Rosacea: Its Symptoms

by Mike August 25, 2011

An estimated 16 million people in the U.S. have Rosacea.

What Is It?

Rosacea (rose-ay-shah) is a common, long-lasting skin condition that causes inflammation and redness of the face. It usually starts with redness on the cheeks and nose, and also can affect the forehead and chin.

Women develop rosacea more often than men, but men are more apt to develop lumpy, enlarged noses, a condition called rhinophyma. Rosacea often is mistaken for sunburn and often goes undiagnosed. It is a very treatable condition.

An estimated 16 million people in the U.S. have Rosacea, a common skin condition characterized by redness, pimples, and broken blood vessels on the face and eyes.

Rosacea is most common in:

Women (especially during menopause) - People with fair skin - Adults between the ages of 30 and 60

Symptoms:

There are four progressive stages of Rosacea:

First stage:

Flushing and intermittent facial redness

Second stage:

Persistent redness on the cheeks, nose, chin or forehead

Third stage:

Small, pus-colored or red bumps, along with tiny blood vessels that appear as red, thin lines called Telangiectasia

Fourth stage:

Bumps and skin thickening of the nose

Here's a detailed look at the most common symptoms of rosacea:

Redness:

Facial skin redness looks like a sunburn or blush. This is caused by flushing, which occurs when excess blood rapidly flows through the skin's blood vessels and the vessels enlarge to handle this flow. Gradually, this redness becomes more noticeable and does not go away. Facial skin also may become very dry.

Pimples and Papules:

Small, red and solid "papules" or pus-filled "pimples" may appear on the face, similar to those found in teen-age acne. In fact, rosacea has often been nicknamed adult acne or acne rosacea. Rosacea has different causes than acne, however, and adults with rosacea do not have the whiteheads or blackheads (called comedones) commonly seen in acne.

Red lines (Telangiectasia) :

Facial blushing or flushing causes small blood vessels to expand and eventually to show through the skin. These enlarged blood vessels appear as thin red lines (Telangiectasia) on the face, especially on the cheeks. At first, Telangiectasia may be hidden by the redness of flushing or blushing, but they usually reappear after this redness fades.

Nasal bumps:

Left untreated, rosacea eventually can create small, knobby bumps on the nose, which make the nose appear swollen. This condition is more common among men and is called rhinophyma.

Eye irritation:

Red, dry eyes develop in about half of people with rosacea. Eye involvement is usually relatively mild. Rarely, severe involvement of the eyes develops. If untreated, it can affect vision.

Some people may notice that their skin has become very sensitive or that they blush easily before they notice other symptoms of rosacea. For example, facial products may burn their skin.

As rosacea develops, redness on the cheeks lingers, like slight sunburn. This redness and other symptoms of rosacea come and go. The main symptoms include:

Triggers:

Such as sun exposure or alcohol, stimulate increased blood flow, which causes blood vessels to expand and facial redness to appear. In women, the redness usually appears on the cheeks, nose, chin, and forehead. The redness may appear in a "butterfly" pattern across the cheeks and nose. Facial redness in men typically appears on the nose, although symptoms can appear on other areas of the face. In some cases, redness may also occur on the neck and upper chest.

Pimples on the face:

Small pimples may occur on the red areas of skin or on the edges. These pimples-red, round bumps in the skin-are different from acne pimples, which are blackheads or whiteheads.

Red lines on the face (Telangiectasia):

These small, thin, red lines are tiny blood vessels that look like spider webs. And they usually appear on the cheeks.

Swollen bumps on the nose: In severe cases, mostly in men, the nose appears enlarged, bulbous, and red, a condition called rhinophyma.

Eye irritation:

Symptoms include redness, dryness, burning, crusted mucus, tearing, a gritty feeling like that of sand in the eye, pinkeye (conjunctivitis), and swelling in the eyelid. The eyes may not tolerate contact lenses, and styes may develop. In some cases, vision may be blurry, but only in severe cases is vision damaged. About half of the people with rosacea have some eye irritation or symptoms.

Rosacea may be mistaken for some other conditions with similar symptoms, such as acne or lupus.

Some research suggests a link between rosacea and migraine headaches. Blood vessels may be the connection between these two conditions.

Rosacea and Adult Acne:

You survived adolescence, with its pitfalls and pinnacles. You're free of the trials and tribulations of your early 20s. But on the road of life, other hazards loom—rosacea and adult acne, which can plague even the most timeworn skin. And you thought you'd seen your last blemish.

Rosacea affects about 13 million American adults, particularly fair-skinned people between ages 30 and 50. It can be confused with adult acne, but in rosacea there are no blackheads (comedones), and adult acne does not cause flushing.

Diagnosis:

A doctor usually can diagnose rosacea based on the history of flushing and the appearance of your skin. In the early stages of rosacea, the rash sometimes can be mistaken for sunburn, acne, hot flashes of menopause or allergy to cosmetics.

Expected Duration:

Symptoms of rosacea commonly come and go in cycles, often triggered by substances and situations that make the face flush. By seeking medical help early and adhering to medical treatments, you can improve your skin condition and perhaps stop, or reverse, the progress of this condition.

Prevention:

There is no way to prevent rosacea, but the symptoms can be reduced by recognizing these common triggers: hot drinks, alcohol, spicy foods, stress, sunlight, extreme heat or cold. These conditions increase blood flow and cause the small blood vessels in the face to widen (dilate). If you have rosacea, try to identify your particular triggers and either modify them or avoid them entirely.

To cleanse and moisturize your face, you should select facial products that do not burn, sting, irritate or cause redness when they are applied. You should wash your face with lukewarm water and a mild soap, using your fingertips to apply the soap gently. You should avoid toners, astringents, scrubs, exfoliating agents and products that contain alcohol or acetone. Hydroxy acids and tretinoin (for example, Retin A) may sensitize the skin to sun and can worsen rosacea.

Sunscreens and sun blockers should be used regularly and liberally to protect the face. Use sunscreens with SPF factor of 15 or higher. If chemical sunscreens cause stinging, switch to physical sun blocks, which contain titanium or zinc oxide.

When To Call a Professional:

Contact your doctor if you notice a persistent facial blush, or if your complexion shows persistent pimples and red, dry, scaly blotches. Also call your doctor if you suspect that constant redness on your cheeks is not caused by sunburn or by your tendency to blush easily. Remember, it's easy to misdiagnose rosacea as acne, and using nonprescription acne medications may worsen your rosacea by irritating skin that is already dry and sensitive.

Prognosis:

The progression of rosacea varies from person to person, depending on factors such as genetics, skin sensitivity, skin complexion, length of time spent in sunlight without sunscreen, consumption of alcohol and spicy foods, and exposure to extreme hot and cold temperatures. With appropriate treatment and avoidance of triggers, rosacea generally can be well controlled.