Rosacea

What is Rosacea?

Rosacea is a common skin disorder which often begins as a redness, like a blush, appearing on the face – usually on the cheeks, nose, chin, or forehead. The redness may gradually appear on the ears, chest, back and eyes. At first, the redness may come and go, but over time, it can become more persistent, and visible blood vessels and tiny pimples may appear. Some people may also feel a burning or itching sensation on the face.

Rosacea is progressive, meaning if symptoms are not treated, and triggers are not managed, they may worsen over time. Rosacea is a chronic (long-term) condition, and while there is no cure, its symptoms can be reduced and managed. Rosacea is not contagious, so you can’t “catch it” from being in contact with someone who has it.

What Causes Rosacea?

No one knows the exact cause of rosacea, but it is possible to identify “triggers”, which can cause symptoms to flare-up. Some triggers are listed later in this brochure. Once diagnosed, you can manage its signs and symptoms.

Who Gets Rosacea?

If you think you may have rosacea, you are not alone. It is estimated that almost 1.6 million Canadians have rosacea, making it a very common skin disorder. There are several factors that may increase your chances of developing rosacea.

  • Rosacea generally occurs between the ages of 30 and 50, although it can sometimes be seen in children.
  • Rosacea often develops in fair-skinned people of Irish, Scottish, English, or of Eastern or Northern European descent.
  • Women are more likely to get rosacea than men; however, men tend to experience more severe symptoms.
  • A family history of rosacea (e.g. a relative that has been diagnosed with or shows symptoms of the condition.

How Do I Know If I Have Rosacea?

Rosacea is often mistaken for other temporary skin conditions, which may clear up on their own, like a sunburn or acne. However, there are a few simple questions you can ask yourself to see if you might have rosacea:

  • Are you between 30 and 50 years of age?
  • Are you fair-skinned and/or of Irish, Scottish, English, or of Eastern or Northern European descent?
  • Do you have a family history of rosacea?
  • Do you feel an itching, burning or stinging sensation where you use certain facial products, such as soap, moisturizers, or cosmetics?
  • Do you blush frequently or experience facial redness often?
  • Is your face red and/or blotchy after a hot bath/shower, or after exercising?
  • Does your face get flushed after drinking alcohol, hot beverages, or eating spicy foods?
  • Do stressful situations make your face flush or become blotchy?
  • Do you have small, dilated blood vessels on your face?
  • Do you have red bumps (pimples) on your face, but with no blackheads?
  • Do your eyes have a gritty feeling or appear bloodshot, even after a good night’s sleep?

If you answered yes to several of these questions, you should speak to your doctor about arranging an appointment with Dr. Tomi.

Common Signs and Symptoms of Rosacea

Although the signs of rosacea can be different from one person to the next, rosacea usually includes at least one of the following primary signs.

Primary Signs of Rosacea

Flushing: People with rosacea generally blush or become flushes easily. This is usually the earliest sign of the condition.

Persistent Redness: The blushing or redness in the face does not go away for long periods of time, often resembling a sunburn. This is the most common sign of rosacea.

Bumps and Pimples: People with rosacea may start to notice small red solid bumps or pus-filled pimples. While these may look like acne, the blackheads often seen with acne are not there, and there may be a burning or stinging in the reddened area.

Visible Blood Vessels: Small blood vessels may appear on the surface of the skin.

Secondary Signs of Rosacea

Eye Irritation: The eyes may become irritated and appear watery or bloodshot, a condition known as ocular rosacea. The eyelids also may become red and swollen, and styes (red, tender bumps on the eyelid) are common. Severe cases of ocular rosacea can result in corneal damage and vision loss without medical help.

Burning or Stinging: People with rosacea often experience burning or stinging sensations on the face, sometimes with itching or a feeling of tightness.

Dry Appearance: The skin on the face may become dry and rough to the touch.

Plaques: Raised red patches, known as plaques, may become noticeable in some areas without changes in the skin around it.

Skin Thickening: The skin may become thick and enlarged from excess tissue, generally on the nose. This condition, known as rhinophyma, affects more men that women.

Swelling: Facial swelling, known as edema, may accompany other signs of rosacea or occur independently.

Signs Beyond the Face: Rosacea signs and symptoms may also develop beyond the face, most commonly on the neck, chest, scalp or ears.

Different Types of Rosacea

There are different types of rosacea, and each type has its own characteristics. Most often, subtype 1.

Subtype Characteristics Scientific Name
1 Mainly flushing and redness around the centre of the face. Swelling and red blood vessels may also appear in this type, as well as rough patches of skin, and burning and stinging sensations. Erythematotelangiectatic rosacea.
2 Persistent redness around the centre of the face, with bumps and pimples resembling acne. Burning and stinging may also occur. This type is often seen after or in combination with subtype 1. Papulopustular rosacea.
3 Thickened skin with a bumpy surface most often affects the nose, which becomes enlarged and bumpy (“rhinophyma”). May occur after or in combination with subtypes 1 and 2. Phymatous rosacea.
4 Red, irritated eyes. Eyes may appear watery or bloodshot. Symptoms may include feeling like there is something in the eye, burning or stinging, dryness, light sensitivity, blurred vision. May occur with or without rosacea. Ocular rosacea.
Erythematotelangiectatic Rosacea Papulopustular Rosacea
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Phymatous Rosacea Ocular Rosacea

While rosacea cannot currently be cured, with proper skin care, lifestyle management and/or medical treatment, its signs and symptoms can be reduced. Signs and symptoms of rosacea can be different from one person to the next, so Dr. Tomi will determine the right management strategy for you.

Skin Care Strategies

A proper skin care routine of “Cleanses, Moisturize, and Protect” can help control rosacea symptoms. People with rosacea often find their skin in sensitive, so it is important to choose products that are gentle and non-irritating.

  • Cleanse: Use a mild, soap-free cleanser, rinse with lukewarm water (not hot), and pat dry gently with a towel. Never rub, scrub, or use a rough washcloth as this can irritate your rosacea.
  • Moisturize: Rosacea can often be associated with dry, flakey skin. To restore moisturize without irritation, choose a moisturizer that is fragrance free and non-comedogenic (won’t clog pores).
  • Protect: The sun’s rays can cause rosacea symptoms to flare-up. Use a fragrance free sunscreen with an SPF of 30 or higher to help protect your skin daily.

Cosmetics and/or Corrective Camouflage can also be used to help reduce the visible signs of rosacea. To avoid irritation, it is best to choose cosmetic products that are fragrance free and non-comedogenic. Corrective Camouflage products, such as green-tinted make-up, will often minimize red tones in the skin and help to hide blemishes caused by rosacea. Corrective Camouflage may also help to re-hydrate the skin. Corrective Camouflage products are available at Alphaderm.

Common Rosacea Triggers

Like many other skin conditions, rosacea symptoms may come and go on their own. Some people may go for weeks, even months, without any symptoms. You may notice that certain factors in your daily like may cause your rosacea symptoms to “flare-up” (an intense outbreak of redness, bumps and/or pimples).

Trigger Details What You Can Do To Help Manage It
Weather Sun, heat, humidity, cold, and wind can all trigger a rosacea flare-up. Protect skin from sun, wind, and excess heat:
  • Use a sun-screen daily
  • Cover your cheeks and face with a scarf when it’s cold and windy
  • Seek out air conditioning when it’s hot and humid
Food and Drink Food and drink can affect rosacea symptoms. Here are just a few foods and drinks that may cause rosacea symptoms to flare-up:
  • Hot soup and hot drinks, such as coffee or tea
  • Alcohol, including red wine
  • Chocolate
  • Certain fruits and vegetables
  • Hot spices
 Keep track of which foods and drinks trigger your rosacea symptoms, so you can try to avoid them in the future.
Intense Exercise Exercise is an important part of a healthy lifestyle, but is may cause rosacea to flare-up. Moderation is the key – if intense exercise triggers rosacea symptoms, try to avoid over-heating:
  • Exercise for shorter, more frequent intervals
  • Try to exercise when temperature are cooler, such as early morning or in the evening during the summer
  • When indoors, keep the room well ventilated and keep a spray bottle filled with cool water to spray you face
Stress Emotional stress is an important trigger for people with rosacea. If stress is a problem for you, try some of the following stress reducers:
  • Maintain good health. Eat well, exercise moderately, and get enough sleep
  • When you’re feeling stress, try relaxation exercises such as deep-breathing and visualization techniques
  • Try gentle stretching to relax your muscles
Medical Conditions Some underlying health conditions can stimulate a flushing response and trigger rosacea flare-ups, such as:
  • Hot flashes associated with menopause
  • Fevers, coughs and colds
  • In many cases, treating the underlying condition may help bring rosacea flare-ups under control.
  • When flushing is accompanied by itching, breathing difficulties or diarrhea, this may be a sign of a dangerous allergic reaction – seek immediate medical attention.
Drugs Certain drugs can cause facial flushing, resulting in flare-ups.
  • Vasodilator drugs: these drugs dilate the blood vessels, leading to increased blood flow, and can cause flushing
  • Topical steroids: can aggravate symptoms when used over the long term
 If you experience flare-ups as a result of these drugs, discuss the problem with your doctor or your pharmacist. Do not discontinue any medication without consulting your physician.

Medical Treatment Options

There are various medical treatment options also available to help manage your rosacea. Talk to Dr. Tomi to find whether any of them are the right treatment option for you. Medical treatment options commonly used for rosacea include:

  • Topical Antibiotics
  • Oral Antibiotics
  • Laser surgery/electrosurgery (to reduce redness and decrease the appearance of blood vessels).

Other Helpful Tips to Protect Rosacea-Prone Skin

  • Treat your face gently: avoid picking or scratching your skin, and do not use loofahs, brushes, hard sponges, or rough towels on your face.
  • Protect your face when outdoors in cold or windy weather: always use a scarf to cover your cheeks and nose.
  • Keep your skin hydrated: drink plenty of water, and use a humidifier during the dry winter months.
  • Avoid over-heating you skin: reduce your bathing time; use lukewarm, instead of steaming-hot water.
  • Avoid using skin cleansers that cause redness or stinging: stay away from skin care products that contain alcohol, including after-shave lotions.
  • Also avoid skin care products that contain any of the following ingredients: witch hazel, menthol, peppermint, salicylic acid, eucalyptus oil or clove oil.
  • Use an electric shaver rather than a blade, which might cause further irritation. If you use a blade, replace it regularly to avoid scraping.
  • Make sure fabrics that will be close to your face or against your skin are soft, breathable, and non-irritating. Choose natural fibres, other than wool. Cotton, linen, and silk are good options.

Alphaderm is the best place to start to obtain a diagnosis of rosacea and for recommendations on the best treatment program for you.

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