Rosacea
Why is my face always so red?
Rosacea is a common skin disorder that typically affects adults and is often limited to the face (and sometimes eyes, called occular rosacea). It commonly affects the forehead, cheeks, chin and nose. The skin becomes bumpy, pimply, red and sometimes dry or oily. Often their is associated small red blood vessels that can be seen and create a more "permanent" look of redness to the skin. In severe cases it can cause the nose to become bulbous.
The causes of rosacea can vary. We do know that it runs in families, so genetics play a major role for some people. Their are also some specific micro-organsims (bacteria and mites) that are found in higher numbers on the skin of people who suffer from rosacea.
What triggers rosacea to have a flare up? Their are many things that can cause a person to have a flare up. Despite the lengthy list, I always encourage my patients to keep a log of things that cause them to flare. Identifying a trigger and eliminating or modifying that trigger can be a tremendous help in helping to control your flares. When you view the list of triggers below, keep in mind that some or none of these things may apply to you and your skin. Use this as a guide only. This is not a complete list, and their are many things that can trigger rosacea. This is a list of most common triggers.
- Sun exposure
- Cold temperatures
- Spicy foods
- Hot beverages
- Caffeine
- Alcoholic beverages
- Chocolate
- Dairy products
- Exercise and rise in body heat
- Stress
- Certain medications
- Some skin care products and make-up, especially those that contain alcohol and/or fragrances
There a few distinct subtypes of rosacea and the way it appears on the skin can vary from person to person. Some people can have multiple subtypes at the same time.
- Type 1: This type often includes facial redness, flushing and visible blood vessels. The skin can be sensitive or feel like it is burning. Theses patients tend to "blush" more than usual.
- Type 2: Type 2 often resembles more acne prone skin. Patients experience pimples and whiteheads, oily skin , the skin can feel sensitive and burn and their will be redness on the skin of the forehead, cheeks, nose and chin.
- Type 3: This type is rare, but when it does occur it causes thickening of the skin and the nose can become bulbous. The chin and cheeks can also be affected and feel thicker. Noticeable broken blood vessels and redness is very prominent.
- Type 4: Type 4 affects the eyes and is called occular rosacea. The white of the eyes become red or bloodshot and their is often a change in the sensation of the eyes such as a dry, sandy feeling or itchy, watery eyes. Sometimes their is swelling around the eyes. Often times patients will say the vision is affected (blurry vision) because of these changes.
Treatment for rosacea begins with trying to identify your trigger. If you are able to identify one or more triggers the first step is eliminating or modifying your diet or habits to minimize your exposure to the trigger. Beyond trigger control their are many very effective prescribed treatments for rosacea.
- Oral antibiotics: Doxycyline or minocycline are very effective for moderate to severe disease. They work quickly and effectively to reverse a flareup.
- Topical metronidazole: For years this has been the "gold standard" in fighting rosacea. You may know of this product as Metrocream or Metrogel. You may have even used it already. It still works very well today and continues to be a go-to medicine for many patients. It is simple to use and it is tolerated well.
- Topical azelaic acid: Another tool to combat inflammation and the redness of rosacea, azelaic acid is applied topically once to twice a day. Some may experience a slight burning or stinging shortly after application, but this does not last long and goes away after a few minutes.
- Soolantra Cream: Soolantra is a newer medication to make its way into the fight against rosacea. This medication helps to treat the mites on our skin that may be implicated in causing rosacea. Its once daily application makes it convenient and well tolerated.
- Rhofade: This is a topical cream that can be prescribed for the redness of rosacea caused by the broken blood vessels in the skin. It is applied once daily, usually in the morning, and it works by constricting the small blood vessels and decreasing the red appearance of the skin. It only last about 10-12 hours and then the effects wear off.
If you have been diagnosed with rosacea their are many things to help get your skin back to where you want it to be. With some medications and a little effort on your part you can be back to clear skin in no time. During our consultation I would be able to discuss the best choices for your skin and type of rosacea.