Rosacea

What is rosacea?

Do you experience periodic flushing of your skin, perhaps after drinking alcohol or a steamboat meal? Do friends and family comment on how red you look, almost as if you are perpetually angry or flustered? Or do you have extreme skin sensitivity or redness, where many products can cause you to break out with small little bumps or exacerbate redness on the face? You might be suffering from rosacea.

Rosacea is a chronic skin condition marked by facial redness, sensitivity, noticeable blood vessels, and sometimes small, red bumps on the face. It commonly develops on facial areas such as the cheeks, nose, chin, and forehead.

Rosacea's severity varies, predominantly affecting the cheeks, nose, chin, and forehead. Unlike acne, which it is often linked to, rosacea is unique and requires bespoke treatment strategies. Recognising the overlap among rosacea subtypes—erythematotelangiectatic, papulopustular, phymatous, and ocular—enables tailored medical interventions.

• Erythematotelangiectatic rosacea (ETR): also known as vascular rosacea, ETR is the most common type that causes redness, flushing, and visible blood vessels on the face.
• Papulopustular rosacea: papulopustular rosacea is characterised by acne-like red bumps or pustules on the face but occurs without blackheads and whiteheads typically found in acne.
• Phymatous rosacea: phymatous rosacea involves thickening of the skin, often on the nose, creating a coarse and bumpy texture.
• Ocular rosacea: ocular rosacea is characterised by eye symptoms such as irritation, burning, tearing, or stinging sensations. There may also be redness of the conjunctiva, eyelids, or papules along the eyelids.

What causes rosacea?

• Genetics and environment: the roots of rosacea are believed to lie in the interplay between genetic makeup and environmental exposures.
• Immune system overreaction: an overactive immune system leads to inflammation, redness, and swelling in rosacea.
• Vascular abnormalities: abnormal or dysfunctional blood vessels lead to persistent redness or visible blood vessels, especially in response to external factors like temperature changes or spicy food.
• Demodex mites: though Demodex mites live on everyone's skin, people with rosacea may have a heightened reaction to these microorganisms. An increased presence of Demodex mites in those with rosacea suggests a link between the mites and the skin's inflammatory response seen in this condition.
• Neurovascular dysregulation: the nervous system's interaction with the skin's blood vessels plays a role in rosacea. This dysregulation can cause uncomfortable flushing and redness, often triggered by stress, temperature changes, or certain foods and beverages.

What are the common symptoms of rosacea?

At Lumine Dermatology & Laser Clinic, we recognise that rosacea is as unique as the individuals it affects. It presents a spectrum of symptoms that vary in severity and impact.

Common rosacea symptoms include:

• Facial redness: ranging from occasional flushing or blushing to persistent redness and inflammation, affecting your confidence and causing discomfort.
• Tingling and burning: if your skin often feels hot, burning, or tingling, especially during a rosacea flare-up, know that these sensations are typical responses in rosacea-affected skin.
• Pimple-like bumps: pus-filled bumps or papules that resemble acne can cause discomfort.
• Visible blood vessels: fine red lines on the cheeks and nose contribute to the facial redness.
• Eye irritation: individuals may experience sore, red, itchy, and dry eyes. The eyes may feel gritty and swollen, and styes may form.

Who is at risk of rosacea?

At Lumine Dermatology & Laser Clinic, we often encounter patients curious about how they developed rosacea.

• Genetic factors: a family history of rosacea may increase the risk because of the genetic predisposition to this condition.
• Skin types: individuals with lighter skin types are at a higher risk of developing rosacea.
• Age: although rosacea can occur at any age, it is more commonly diagnosed in individuals between 30 and 50.
• Gender: rosacea is more prevalent in women, but it tends to be more severe when it occurs in men.
• Environmental triggers: exposure to certain environmental triggers, such as sunlight, heat, wind, spicy foods, smoking, alcohol, and stress, may lead to or worsen rosacea symptoms.

Understanding the multifaceted causes of rosacea helps us at Lumine Dermatology & Laser Clinic tailor a treatment plan that addresses the symptoms and the triggers unique to each individual. Embrace a clearer, more comfortable complexion—reach out to Lumine Dermatology & Laser Clinic to discover how we can help you manage rosacea and enhance your skin health.

How is rosacea diagnosed?

With its varied symptoms and triggers, rosacea requires a nuanced approach to diagnosis. Here's how we ensure a comprehensive evaluation at Lumine Dermatology & Laser Clinic:

• Detailed physical examination: our initial step is a thorough physical examination of your skin and, if necessary, other affected areas such as the eyes.
• In-depth medical history review: your journey and experiences with your skin are vital to us. We encourage you to share your detailed medical history, including any observed symptoms and factors that trigger flare-ups. This personalised insight helps us form a more accurate diagnosis and tailor treatment.
• Diagnostic tests: we may recommend additional tests to ensure a precise understanding of your skin's condition. This could include:
  • Skin biopsy: occasionally, a small skin sample may be taken and examined to rule out other skin conditions or confirm a rosacea diagnosis.
  • Blood tests: these can help identify any underlying health issues that might contribute to your skin's condition, such as autoimmune or hormonal conditions that predispose you to flushing.

What are the treatment options for rosacea?

Although rosacea is a chronic condition with no definitive cure, our clinic provides customised treatments to manage symptoms and significantly improve your skin’s appearance. Here’s how we can help at Lumine Dermatology & Laser Clinic:

• Topical and oral medications: to help you tackle rosacea, we offer a range of medications, including azelaic acid, topical and oral antibiotics, non-steroidal anti-inflammatory medications, anti-mite treatments, and isotretinoin. We also prescribe brimonidine and beta blockers to target flushing and redness.
• Laser treatments:
  • Vbeam laser: the Vbeam laser is a pulsed-dye laser that is an effective treatment for targeting and diminishing the appearance of abnormal blood vessels, reducing facial redness, and improving skin tone.
  • CO2 laser: for concerns like rhinophyma or prominent pores, CO2 laser offers a solution to refine skin texture and appearance.
• Polynucleotide treatment: polynucleotide treatment can alleviate inflammation and skin sensitivity, reduce the occurrence of papulopustular eruptions, and promote healthier skin. 

Need a consultation for rosacea? Make an appointment with Dr Evelyn today!

Frequently asked questions

What is the main cause of rosacea?
The exact cause of rosacea is still unknown. However, it is believed to be triggered by a mix of genetic and environmental factors, such as abnormalities in the blood vessels of the face and a dysregulated immune reaction to Demodex mites.

How can I heal my rosacea naturally?

Many ingredients are available in skin care products to manage rosacea symptoms. Look for ingredients such as Centella Asiatica, allantoin, niacinamide, pathenol, and other soothing botanicals suitable for sensitive skin. Lifestyle changes like managing stress and sun protection can also improve rosacea symptoms. However, it is essential to consult a dermatologist before trying natural remedies, as they may worsen symptoms if not appropriately instituted. 

Does rosacea go away eventually?

The nature of rosacea involves periods of exacerbations and remissions, where symptoms flare up for a duration before diminishing in intensity. However, the good news is that many individuals with rosacea can achieve long periods of remission with effective management strategies.

Individuals with rosacea must work closely with a dermatologist to develop a personalised treatment plan. While rosacea may not "go away" traditionally, with proper management, individuals can lead comfortable lives with minimal impact from their condition.

Can steroids cause rosacea?

Some individuals can develop steroid-induced rosacea. This is more common in individuals who use topical steroids rather than oral steroids.

Is dry, flaky skin a common symptom of rosacea?

Dryness and flakiness occur quite commonly in rosacea. The skin barrier function in individuals with rosacea is often compromised, making it more difficult to retain moisture. This can lead to dryness and subsequent flakiness, which may exacerbate the appearance of redness and irritation. Mistaking rosacea for acne and applying products more suitable for acne-prone skin can further aggravate these symptoms.