By Darrel Arthurs, ARNP, DCNP
Rosacea is a very common disorder that affects the skin of the face with flares that wax and wane in severity. The condition can be mild, with only a light pink color on the cheeks and nose, or very severe and deep red. Very severe cases may have papules, pustules and broken blood vessels especially over the cheeks. Rosacea can also affect the eyes, causing itching or dryness. Over many years, the condition can also cause a thickening of the tissue across the nose. This particular condition is referred to as rhinophyma.
Frequently, people will experience multiple forms of the symptoms described above. A genetic predisposition to the condition is most likely. They also may have other contributing factors, such as over-reactive facial blood vessels, inflammation of the skin, and increased reaction of nerves that respond to triggers such as spicy foods, alcohol, exercise, or weather. An association with the demodex mite, which commonly lives on human skin, has been found to exacerbate rosacea.
How is Rosacea Diagnosed?
Some signs that a person has rosacea include:
- 1. Chronic pink or rosy colored skin affecting the cheeks and nose.
- 2. Small blood vessels on the cheeks, which are broken and plainly visible.
- 3. Facial flushing of the skin, which occurs after triggers such as sun exposure, alcohol or spicy food consumption, warm drinks, exercise, wind, and warm temperatures.
- 4. Small pink papules and/or pustules form on the cheeks.
- 5. Enlargement of the nose or skin texture changes.
- 6. Redness, dryness and itching of the eyes.
Treatment of Rosacea
There are many effective treatments for rosacea. Some common topical medications include metronidazole, azalaic acid, ivermectin, or sulfur-based products. Oral antibiotics are commonly used, such as doxycycline, especially when papules and pustules are present. Redness and broken blood vessels are much more difficult to treat with medications. A topical medication that was originally designed to treat glaucoma can be used, providing temporary relief by blanching the superficial blood vessels. This medication, called Mirvaso, is very effective for some people but, unfortunately, not all patients are responsive.
Frequently, laser therapy is warranted to treat both redness and the broken blood vessels. Lasers provide a longer-lasting relief from the symptoms of rosacea. They are capable of breaking up the superficial broken blood vessels, as well as decreasing the inflammation of the cheeks.
An acute awareness of the symptoms associated with rosacea, as well as the triggers that can exacerbate the condition, is tantamount to successful treatment. The National Rosacea Society has a wealth of knowledge for both clinicians and patients. The website should be utilized to further education concerning this very common condition.
Darrel Arthurs's passion for dermatology developed while he was serving in active duty in the U.S. Navy. Since then he has accumulated over 11 years' experience in medical and surgical dermatology. Currently he works independently in a small city in northeastern Oklahoma. Arthurs is on the NADNP Board of Directors.