Rosacea is an acne-like condition that occurs on the face, especially the nose, cheeks, chin, and central forehead. It often starts with redness and flushing. Sometimes, these are the only signs a patient may exhibit. However, red bumps (papules), whitish bumps (pustules), and dilated blood vessels (telangiectasias) often also develop. Eyelids will frequently be involved with redness, scaling, and crusting. More rarely, deep bumps can develop in the same areas.
Rosacea is more common in women than men. It occurs commonly in patients in their 20's and 30's and peaks during ages 40-60. It rarely occurs in dark-skinned individuals.
The exact cause of rosacea is unknown. Many theories have been hypothesized including stress, heredity, and gastrointestinal disease, but none of these have been proven. Stress does exacerbate rosacea but is probably not a primary cause. Sunlight, hot (temperature) foods and drinks, alcoholic beverages, and spicy foods are known as tripwires because they may aggravate redness and flushing.
Treatment options include the following:
Topical antibiotics are often prescribed. Erythromycin, clindamycin, and metronidazoles are the ones typically used to treat rosacea. Topical Azelaic acid cream is a new fungal medication used to clear up redness and bumps. Topical antifungal creams will sometimes work in stubborn cases. Occasionally, topical steroid creams can help to cut down the redness and inflammation. Sunscreens are a must because of the role sun often plays in exacerbating rosacea.
Oral antibiotics usually work great in rosacea. Tetracyclines (tetracycline, doxycycline, minocycline) typically work best and are usually the first choice. Sometimes, other antibiotics are prescribed. Severe cases may require a more powerful medication called isotretinoin.
Dilated blood vessels and diffuse redness can be treated nicely with electrocautery, Diode laser, IPL light treatment or V-beam laser therapy. Usually insurance companies do not cover this treatment.