Rosacea is a skin condition that can be distressing. If you think you have the condition, here’s all you need to know about its causes and triggers.
What is Rosacea?
Rosacea is a long-term skin condition that affects the face that causes the small blood vessels in the face, called capillaries, to become inflamed and widen. This inflammation leads to skin redness and pimple-like bumps.
The nose, under eye area, cheeks, forehead and chin are the areas where rosacea occurs most frequently. Rosacea can cause the formation of a red, enlarged nose, with uneven skin - a condition known as rhinophyma.
Rhinophyma is the result of an enlargement of oil-producing glands on the nose.
What Do Rosacea Pimples Look Like?
Rosacea pimples look like acne pimples - red, solid conical skin bumps and pus-filled bumps. However, there are no blackheads. Rosacea symptoms include pimples that may look like whiteheads, but they are not associated with skin oil glands and hairs like acne whiteheads are.
Other acne rosacea symptoms include:
- Dry, peeling skin
- Skin that becomes more oily
- Skin that becomes red
- Often it’s possible to see small blood vessels in the skin
- Sometimes there are small patches of red skin
- Itching or burning sensations
How Do You Develop Rosacea?
The exact cause of rosacea is not known. Genetics plays a role, that is the tendency to develop rosacea occurs more frequently in some families.
Rosacea can also be triggered by environmental factors such as sunlight and cold weather or lifestyle choices such as particular skin care products, spicy food or alcohol.
Here’s some other causes of rosacea…
Malfunctioning innate immune system
The immune system is the body’s first line of defence and triggers a defence response when bacteria, viruses or other pathogens are present.
Studies have shown that an abundance of certain molecules and cells of the immune system including cathelicidins and mast cells can cause the symptoms of rosacea.
Research has shown that exposure to UV radiation from the sun can lead to the production of vascular endothelial growth factor (VEGF) which has been linked to the development of visible blood vessels.
Demodex Mites & Microbes
Demodex mites are a natural part of the normal range of microorganisms that live within and on the body.
Research has shown that demodex mites are found in greater numbers in people with rosacea and an abundance of them can trigger an immune response.
Another theory is that inflammation can be caused by certain bacteria associated with the mites.
Studies have shown that the nervous system is linked with the vascular system and can trigger the symptoms of rosacea.
The sensory nervous system can trigger symptoms of rosacea by exposure to skin irritants and UV radiation, changes in temperature, alcoholic drinks and spicy food.
There is a nervous system disorder called neurogenic inflammation where the symptoms are similar to those of rosacea.
What Triggers Rosacea?
It’s still not entirely clear what triggers rosacea, but researchers think that anything that can make your face flush can contribute to rosacea in some people. For example, environmental conditions such as extremely hot or cold weather as well as sunlight or strong winds can trigger rosacea.
When we experience a facial flush, blood rushes to the surface of the skin, causing it to feel hot and appear red. Easier said than done, but avoiding activities that make you flush, and managing emotional triggers that perhaps make you feel embarrassed can help to reduce rosacea symptoms.
Lifestyle factors can also trigger rosacea, including the following:
- Hot drinks or spicy food
- Strong emotions - this is more typical for young people
- Cosmetics or facial products such as creams
- Medications that widen blood vessels
What Might Make Us More Prone to Developing Rosacea?
Anyone who tends to easily blush and happens to also have very fair skin may have more chance of developing rosacea. It does sometimes affect children and young adults, but we’re more likely to experience it in our 30s.
Rosacea is more common in women, but men tend to experience more severe symptoms if they do develop it.
What Are the Four Stages of Rosacea (and Their Symptoms?
The symptoms of rosacea tend to occur over four stages. Understanding these stages can help you to recognise the rosacea signs and symptoms.
1. Pre Rosacea
Rosacea early symptoms include frequent flushing on the cheeks, chin, nose or forehead. Some people also experience a burning sensation as well as swelling.
2. Vascular Rosacea
Small blood vessels on the nose and cheeks can become visible and appear as thin red lines. Due to the inflammatory nature of rosacea, the skin that is affected can become puffy and swollen, and small pimples and bumps can appear. The skin can also start to feel sensitive and become more oily than usual.
3. Inflammatory Rosacea
Small bumps can appear, some containing pus, and they may become painful. Oil glands on the nose and cheeks can also become enlarged and inflamed leading to a buildup of tissue which can make the nose look bulbous.
4. Ocular Rosacea
This is a serious condition and can lead to a loss of vision. Symptoms include irritation in the eye, dry eyes and burning in the eyes. You may also feel sensitive to light. Anyone experiencing these symptoms should see an ophthalmologist as soon as possible.
It’s important to note that not everyone advances through all stages.
Does Rosacea Cause Hot Flushes?
One of the most common symptoms of rosacea is hot flushes - when the skin rapidly warms up, and there is a feeling of internal heat.
In people with fair skin, this is more noticeable as the skin suddenly and uniformly becomes red. Rosacea is characterised by skin flushes to the the head and upper body on the face, neck and scalp.
How Common is Rosacea?
Rosacea is a common condition affecting between 1% and 10% of people in different populations. It’s most widely spread among Caucasians as it is more noticeable on fair skin.
Women between 30 and 50 years of age are the most frequently affected. However, one of the most prominent rosacea forms that affects the nose, rhinophyma, is more common among men.
Does Rosacea Spread?
Rosacea is an inflammatory skin condition, and the overall affected area depends on the degree of inflammation. Rosacea can start as a small spot, but if the cause is not managed, the affected area can increase.
Where Does Rosacea Appear on the Skin?
Rosacea symptoms on the face are the most common. However, in severe cases, rosacea can appear on the ears and scalp as well as upper torso areas - neck, chest, upper back and scalp.
The same kind of rosacea that affects the nose, phymatous rosacea, can affect the eyelids. The symptoms of rosacea in the eyes includes the eyelid skin becoming thicker and developing an uneven surface with nodules.
Ocular (eye) rosacea symptoms include the eyes and eyelids becoming red due to small dilated blood vessels (spider veins) and inflammation. The eyes feel dry, irritated and they may itch and become sensitive to light. They are also more susceptible to infection.
‘Rosacea nose’ or rhinophyma is a characteristic red, enlarged, bulbous nose that develops as a result of rosacea. The skin pores on the nose become enlarged, and the nose skin develops circular enlargements. Small blood vessels also expand, leading to permanent nose redness.
Contrary to popular opinion, alcoholism is not the cause of rosacea nose. However, alcohol may cause skin flushing and worsen the symptoms of rosacea.
The face is the area where rosacea usually starts. However, all adjoining places, such as the scalp and neck are also prone to developing rosacea. Rosacea scalp symptoms are the same as on the face, but if you have hair, may be less visible.
The chest is another area of the body that can develop rosacea. Other upper body areas that can be affected by more advanced forms of rosacea are the neck and upper back.
The upper torso, including the back, can be affected in severe cases of rosacea.
There are no cases of rosacea forming on the lips in the current medical literature. However, the bumps and pimples of rosacea may appear around the mouth.
Does Rosacea Leave Scars?
Rosacea doesn’t usually leave scars. However, unlike acne pimples that can disappear, rosacea is a persistent condition.
This article is not meant to treat or diagnose. Please visit your doctor for advice about any health concerns you may have.