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What is rosacea?

Rosacea is a common chronic inflammatory skin disease that is often underrecognized and underdiagnosed.  It commonly affects the skin on the face, cheeks, and nose. There is a continuum of disease processes that may begin with facial flushing, leading to persistent redness, and progressing over time to include permanent spider veins (broken capillaries). Other presentations include pimple-type bumps, and eye and nose symptoms. Presentation and progression are different for each person. Acne and rosacea share overlapping features.

Rosacea affects more than 16 million people in the US. Men and women are equally affected. Those with an Irish background are at an increased risk of developing rosacea.

The exact cause of rosacea is unknown. Environmental factors trigger its development and also aggravate it. Rosacea is incurable. Long term treatment and lifestyle modifications can keep the condition under control. Demodex mites, which normally live on the skin, are found in greater numbers in those with pimple-type rosacea. Demodex mites live on tiny hair follicles on facial skin and eyelashes. They are microscopic meaning one cannot see them with the naked eye. Mounting evidence suggests that in large numbers these mites are a cause of skin and ocular rosacea.

Who is at risk for rosacea?

Although rosacea affects all skin types, it is more apparent in people with lighter skin tones between the ages of 30 and 50. There is a possible genetic component as well.

What are the symptoms?

Rosacea is a syndrome that produces overall redness on the forehead, cheeks, nose, and chin and can spread to the ears, chest, and back. Redness on the face can become permanent.

Characteristic symptoms are:

  • Flushing and redness
  • Dilated blood vessels (spider veins)
  • Pimples or small bumps on the face that look like an acne breakout
  • Skin that stings and burns
  • Swollen and thickened facial skin
  • Thickened and bumpy skin on the nose
  • Eyes that are watery or irritated, sensitivity to light, burn and itch
  • Swollen, red and irritated eyes and eyelids

The symptoms of rosacea can flare for weeks or months at a time before diminishing.  Triggers may include:

  • Sun exposure
  • Hot foods or drinks
  • Spicy foods
  • Alcohol
  • Extreme temperatures
  • Stress, anger, or embarrassment
  • Intense physical exercise

How is rosacea diagnosed?

Dr. Rachel White reviews your medical history, current complaints including symptoms and examines your skin and eyes. She may take a small sample of the skin surface to biopsy. Demodex mites are visible under a microscope. She may also order tests to rule out other conditions like lupus and allergic reactions that look like rosacea.

Dr. White will create a detailed plan to address your specific needs, and help you  identify triggers that cause your rosacea to flare up so that you can learn to avoid these triggers.

Rosacea treatment

While the cause is not completely understood and the disease is not curable, it can be treated. Treatment is geared towards reducing or eliminating signs and symptoms, treating Demodex mite overgrowth, preventing flare ups, and preventing progression of the disease.

For most patients, treatment involves a combination of topical and oral medications.  Lasers and light-based treatments can be effective. If you have ocular rosacea, your treatment plan may include warm compresses, eyelid cleansing, eye medications, as well as, oral anti-inflammatory antibiotics.

Schedule a consultation with Dr. White to learn if you have rosacea or other inflammatory skin disease, and the best options to control your symptoms. Left untreated rosacea signs and symptoms can become increasingly severe.

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