What is rosacea? 

Rosacea is a chronic inflammatory skin condition that presents with redness, flushing, pimples, thickening of the skin, or bumpy textured skin located on the nose, cheeks, forehead and chin. Typically, the skin around the eyes is not affected. It is most common in individuals over 30, but children and teens can also develop rosacea.  

Is it acne or rosacea? 

A common question that gets asked in a dermatology practice is “why am I getting acne now as an adult?”. Acne can develop in adulthood but often it is rosacea, not acne. It is important to determine if it is acne or rosacea to choose the best treatment plan.  

Acne presents with blackheads, whiteheads and red, sometimes painful or swollen pimples. These can be scattered anywhere on the face, chest or back. In acne, redness is only seen around the pimple lesions themselves and the skin between is normal. There are no symptoms of flushing.  

Rosacea presents as flushing of the face especially the forehead, cheeks, nose and chin with certain triggers. Rosacea can develop into pimple acne-like lesions however rosacea does not cause blackheads. There is often redness or broken blood vessels called telangiectasias between the pimple lesions causing the face to appear more red and flushed. Rosacea, unlike acne, may also have eye symptoms such as dry, gritty, irritated eyes.  

What is a trigger for rosacea? 

There are several things that cause rosacea to flare. These causes are what dermatology providers call triggers.  

10 common triggers of rosacea 

  • Sunlight 
  • Heat 
  • Alcohol, especially red wines 
  • Hot, spicy foods 
  • Hot temperature foods or liquids (such as teas, coffee, soups) 
  • Stress 
  • Wind or cold temperatures 
  • Exercise 
  • Some makeups, lotions or hair care products 
  • Some medications 

Who gets rosacea? 

It is important to know rosacea is very common and is one of the most commonly treated skin conditions in dermatology. More than 14 million people are living with rosacea in the United States.  

Rosacea tends to begin at age 30 to 50 and seems to affect people with lighter skin types more often. Rosacea tends to run in families with patients often having a relative who has also experienced rosacea in the past. Some causes of rosacea include the immune system’s overactive response to some normal bacteria found on the skin, demodex or skin mites, and another bacteria called H. pylori that can cause an infection in the gastrointestinal tract. There is on-going research to further understand how bacteria and mites affect those with rosacea as not everyone who has rosacea has these present and some patients have these bacteria and mites and do not have rosacea.  

How do we treat rosacea? 

Rosacea is a very treatable skin condition. Your dermatology provider will perform an exam and a thorough review of your personal and family history, medications and potential triggers for your symptoms. There are many medications that can help control rosacea but there is no cure. These include topical prescription medications, oral antibiotics and other oral medications. Gentle skin care and diligent sun protection are baseline treatments. Laser procedures, such as IPL and BBL can quickly and drastically improve the redness caused by telangiectasias. Rosacea often requires a combination approach to management, and it is a chronic condition that requires long-term maintenance therapy.  

How can I improve my rosacea at home? 

  1. Identifying and avoiding your triggers can help prevent rosacea flares. Pay attention to what appears to worsen your rosacea and avoid them as much as possible.  
  2. Sun exposure worsens rosacea and can even lead to changing the texture and appearance of your skin. Diligent sun protection is recommended. Wearing sunscreen with SPF 30-50 protection daily, even when cloudy, and re-applying frequently is encouraged. Wide-brimmed hats and sunglasses are also important. 
  3. Rosacea does best when harsh cleansers, soaps and occlusive skin products are avoided. Use only a gentle cleanser (not soap) to wash your face once or twice daily. Use only lukewarm, not hot water, to rinse. Avoid any harsh astringents or exfoliating treatments. Apply a good moisturizer after washing.  

For more information visit the American Academy of Dermatology Association Website link: https://www.aad.org/public/diseases/rosacea 

References 

James, W. D., Elston, D. M., Treat, J. R., & Rosenbach, M. A. (2019). Andrews’ Diseases of the Skin (13th ed.). Elsevier – OHCE. 

Lebwohl, M. G., Heymann, W. R., Berth-Jones, J., & Coulson, I. H. (2017). Treatment of Skin Disease (5th ed.). Elsevier – OHCE.