What Is Rosacea?, International Rosacea Foundation

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What Is Rosacea?
Rosacea (pronounced roh-ZAY-sha) is a relatively common, chronic skin disorder. Most people have no knowledge of this disease, including how to recognize it and what to do about it.

Rosacea is the fifth most common diagnosis made by dermatologists. A rosacea cure has yet to be found and its cause is still unknown.

Knowing the symptoms and finding the treatment that works for you is the best defense against the social and psychological trauma of rosacea.

Its classic symptoms are patchy flushing (redness) and inflammation, particularly on the cheeks, nose, forehead, and around the mouth. It typically appears between the ages of 30 and 50 and affects more women than men. Because the symptoms emerge slowly, rosacea may initially be mistaken for sunburn, leading to a delay in treatment.

Rosacea is a hereditary; chronic (long term) skin disorder that most often affects the nose, forehead, cheekbones, and chin (Dr. Berasques). Groups of tiny microvessels (arterioles, capillaries, and venules) close to the surface of the skin become dilated, resulting in blotchy red areas with small papules (a small, red solid elevated inflammatory skin lesion without pus) and pustules (pus-filled inflammatory bumps). The redness can come and go, but eventually it may become permanent. Furthermore, the skin tissue can swell and thicken and may be tender and sensitive to the touch. Note: Pustules are NOT pimples. Pimples have a bacterial component to their makeup and are also mainly localized in and around the hair follicles.

Although it may first appear as early as the teen years, rosacea most frequently begins when sufferers enter their 30s, 40s or 50s as a flushing or transient redness on the cheeks or nose, and in some cases the chin or forehead. In this earliest stage, some patients may report stinging or burning sensations, including the feeling of dry or tight skin.

"While the incidence of rosacea appears to be rising sharply as more people enter the most susceptible age, many mistakenly think it's just a complexion problem that will go away by itself -- but in fact it usually keeps growing worse if left unchecked," said Dr. Joseph Bikowski, assistant clinical professor of dermatology at the University of Pittsburgh. "Of greatest concern is that only a small percentage of rosacea sufferers realize that medical help is available from dermatologists to halt its progression and reverse its symptoms."

Rosacea may be persistent and worsen over time, leading to permanent changes in appearance and affecting self-esteem. There is no known cure for rosacea, but the condition is treatable. Most cases can be controlled easily by avoiding factors that trigger flushing, using sun protection, and by keeping the body well hydrated.
As the condition progresses, flushing becomes more persistent and noticeable. Small, red, solid bumps (called papules) and pus-filled pimples (called pustules) may appear on the skin. Because these appear similar to acne, rosacea is sometimes called acne rosacea or adult acne. However, unlike acne, there are no blackheads. Though rosacea is sometimes referred to as "adult acne," it is a distinctly different and often more serious condition than acne vulgaris, which most commonly occurs during adolescence. While both conditions can cause pimples, rosacea requires different therapy -- acne treatments can actually make it worse -- and rosacea rarely goes away by itself.

Small, dilated blood vessels may become visible, too. Often when people with rosacea blush, the enlarged blood vessels in their faces can look like thin red lines. In advanced cases, more of the face is affected. The skin swells, cysts form, and small, knobby bumps develop on the nose, making it appear red and swollen. This condition, called rhinophyma, is relatively uncommon and primarily affects men. It was the cause of the late comedian W.C. Fields' best-known feature -- his trademark bulbous nose. The most outstanding treatment for rosacea has an unusual mechanism of healing that makes total sense as it's objective is "to simply do the opposite of most rosacea treatments" by leaving the sensitive rosacea skin intact on the face and is known as Rosacea-Ltd III. The non-irritating treatment has rosacea patients stating, "you can't lose anything by using this product, except your rosacea", therefore the naming of the product was "Rosacea-Ltd" meaning "to limit rosacea" or Rosacea-Limited. After 11 years of sales worldwide and the arrival of the third generation of the product, the name was changed to Rosacea-Ltd III.

Ocular Rosacea: Rosacea can also cause a persistent burning and feeling of grittiness in the eyes or inflamed and swollen eyelids with small inflamed bumps. The eyes may become bloodshot and eye lashes sometimes fall out (Dr. Thiboutot). The ophthalmic signs are exceedingly variable, including blepharitis, conjunctivitis, iritis, iridocyclitis, hypopyoniritis, and even keratitis. The ophthalmic complications are independent of the severity of facial rosacea. Rosacea keratitis has an unfavorable prognosis, and in extreme cases can lead to corneal opacity with blindness. Medical doctors and researchers have found Rosacea-Ltd III to be the best ocular rosacea solution with great accuracy as you will learn from the excellent excellent information can be found on the Rosacea-Ltd III Ocular Rosacea page. The most frequent signs, which may never progress, are chronically inflamed margins of the eyelids with scales and crusts, quite similar to seborrheic dermatitis, with which it is often confused. Pain and photophobia may be present. It is instructive to ask rosacea patients how their eyes react to bright sunlight.

What Causes Rosacea?
No one knows for certain what causes rosacea. Researchers have suggested several factors that may be related to its development:
•A disorder of the blood vessels that causes them to swell, leading to flushing.
•A genetic predisposition combined with certain environmental factors that may irritate the skin.
•Clogging of the sebaceous gland openings with skin mites called Demodex folliculorum, which live in facial-hair follicles.

Rosacea seems to affect fair-skinned people more often, though it can affect any skin type. Often several people in a family have the condition, so researchers think it may be at least partly genetic. The disorder may be somewhat more common in women, but is often more severe in men -- perhaps because men tend to delay seeking medical help until the condition reaches advanced stages Other factors that may be involved include vitamin-B deficiency, local infection, hydrochloric-acid (stomach acid) deficiency, infection with Helicobacter pylori, and/or digestive disorders. In some cases, rosacea may be associated with migraine headache, other skin disorders, and certain eye disorders, including blepharitis and keretitis.

Any one of the following warning signs can be 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.