How does rosacea occur

Causes of rosacea The exact cause of rosacea is unknown, although a number of possible factors have been suggested, including abnormalities in the blood vessels of the face and a reaction to microscopic mites commonly found on the face.

These include: exposure to sunlight stress strenuous exercise hot or cold weather hot drinks alcohol and caffeine certain foods, such as spicy foods Read about causes of rosacea Treating rosacea There's currently no cure for rosacea, but treatment can help control the symptoms. For most people, treatment involves a combination of self-help measures and medication, such as: avoiding known triggers — for example, avoiding drinks containing alcohol or caffeine creams and gels — medications applied directly to the skin to reduce spots and redness oral medications — tablets or capsules that can help clear up more severe spots, such as oral antibiotics In some cases procedures such as laser and intense pulsed light IPL treatment may be helpful.

Read about more about treating rosacea and self-help measures for rosacea Living with rosacea Any long-term chronic condition can have an adverse psychological effect, but rosacea can be particularly troublesome as it affects your appearance.

As your physical symptoms improve, you may start to feel better psychologically and emotionally. You can find support and information from organisations such as: Changing Faces — a charity for people with facial disfigurements, who can be contacted on for counselling and advice Speak to your GP if you're feeling depressed as a result of your condition. Ocular rosacea Rosacea that affects your eyes ocular rosacea can lead to a number of eye problems, some of which can be serious.

Symptoms of ocular rosacea can include: feeling like there is something in your eyes dry eyes irritated and bloodshot eyes inflammation of the eyelids blepharitis Rosacea can sometimes cause the cornea, the transparent layer at the front of the eyeball, to become inflamed and damaged.

Symptoms of serious problems with your corneas include: eye pain sensitivity to light photophobia deterioration in your vision Contact your GP immediately if you think you may have a problem with your corneas. Symptoms of rosacea Rosacea causes a range of symptoms, although not everyone will experience them all.

The main symptoms of rosacea include: flushing persistent facial redness visible blood vessels papules and pustules thickened skin These are discussed in more detail below. Other symptoms associated with rosacea include: sensitive skin — burning, itching, stinging and pain dry, rough skin raised red patches plaques on your skin facial swelling lymphoedema Permanent damage to the face scarring almost never occurs in rosacea.

Flushing Flushing is when your skin turns red for a short period — usually a few minutes. In some cases the redness may be accompanied by an unpleasant feeling of heat. Persistent facial redness Persistent facial redness erythema is like a blush or a patch of sunburn that doesn't go away, or the sort of blotchy skin often associated with drinking too much alcohol.

Visible blood vessels Over time the blood vessels in the skin may become permanently widened dilated and visible. Papules and pustules If you have rosacea, you may develop round red bumps that rise from your skin papules and pus-filled swellings pustules. Thickened skin In the most serious cases of rosacea the skin can thicken and form excess tissue, usually around the nose. Causes of rosacea The exact cause of rosacea is unknown, although a number of potential factors have been suggested.

Some of the main factors that have been suggested are outlined below. Blood vessel abnormalities Some experts believe abnormalities in the blood vessels of the face may be a major contributing factor for rosacea.

Skin peptides Recent research has shown external triggers such as ultraviolet UV light, spicy food, alcohol particularly red wine , exercise, stress, heat and cold can lead to the activation of certain molecules within the skin called peptides. Microscopic mites Microscopic mites called demodex folliculorum usually live harmlessly on human skin, but people with rosacea have particularly large numbers, which may play a role in the condition. Helicobacter pylori bacteria Helicobacter pylori bacteria are bacteria found in the digestive system.

Genetics Rosacea seems to be more common in families, although it's not clear which genes — if any — are involved or how they're passed on. Triggers of rosacea Although they're not thought to be direct causes of the condition, many people with rosacea find certain triggers make their symptoms worse. Different people can have different triggers, but triggers that have been commonly reported include: exposure to sunlight stress hot or cold weather strong winds strenuous exercise alcohol hot baths spicy foods hot drinks humidity caffeine — found in tea, coffee and cola the menopause dairy products other medical conditions certain medicines — such as amiodarone, corticosteroids and high doses of vitamins B6 and B Treating rosacea Although rosacea can't be cured, treatment can help keep the symptoms under control.

Self-help measures There are a number of things you can do yourself to help keep the symptoms of rosacea under control, including: avoiding things that trigger your symptoms — for example, by using sun cream and covering yourself up if direct sunlight makes your symptoms worse taking good care of your skin — for example, by using products suitable for sensitive skin using make-up — patches of persistent red skin can be disguised using specially designed camouflage make-up keeping your eyelids clean — if rosacea is causing your eyelids to become inflamed blepharitis Treating papules and pustules If you have round red bumps that rise from your skin papules and pus-filled swellings pustules caused by rosacea, there are a number of different medications that can be effective.

Topical treatments Topical medications are usually prescribed first. These include: metronidazole cream or gel azelaic acid cream or gel ivermectin cream Ivermectin is a relatively new medicine.

Oral antibiotics If your symptoms are more severe, an oral antibiotic medication may be recommended as these can help reduce inflammation of the skin. Common side effects of these medications include: feeling and being sick diarrhoea bloating and indigestion tummy abdominal pain loss of appetite Some of the medications used can also make your skin sensitive to sunlight and artificial sources of light, such as sun lamps and sunbeds. Oral isotretinoin Isotretinoin is a medicine often used to treat severe acne , but at lower doses it's also occasionally used to treat rosacea.

Common side effects of isotretinoin include: dryness and cracking of the skin, lips and nostrils inflammation of your eyelids blepharitis or eyes conjunctivitis headaches muscle or joint pain back pain blood in your urine haematuria mood changes Isotretinion can also cause birth defects if taken during pregnancy.

Treating facial redness Treating facial redness and flushing caused by rosacea is generally more difficult than treating papules and pustules caused by the condition. But as well as the self-help measures mentioned above, there are some medications that can help.

Brimonidine tartrate Brimonidine tartrate is a relatively new medication for facial redness caused by rosacea. Less common side effects can include: a dry mouth headaches pins and needles dry skin A rebound effect, where flushing becomes worse, has also been reported with this medication.

Oral treatments Alternatively, there are a number of oral medications that may help improve redness caused by rosacea. These include: clonidine — a medication that relaxes the blood vessels beta-blockers — medications that decrease the activity of the heart anxiety medications — medications sometimes used to help calm the person and reduce blushing It's not clear how effective these medications are at treating redness caused by rosacea, but they may sometimes be prescribed under the supervision of a dermatologist.

Laser and intense pulsed light IPL treatment Redness and visible blood vessels telangiectasia can also sometimes be successfully improved with vascular laser or intense pulsed light IPL treatment. Side effects of laser treatment are usually mild and can include: bruising crusting of the skin swelling and redness of the skin blisters in rare cases infection in very rare cases These side effects usually only last a few days and are rarely permanent.

Treating thickened skin In some people with rosacea the skin of the nose can become thickened. Treating eye problems If rosacea is affecting your eyes ocular rosacea , you may require further treatment. Preventing rosacea If you have rosacea, there are a number of things you can do to help keep the condition under control. Avoid triggers Many people with rosacea notice certain triggers make their symptoms worse.

Advice about how to avoid some common triggers can be found below. Sunlight As sunlight is the most commonly reported trigger of rosacea, you should use sun cream whenever possible, even when it's overcast. Stress Stress is also a commonly reported trigger of rosacea. Ways you can reduce stress include: learning relaxation techniques, such as deep breathing exercises, meditation and yoga taking regular exercise As strenuous exercise can sometimes make rosacea symptoms worse, a low-intensity exercise programme, such as walking or swimming, may be better than high-intensity activities, such as running or aerobics.

Food and drink Some of the most commonly reported food- and drink-related triggers are alcohol and spicy foods. But there are many other dietary triggers that can also affect some people with rosacea.

Cold weather Covering your face and nose with a scarf can help protect your skin from cold temperatures and wind. Skincare techniques The advice below about skincare techniques may also help control your rosacea symptoms. Clean your skin every morning and evening using a gentle, non-abrasive cleanser. Use soap-free cleansers with non-alkaline or neutral pH.

Avoid scented soaps and alcohol-based skin cleansers Rinse your face with lukewarm water and allow skin to dry thoroughly before you apply medication or make-up Look for products suitable for sensitive skin. These are usually described as mild, hypoallergenic, fragrance-free and non-comedogenic will not block pores Use a moisturiser to soothe skin if it feels sore Avoid oil-based or waterproof cosmetics requiring solvents for removal.

Use water-based make-up and skin products instead Avoid astringents, toners and other facial or hair products that contain ingredients that might irritate your skin, such as fragrances, alcohol, menthol, witch hazel, eucalyptus oil, camphor, clove oil, peppermint, sodium lauryl sulphate and lanolin You may want to avoid using anything on your skin that you aren't sure of. You can then gradually reintroduce products once your symptoms have been treated and cleared to see if you can use them again without any problems Men may find that using an electric razor, rather than a blade, helps reduce skin irritation Some people find regular gentle facial massage reduces swelling lymphoedema Don't use steroid cream unless you're specifically instructed to by your GP, as it may make your symptoms worse Make-up It may be possible to disguise patches of persistent red skin using specially designed camouflage make-up.

Eyelid hygiene If your eyelids are inflamed as a result of rosacea blepharitis , cleaning your eyelids every day with warm water and a small amount of cleaning solution can help ease your symptoms. Tweet Click here to share this page on Twitter This will open a new window.

Print Click here to print this page This will open your print options in a new window. Source: NHS 24 - Opens in new browser window. Last updated:. How can we improve this page? Email Address e. Message Maximum of characters. Send feedback. Community content from Health Unlocked - This will open in a new window. Never pull, tug or use a rough washcloth. Mild or pediatric formulations are available for sensitive skin, and look for non-chemical mineral sunscreens that contain zinc or titanium dioxide.

Rosacea patients should avoid any skin-care products that sting, burn or cause additional redness. Cosmetics may be used to conceal the effects of rosacea. Green makeup or green-tinted foundations can be used to counter redness. This can be followed by a skin-tone foundation with natural yellow tones, avoiding those with pink or orange hues.

In addition to long-term medical therapy, rosacea patients can improve their chances of maintaining remission by identifying and avoiding lifestyle and environmental factors — often related to flushing — that may trigger flare-ups or aggravate their individual conditions.

Identifying these factors is an individual process, however, because what causes a flare-up in one person may have no effect on another. To help identify personal trigger factors, rosacea patients are advised to keep a diary of daily activities or events and relate them to any flare-ups they may experience. NRS members may obtain a Rosacea Diary booklet and other materials at no charge. Join the NRS today! Please see our Frequently Asked Questions page for more specific information.

Standard classification and pathophysiology of rosacea: The update by the National Rosacea Society Expert Committee. J Am Acad Dermatol Jan;78 1 Acknowledgments: This section was reviewed and edited by Dr. Diane Thiboutot, professor of dermatology, Pennsylvania State University. Phone: Email: info rosacea.

The National Rosacea Society is a c 3 non-profit organization whose mission is to improve the lives of people with rosacea by raising awareness, providing public health information and supporting medical research on this widespread but poorly understood disorder. The information the Society provides should not be considered medical advice, nor is it intended to replace consultation with a qualified physician.

The Society does not evaluate, endorse or recommend any particular medications, products, equipment or treatments. Rosacea may vary substantially from one patient to another, and treatment must be tailored by a physician for each individual case.

For more information, visit About Us. All About Rosacea. What Should I Look For? Diagnostic Signs of Rosacea The presence of either of these signs is diagnostic of rosacea.

Persistent Redness Persistent facial redness is the most common individual sign of rosacea, and may resemble a blush or sunburn that does not go away. This condition is less common, but can lead to facial disfigurement and inadequate nasal airflow if severe. Major Signs of Rosacea The presence of at least two of these signs is diagnostic of rosacea. As your symptoms improve, the amount of medicine you take may be cut down or stopped. It is hard to know how long you will need treatment for rosacea.

For severe cases of rosacea, surgery may be an option. It is most often done to treat rhinophyma. Enlarged blood vessels on your face can sometimes be removed with a fine electric needle or laser surgery. Rosacea cannot be cured, but treatment can help relieve symptoms and improve skin appearance. Remember to always wear sunscreen. Avoid known triggers to prevent flare-ups.

If left untreated, rosacea can get worse over time. This can have emotional and social effects. It is important to work with your doctor to treat symptoms and improve your quality of life. This article was contributed by: familydoctor. This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.

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What is rosacea?