What is Rosacea?
Rosacea is a long-term skin condition that affects the face. Rosacea starts when small blood vessels, capillaries in face skin, become inflamed and widen. Capillaries inflammation leads to skin redness and pimple-like bumps.
The nose, area underneath the eyes, cheeks, forehead, and chin are areas where rosacea occurs most frequently. Mostly in men, rosacea causes 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.
The Four Stages of Rosacea
The main symptoms here are frequent flushing on the cheeks, chin, nose or forehead. People can 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 by Rosacea can become puffy, swollen, small pimples and bumps can appear and the skin can start to feel sensitive. The skin can also become more oily than usual.
3. Inflammatory Rosacea
Small bumps can appear, some containing puss which can be painful. Oil glands on the nose and cheeks can also become enlarged and inflamed leading to a build up of tissue which can make the nose look bulbus.
4. Ocular Rosacea
This is a serious condition and can lead to loss of vision. Symptoms include irritation in the eye, dry eyes and burning in the eyes. You can also feel sensitive to light. Anyone experiencing these symptoms should see an ophthalmologist. It is important to note that not everyone advances through all stages. The cause of rosacea isn’t known but there are various theories of what could cause it.
Is Rosacea Common?
Rosacea is a common condition affecting between 1% and 10% of people in different populations. It is 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 disease, and the overall affected area depends on the degree of inflammation. Rosacea can start as a small spot, but if the cause is not removed and no measures against it are taken, the area affected can increase.
Is Rosacea Only on The Face?
The face is the part of the body most affected by rosacea. However, in severe cases, rosacea can appear on the ears and scalp as well as upper torso areas - neck, chest, upper back, and scalp.
Can Rosacea Affect Eyes?
Several types of rosacea affect eyes:
* The same kind of rosacea that affects the nose, rhymatous rosacea, can affect eyelids. The eyelid skin becomes thicker and has an uneven surface with nodules.;
Ocular (eye) rosacea eyes and eyelids are red due to small dilated blood vessels (spider veins) and inflammation. The eyes feel dry, irritated, they may itch and become sensitive to light. They are also more susceptible to infection.
What is Rosacea Nose?
‘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. The nose skin grows 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 flashing and worsen the symptoms of rosacea.
Can You Get Rosacea on Your Scalp?
The face is the area where rosacea usually starts. All adjoining places, such as scalp and neck are prone to developing rosacea as well.
Can You Get Rosacea on Your Chest?
The chest is one of the body areas that can develop rosacea. Other upper body areas that can be affected by more advanced forms of rosacea are neck and upper back.
Can You Get Rosacea on Your Back?
Upper torso, including the back, is affected in severe cases of rosacea.
Can You Get Rosacea on Your Lips?
There are no cases of rosacea forming on lips in the current medical literature. However, the bumps and pimples of rosacea may appear around the mouth.
Do I Have Rosacea?
If you have rosacea symptoms - your skin on the face and upper body become red suddenly (flushes) easily or permanently red, sometimes little pimples appear that are not white and blackheads. If small blood vessels in skin become visible, you may have rosacea.
The next step in rosacea diagnosis is to contact your doctor. Other skin conditions that need to be ruled out before the diagnosis of rosacea are acne, psoriasis, eczema, or lupus. These conditions may have similar symptoms to rosacea, but they have different causes and treated differently.
Is Rosacea Painful?
The symptoms of rosacea can be painful. A person who has rosacea can feel burning, itching, or stinging in places where symptoms of rosacea occur.
Is Rosacea Itchy?
Rosacea can be itchy in places of its occurrence, including the face. Unlike acne that correlates with oily skin, rosacea happens when the person has dry, flaky skin. Other symptoms of rosacea include burning sensation.
Does Rosacea Cause Hot Flashes?
One of the most common symptoms of rosacea is hot flashes - when the person feels skin rapidly warm 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 characterised by flashes to the skin on the head and upper body - face, neck, scalp.
The other condition that causes hot flashes is perimenopause - period in a woman’s life before menopause and the menopause itself. Because rosacea is most frequent in women between 18 and 50, early onset of hot flashes is more probably rosacea, especially if the woman has other rosacea symptoms - spider veins, pimples, skin thickening. After 40, hot flashes may be associated with other conditions such as menopause.
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. The pimples may look like whiteheads, but they are not associated with skin oil glands and hairs like acne whiteheads.
Accompanying symptoms will allow distinguishing between acne and rosacea pimples:
- Skin is dry and peeling, not oily
- Skin 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 sensation
Does Rosacea Leave Scars?
Rosacea usually does not leave scars. However, unlike acne pimples that disappear after the change of hormonal balance, rosacea is a persistent condition.
Do I Have Rosacea or Something Else?
The symptoms of skin conditions vary widely and overlap for different skin disorders. If you are unsure whether you have rosacea or a similar skin condition, you need to contact your doctor.
Is it Rosacea or Lupus?
The rash on skin may be similar during rosacea and lupus. However, lupus rash has a characteristic pattern. It is called a ‘butterfly pattern’ as the pimples locate to the nose and face next to the nose on both sides - so-called ‘malar rash.’ Malar rash can appear in other places of the body - arms, legs, and trunk. Rosacea rash doesn't have a defined pattern and doesn’t appear on arms and legs.
In some cases, it’s hard to distinguish between rosacea and lupus. Contact your doctor for the correct diagnosis.
Do I Have Rosacea or Just Red Cheeks?
During rosacea, red skin is not a permanent condition. It has triggers such as strong emotions or alcohol and usually subsides after a while. More advanced forms of rosacea that can have permanent skin redness often also have pimples and pustules on the skin. However, these forms develop gradually from an occasional deep blush that is getting worse over time. So if you have red cheeks but not any other symptoms it is unlikely you have rosacea.
Do I Have Rosacea or Sensitive Skin?
‘Sensitive skin’ is an unspecific umbrella term that is applied to a range of skin conditions starting with rosacea and including eczema and allergies. Firstly, you need to compare your symptoms with rosacea symptoms, but only a medical doctor can make the correct diagnosis.
Do I Have Rosacea or Eczema?
Start with comparing your symptoms with symptoms of both rosacea and eczema. For example, eczema spots can be located anywhere on your body while rosacea concentrates on the face, neck, back, and chest. Eczema presents as inflamed skin spots, while rosacea is associated with inflamed small blood vessels and pimples. For a definitive diagnosis, visit a doctor.
Can You Have Rosacea and Psoriasis?
Both rosacea and psoriasis are autoimmune diseases. The immune system targets parts of its own body. During both rosacea and psoriasis, skin is the subject of antibodies attack. Having one autoimmune disease increases the chances of another similar disease, so its possible to have both rosacea and psoriasis.
Do I Have Rosacea or Seborrheic Dermatitis?
Seborrheic dermatitis is also called dandruff where the scalp skin is rough and flaking. Sometimes this condition affects the face. While during rosacea, skin is too dry, the condition associated with the inflammation of small blood vessels of the skin. Seborrheic dermatitis usually doesn’t have any symptoms while rosacea associated with changes in skin temperature and colour - flashes. Also, pimples and pustules that form during rosacea do not appear during seborrheic dermatitis.
However, it is possible to have seborrheic dermatitis and rosacea at the same time. In this case, it is essential that the treatment of dandruff such as steroids doesn't make rosacea worse.
Can You Have Blackheads and Rosacea?
Blackheads - blocked skin glands is a sign of acne. Rosacea is a different condition that can have white-head like pimples that do not develop into blackheads. But because these are two independent skin conditions, they can develop at the same time. They also can have common triggers such as using irritating cosmetics and fatty and spicy food. It is vital to make sure that blackhead treatments do not make rosacea worse, e.g., find a treatment that doesn’t trigger rosacea.
What is Acne Rosacea?
One of the acne symptoms is the occurrence of red pimples that can be mistaken for acne. Sometimes the pimples are filled with pus, just like whiteheads. However, while acne pimples are inflamed skin pores connected to skin hair, rosacea pimples associated with blood vessels.
Unfortunately, because acne and rosacea have different causes and different mechanisms of development, it is possible to have acne and rosacea at the same time.
Is Rosacea Acne?
Rosacea used to be classified as a type of acne ‘rosacea acne’. However, despite similar appearance, these are two different conditions with different causes. Acne is caused by changes in the hormonal balance that result in oil glands blockage and inflammation. Rosacea, on the other hand, starts with inflammation around skin blood vessels.
How do You Get Acne Rosacea?
The exact cause of rosacea is not known. Genetics plays a role, e.g., the tendency to develop rosacea occurs more frequently in some families. Predisposition to rosacea is triggered by environmental factors such as sunlight and cold weather or lifestyle choices such as particular skin care products, spicy food, or alcohol.
What Causes Rosacea?
Mal Functioning 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. Study’s have shown that an abundance of certain molecules of the immune system including Cathelicidins and Mast Cells can cause the symptoms of Rosacea.
Research has shown that exposure of UV radiation 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 human ecological community 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.
Study’s have shown that the nervous system is linked with the vascular system and can trigger the symptoms of rosacea.
That the sensory nervous system can trigger symptoms rosacea can be demonstrated with exposure to skin irritants and uv radiation, changes in temperature, alcoholic beverages and spicy food.
There is a nervous system disorder called neurogenic inflammation where the symptoms are similar to those of rosacea.
Is Rosacea Genetic or Hereditary?
Rosacea has a genetic predisposition; it runs in families. People of North European descent are more prone to rosacea. Little is known about which genes increase rosacea predisposition, but it’s known that it is connected to HLA genes that code cell-surface proteins responsible for the regulation of the immune system in humans.
Is Rosacea an Autoimmune Condition?
Rosacea is an autoimmune disorder in which immune system cells attack other cells of the same organism. Immune cells of the hyperactive immune system cause it by attacking skin cells.
How Does Rosacea Develop?
The specific factors that cause rosacea in each case are not known. Uncertainty is common for autoimmune diseases that have a hyperactive immune system at the bottom of it. We know that genetics plays a part in the condition development as rosacea appears more frequently in some of the families. Environmental factors also play a role. The more polluted the environment the person lives in, the more frequently rosacea occurs.
What Triggers Rosacea?
Environmental conditions such as extremely hot or cold weather as well as sunlight or strong winds can trigger rosacea.
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 Steroids
Can Rosacea Come and Go?
Rosacea is an inflammatory disease which means that the immune system mediates it. The inflammatory diseases usually have a trigger that kick starts the immune response. For example, allergies are triggered when the person allergic to a particular antigen has contact with it. Similarly, rosacea has one or several triggers such as spicy food or sudden change in the environmental temperature. Withdrawal of the trigger relieves the rosacea symptoms, and eventually, they disappear until the next contact with a trigger.
It is essential to notice the triggers, for example, by writing down what the surrounding conditions were and what you ate before the rosacea flare and avoid them.
Does Rosacea go Away on It's Own? How Long Does Rosacea Last?
When the trigger that caused rosacea flare disappears, the symptoms of rosacea disappear too. For example, for rosacea caused by hot weather, when the temperature goes back to normal the Rosacea symptoms will reduce with it. But this is a temporary relief, and when the trigger condition reappears rosacea symptoms also appear. The stronger are the signs, the longer they will be visible. However, with age, rosacea usually becomes less prominent.
Does Rosacea go Away With Age?
Rosacea appears in persons of fertile age e.g., between 18 and 50 years of age. However, in women of menopausal age it may become worse as the symptoms of menopause include hot flashes. ‘Rosacea nose’ that affects mostly men become worse with age.
How to Control Rosacea?
While there is no cure for rosacea, it can be controlled. Firstly, rosacea triggers have to be found and avoided where possible. Triggers removal will make rosacea flares less frequent and less severe.
Although rosacea is not associated with microbes or fungi, antibiotics often used to control it. Antibiotics reduce general inflammation levels, and rosacea is an inflammatory disease. Antibiotics that are prescribed for rosacea control can be topical e.g., applied to the skin in flare areas or oral in the form of tablets.
Laser therapy is also used to diminish the symptoms of rosacea.
Does Rosacea go Away After Pregnancy?
Hormone fluctuations and immune system adjustments often cause deterioration of skin condition. Acne and rosacea can flare during pregnancy. After giving birth, the skin condition usually returns to normal.
It is essential to know that many rosacea treatments such as antibiotics are not suitable for pregnant women. Always consult your doctor before using any treatment.
Does Rosacea go Away After Menopause?
While menopause can make symptoms of rosacea worse, they usually lessen after the menopause. However, there is little medical data on the condition progression after the menopause.
Zip C. (2017) The Role of Skin Care in Optimizing Treatment of Acne and Rosacea. Skin Therapy Lett. 22(3):5-7. PMID: 28492949