Rosacea Symptoms, Signs, Triggers

Rosacea (pronounced "roh-ZAY-sha"), also referred to as Acne Rosacea, is a chronic and potentially life-disruptive disorder primarily of the facial skin, often characterized by flare-ups and remissions. Many have observed that it typically begins any time after age 30 as a redness on the cheeks, nose, chin or forehead that may come and go. In some cases, rosacea may also occur on the neck, chest, scalp or ears. Over time, the redness becomes ruddier and more persistent, and visible blood vessels may appear. Left untreated, bumps and pimples often develop, and in severe cases the nose may grow swollen and bumpy from excess tissue. This is the condition, called Rhinophyma (pronounced "rhi-no-FY-muh"), that gave the late comedian W.C. Fields his trademark bulbous nose. In many rosacea patients, the eyes are also affected, feeling irritated and appearing watery or bloodshot.

Although rosacea can affect all segments of the population, individuals with fair skin who tend to flush or blush easily are believed to be at greatest risk. The disease is more frequently diagnosed in women, but more severe symptoms tend to be seen in men -- perhaps because they often delay seeking medical help until the disorder reaches advanced stages.

While there is no cure for rosacea and the cause is unknown, medical therapy is available to control or reverse its signs and symptoms. Individuals who suspect they may have rosacea are urged to see a dermatologist or other knowledgeable physician for diagnosis and appropriate treatment.

Rosacea can vary substantially from one individual to another, and in most cases some rather than all of the potential signs and symptoms appear. According to a consensus committee and review panel of 17 medical experts worldwide rosacea always includes at least one of the following primary signs, and various secondary signs and symptoms may also develop.

Primary Signs of Rosacea
Flushing
Many people with rosacea have a history of frequent blushing or flushing. This facial redness may come and go, and is often the earliest sign of the disorder.
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.

Bumps and Pimples
Small red solid bumps or pus-filled pimples often develop. While these may resemble acne, blackheads are absent and burning or stinging may occur.
Visible Blood Vessels
In many people with rosacea, small blood vessels become visible on the skin.
Other Potential Signs and Symptoms

Eye Irritation
In many people with rosacea, the eyes may be irritated and appear watery or bloodshot, a condition known as ocular rosacea. The eyelids also may become red and swollen, and styes are common. Severe cases can result in corneal damage and vision loss without medical help.

Burning or Stinging
Burning or stinging sensations may often occur on the face. Itching or a feeling of tightness may also develop.

Dry Appearance
The central facial skin may be rough, and thus appear to be very dry.

Plaques
Raised red patches, known as plaques, may develop without changes in the surrounding skin.

Skin Thickening
The skin may thicken and enlarge from excess tissue, most commonly on the nose. This condition, known as rhinophyma, affects more men than women.

Swelling
Facial swelling, known as edema, may accompany other signs of rosacea or occur independently.

Signs Beyond the Face
Rosacea signs and symptoms may also develop beyond the face, most commonly on the neck, chest, scalp or ears.

Rosacea affects an estimated 14 million Americans -- and most of them don't know it. In fact, while rosacea is becoming increasingly widespread as the populous baby boom generation enters the most susceptible ages, a Gallup survey found that 78 percent of Americans have no knowledge of this disease, including how to recognize it and what to do about it.

Because of its red-faced, acne-like effects on personal appearance, however, it can cause significant psychological, social and occupational problems if left untreated.

In recent surveys by the National Rosacea Society, nearly 70 percent of rosacea patients said this condition had lowered their self-confidence and self-esteem, and 41 percent reported it had caused them to avoid public contact or cancel social engagements. Among rosacea patients with severe symptoms, nearly 70 percent said the disorder had adversely affected their professional interactions, and nearly 30 percent said they had even missed work because of their condition.

While the cause of rosacea is unknown and there is no cure, today medical help is available that can control the signs and symptoms of this potentially life-disruptive disorder. Any one of the following warning signs is a signal to see a dermatologist or other knowledgeable physician for diagnosis and appropriate treatment before the signs and symptoms become increasingly severe:
Redness on the cheeks, nose, chin or forehead.
Small visible blood vessels on the face.
Bumps or pimples on the face.
Watery or irritated eyes.

Rosacea Triggers Survey
While the list of potential rosacea triggers in various individuals may be endless, a survey of 1,066 rosacea patients found that the most common factors included the following:

Factors Percent Affected

Emotional stress 81%
Hot weather 75%
Wind 57%
Heavy exercise 56%
Alcohol consumption 52%
Hot baths 51%
Cold weather 46%
Spicy foods 45%
Humidity 44%
Indoor heat 41%
Certain skin-care products 41%
Heated beverages 36%
Certain cosmetics 27%
Medications 15%
Medical conditions 15%
Certain fruits 13%
Marinated meats 10%
Certain vegetables 9%
Dairy products 8%
Other factors 24%