

This first-line treatment involves mild facial cleansers applied only using the fingertips, oil-free, water-based skincare products, rinsing with lukewarm or cool water, and foregoing products containing alcohol, menthol, and exfoliating agents to avoid irritating the skin. Moreover, flare-ups can also be disguised using green-tinted facial powders or concealers prior to applying a light, liquid foundation.

2- Sunlight Protection

Sufferers of rosacea should avoid direct sunlight, particularly during midday, wear sun-protective clothing and sunglasses, and apply broad spectrum sunscreen (a minimum of SPF 30) before going outdoors.

3- Medication

Commonly prescribed for severe cases, medication options can be in the form of oral or topical antibiotics, such as:

  • Isotretinoin for severe acne treatment and preventing further skin thickening.
  • Brimonidine Gel, Oxymetazoline Hydrochloride Cream, or Metronidazole (gel or cream) to reduce facial redness by shrinking blood vessels for up to 12 hours. A complete course of metronidazole can yield results for up to 6 months.
  • Antibiotics such as tetracycline to control redness and acne-like breakouts, after which another medication is used to maintain results.
  • Blephamide, among other steroid eye drops is used to reduce symptoms of ocular rosacea, with a short break or tapered use after a 3 day-1week course.

4- Lasers and Light Therapy

Severe facial redness can also be reduced via a series of laser or light exposure treatments that work by shrinking blood vessels, with effects lasting between 1-2 years. However, it can produce dangerous side-effects such as burns, blisters, skin discoloration, and permanent scarring if performed incorrectly.

For thickened skin reduction, Microdermabrasion, a form of exfoliation that works by sanding off the top layer of skin, is also a viable option.

5- Surgery

Extremely thickened skin can be treated surgically by removing the excess skin and reshaping the operated area, such as the nose, or chin. Patients often require regular isotretinoin use to maintain the results post-surgery.

As symptoms and treatment for Rosacea are common with many other skin conditions and eye infections, prolonged inflammation, particularly in the eye region, should be examined by a professional in order to rule out other skin and eye conditions. You can book an appointment with a top Ophthalmologist (in case of ocular rosacea) or Dermatologist in Karachi, Rawalpindi and Multan through oladoc.com, or call our helpline at 042-3890-0939 for assistance to find the RIGHT Doctor for your dermal concerns.

Disclaimer: The contents of this article are intended to raise awareness about common health issues and should not be viewed as sound medical advice for your specific condition. You should always consult with a licensed medical practitioner prior to following any suggestions outlined in this article or adopting any treatment protocol based on the contents of this article.

Dr. Nazia Shakeel - Author Dr. Nazia Shakeel is a consultant dematologist. She graduated from DOW Medical College in 2001. She is also a holder of a certificate from the American Academy of Aesthetic Medicine. She remained the Medical Officer at PN Shifa Hospital from 2007 till 2010. She is currently a consultant dermatologist at Tahir Medical Centre and Medicare Hospital. Alongside this, she also work in DHA Clinics Housing Authority and south city since 2014 and 2016 respectivly.

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