Rosacea is a common skin disease affecting over 16 million Americans. It is characterized by flushing, redness, and bumps or pimples on the face, particularly around the nose and cheeks. Because it affects appearance, rosacea can causes distressing emotional effects for people who suffer from it, sometimes leading patients to avoid work or social situations if they have a flare-up.
Symptoms of Rosacea
The American Academy of Dermatology has identified four types of rosacea, each with slightly different symptoms. The types are as follows: 1) erythematotelangiectatic rosacea, which is characterized by visible blood vessels (telangiectasia) as well as redness and flushing; 2) papulopustular rosacea, which is characterized by acne-like breakouts, swelling, and redness; 3) phymatous rosacea, which is characterized by thickened skin with a bumpy texture; and 4) ocular rosacea, which is characterized by red and irritated eyes and swollen eyelids.
Symptoms of rosacea vary from person to person, and they often begin slowly and progress to being more severe. Rosacea can affect anyone, but it is more common in adults who are between 30 and 50 years old.
Causes of Rosacea
Unfortunately, researchers do not fully understand what causes rosacea, but there are many avenues of scientific inquiry into the subject and several promising theories regarding rosacea causes.
Genetics: rosacea tends to run in families, and it is more common in people of Celtic or Scandinavian ancestry and in people with fair skin, blond hair, and blue eyes, suggesting a genetic component to the disease.
Immune system: inflammation is a reaction by the body’s immune system, and scientists have theorized that rosacea could be related to an improper functioning of the immune system. More specifically, research has identified cathelicidins as a possible factor in rosacea. Cathelicidins are anti-microbial molecules that help activate the immune system and assist in defending against bacteria. Researchers have discovered that “cathelicidins may cause inflammatory bumps and pimples as well as vascular effects such as flushing and the visible blood vessels called telangiectasia, all primary characteristics of rosacea.”
Demodex mites and other microbes: Demodex is the name of a mite that lives on everyone’s skin, and it is particularly abundant on the nose and cheeks (places where rosacea commonly presents). It’s possible that larger numbers of these mites could contribute to rosacea, and it does seem that patients with rosacea typically have large numbers of these mites; however, there are people who have a large number of Demodex mites who don’t have rosacea, so the exact relationship is still unclear.
Vascular changes: Vascular endothelial growth factor (VEGF) is a substance that has been linked to the development of visible blood vessels, and at least one study has found that exposure to UV radiation in sunlight can stimulate the production of VEGF, possibly contributing to the telangiectasia observable in rosacea.
Treatment of Rosacea
There is no current cure for rosacea, so most treatments focus on preventing flare-ups and reducing severity of symptoms. For patients who have rosacea, it is important to seek the advice of a dermatologist when determining which rosacea treatment is right for you, because different symptoms have different treatments.
Some treatments for rosacea include topical medication, laser or other light therapies, antibiotics (either oral or topical), and the use of emollients to repair the skin. Isotretinoin is an oral anti-acne drug that is sometimes prescribed in cases of severe rosacea. Rosacea affecting the eyes may be treated with prescription eye medication, and rosacea that results in thickened skin can be treated by the use of lasers or dermabrasion to remove excess skin.
There are also many alternative therapies and home remedies that some patients with rosacea find helpful. Although there is not really any scientific research regarding their effectiveness, colloidal silver, emu oil, laurelwood, and oregano oil are a few of the substances that have been suggested as possible treatments.
Rosacea can come and go, and there are several factors that have been found to contribute to flare-ups, including sun exposure, heat, spicy foods, exercise, and stress. Minimizing exposure to triggers as well as consulting with a dermatologist is key to living with rosacea.