[L. rosaceus, rosy]
A chronic rose-colored, inflammatory eruption, usually found in the middle of the face (nose, cheeks, forehead, around the eyes, on the chin).
SYN: SEE: acne rosacea
The condition is common, esp. in people of Northern European ancestry. It usually is noted first between the ages of 30 and 50. Women are affected more often than men. According to the National Rosacea Society, approx. 16,000,000 Americans have rosacea.
The cause is unknown.
SYMPTOMS AND SIGNS
There are four types named for the predominant skin finding: (1) telangiectatic, marked by the appearance of spidery blood vessels on affected skin; (2) papulopustular, marked by bumpy or pustular lesions; (3) phymatous, marked by nasal scarring and deformity; and (4) ocular, involving the lids, lashes, or conjunctiva.
There is no specific test for rosacea. Most people with the condition have only mild redness and are never formally diagnosed or treated.
Treatments vary with the presenting findings. Electrolysis, lasers, and pulse light therapy can be used to treat telangiectases and rhinophyma. Topical medications, such as azelaic acid or metronidazole, are used to treat the papulopustular form of the disease. Oral antibiotics are also used in treatment-resistant disease. Topical steroids, which worsen rosacea, should be avoided.
Aggravating factors include ultraviolet light exposure, psychological stress, some foods and beverages, exercise, and skin care products. The health care provider should provide the patient with a list of the most common triggers and printed materials that offer tips for coping with them. Patients with rosacea should avoid irritating the skin of the face during cleansing and should wear a sunscreen that blocks both ultraviolet A and B rays, with a protection factor or 15 or higher on a year-round basis. Sunscreens containing micronized zinc oxide or titanium oxide to absorb photons may be less irritating to sensitive skin. Actual or feared facial changes affect one’s body image and may cause embarrassment, frustration, low self-esteem, anxiety, and depression. Empathic support can be helpful. Individuals who seek organized group support should contact the National Rosacea Society (www.rosacea.org). Telephone: 1-888-NO-BLUSH.
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