Rosacea
Rosacea
Acne, close-up of cysts on the back
Acne, close-up of cysts on the back

Rosacea

Definition:
A disorder involving chronic inflammation of the cheeks, nose, chin, forehead, or eyelids; it may cause redness, vascularity (increased prominence of the blood vessels), swelling or hyperplasia (increase in size of the tissue), or skin eruptions similar to acne.

Alternative Names:
Acne rosacea

Causes, incidence, and risk factors:
The cause of rosacea is unknown. The disorder involves enlargement of the blood vessels just under the skin. It occurs most often in fair skinned people, particularly those who blush easily. Women are more commonly affected, but men are usually more severely affected. Symptoms usually begin between ages 30 to 50. Rosacea may be associated with other skin disorders (acne vulgaris, seborrhea) or eye disorders (blepharitis, keratitis).
Symptoms:
  • rashes
    • erythema (red areas on the face)
    • discrete areas or the entire face
  • a tendency to flush, blush easily
  • increased vascularity (telangiectasis) of the face
  • a red, bulbous nose
  • acne-like skin eruptions (macules, nodules, pustules, may ooze or crust)
  • a burning or stinging sensation of the face
Signs and tests:

Your physician can usually diagnose rosacea with a thorough medical history and physical exam.

Treatment:
There is no cure known for rosacea. The treatment is aimed at the control of redness, inflammation, and skin eruptions.

Long-term treatment (5 to 8 weeks or more) with oral antibiotics such as tetracycline may control skin eruptions. Oral medications similar to Vitamin A (isoretinol or Accutane) are a stronger alternative.

The treatment of skin eruptions may also include long-term treatment with topical (applied to a localized area of the skin) antibiotics such as metronidazole.

In severe cases, laser surgery may help reduce the redness. Surgical reduction of the nose hyperplasia may also improve the patient's cosmetic appearance.
Expectations (prognosis):
Rosacea is not medically dangerous. It is not curable, but usually is controllable with treatment. It may be persistent and chronic.
Complications:
  • permanent changes in appearance
  • psychological damage, loss of self esteem
Calling your health care provider:
Call for an appointment with your health care provider if rosacea does not respond to treatment.
Prevention:
There is no known prevention for rosacea. Patients with rosacea may help control their disease, however, by avoiding triggering factors. For many, sun avoidance and sunscreen use is helpful. Others are aggravated by embarrassment, hot or spicy foods, alcohol, or extremes of temperature.

Review Date: 11/10/2001
Reviewed By: Michael Lehrer, M.D., Department of Dermatology, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network.
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