Rosacea, also referred to as acne rosacea, is different from acne vulgaris, which normally effects younger people. Rosacea affects mostly adults over the age of 30, with a higher incidence in women.1-2 People with fair skin are more often affected, although darker skin types may also experience symptoms.2 Rosacea is fairly common (worldwide estimates average about 5% of people), and while its symptoms may wax and wane, it is most often referred to as a chronic condition. Rosacea is usually a progressive disease, and without treatment may continue to worsen over time. Rosacea can also cause emotional repercussions.
The most common sign of rosacea is frequent or sustained blushing or flushing of the skin. The skin of the central face appears red and inflamed. In women, this is not to be confused with monthly flushing before menstruation.
Red, inflamed lesions which may or may not have a white/yellow center. Rosacea does not include non-inflamed whiteheads or blackheads, although one can have rosacea and acne vulgaris simultaneously, so whiteheads or blackheads may be present if this is the case.
Called telangiectasia, these dilated blood vessels resemble small squiggles on the surface of the skin. They may be obvious or they may be hidden by the redness of the surrounding skin.
Rosacea symptoms may also include any combination of the following:2-3,5
Physicians experience a challenge when diagnosing rosacea because of the numerous ways it can present itself. The National Rosacea Society has broken rosacea into four main categories:2-3
According to a thorough and informative 2009 Review on Rosacea published by Thomas Jefferson University (Jefferson Medical College), "...the cure for rosacea remains elusive, and all currently used medications are for symptomatic control only. No precise treatment algorithm has become the standard of care; treatment remains empirical."1 This may sound ominous, but in reality, we have several methods of tackling rosacea which are proven effective.
Wear sunscreen: Sunscreen is an important adjunct to rosacea care.15 Pharmaceutical manufacturers incorporate sunscreen into prescription preparations at times. Zinc oxide and titanium dioxide are effective broad spectrum sunscreen ingredients that seem to be well tolerated by people with rosacea.
Avoid products that strip or irritate the skin such as soap (use soap-free cleanser instead), sodium lauryl sulfate (avoid cleansers with this ingredient), astringents, toners, menthol, and camphor.
Because of its wide ranging symptoms, rosacea can easily be confused with other conditions. Be sure to educate yourself and be your own advocate when speaking to a medical professional.
When choosing a doctor, be certain to find someone experienced in treating patients with rosacea (this will often mean a dermatologist). Then don't be afraid to ask some tough questions such as:
Most importantly, trust your gut. Your dermatologist's diagnosis and strategy for treatment should be strong and confident. If you feel uncomfortable, simply visit another dermatologist. Very often with dermatology as well as with other conditions, a second or third opinion is incredibly valuable.
Then, once your doctor prescribes a treatment protocol, stick with it closely and orchestrate regular follow-up visits. If you do not improve, a second opinion may be in order.