Understanding Rosacea: Treatments, Causes and Symptoms

Rosacea (rose-AY-sha) is a common skin problem that appears as a vivid blush, and skin that is much redder than normal.

The symptoms of Rosacea, include inflammation around the cheeks, nose, chin, forehead, or eyelids. It may cause redness, prominent blood vessels, swelling, or skin eruptions similar to acne.

It will often flare up and remit at any time, but since there is no permanent cure, it won’t go away for forever.

How to Treat Rosacea

Since rosacea is an inflammation of the skin, we first address the inflammation to try to heal the skin by targeting topical pro-inflammatory factors. Patients usually see some improvement once harmful aggravators are eliminated.

When rosacea flares up due to hot weather or stress, we might prescribe medication for a limited time. A gentle, non-chemical based moisturizer and cleanser are strongly recommended.

There is no known permanent cure for rosacea, but we can control the redness and inflammation. We treat skin eruptions with a variety of agents including oral & topical antibiotics, topical anti-inflammatories, and other agents with our long-term, 5+ week treatment of oral antibiotics.

If you have damaged blood vessels, which look like red squiggly lines (technically called telangiectasia) due to the inflammation, we use laser treatments to reduce the redness.

Rosacea is not difficult to treat compared to some other skin conditions, so don’t hesitate to address it head-on. We have many different, individualized treatment options that are available for you. We make sure to treat each specific type of rosacea depending on your needs.

Common Rosacea Treatments

Rosacea can commonly be treated with one or more of the following treatments:

  • Topical Anti-Inflammatories
  • Topical Antibiotics
  • Oral Antibiotics
  • Non-Chemical Based Makeup Moisturizers & Cleansers
  • VBeam Perfecta Laser Treatments
  • Radiance & Rosacea Peel

What Causes Rosacea?

The symptoms of rosacea appear when the skin becomes inflamed.

Some of these factors that contribute to rosacea are:

  • Chemical-based sunscreens
  • Cheap makeup
  • Some medications
  • Skin products
  • Over-the-counter anti-aging products
  • Fragrances
  • Skin mites*

*Some patients are surprised to learn that we can have mites living in the oil glands of our skin. These mites carry a bacteria that changes the oil on our skin, making it pro-inflammatory. If we remove some of the oil, we kill the mites in the process, which helps the skin fight the inflammation.

What Does Rosacea Look Like?

Patients experience the symptoms of rosacea in many different ways.

  • Rosacea can cause the skin to be a soft pink or a deep red. Some patients get rosacea in their eyes – it looks like pink eyeliner and the eyes feel irritated and gritty.
  • Occasionally, patients develop white pustules similar to acne (especially common for those with particularly oily skin), a rhinophyma nose (an extreme case of rosacea that creates a large mass at the bottom of the nose) in extreme cases, or deep cysts.
  • One form of rosacea occurs when a patient has exceptionally large oil glands, called sebaceous hyperplasia, that secrete too much oil. Other patients don’t get pink, but they still see inflammation.

A dermatologist is a detective of sorts. We look at your skin to identify your symptoms and determine what type of rosacea you have. Once we can pinpoint the type, we know better how to treat.

Rosacea isn’t a disease; it’s a condition. Although there is no known cause or cure, we can target and control the symptoms, as well as eliminate anything that aggravates the condition.

Types of Rosacea

Because rosacea affects so many people, and the severity of the condition varies so widely, it has been divided into 4 subcategories. However, many patients who struggle with rosacea experience more than one type at a time, and treatment options are similar.

We’ll discuss each of these subtypes in detail, but keep in mind that a board-certified dermatologist is trained to detect which type of rosacea each patient has. If you aren’t sure, simply schedule an appointment and we’d be happy to help!

1.) Erythematotelangiectatic Rosacea

Don’t let the long name make you feel uncomfortable (and you won’t be asked to pronounce it!). This type of rosacea is characterized by facial redness, frequent flushing, and visible small blood vessels.

These damaged blood vessels, technically referred to as telangiectasia in the medical field, are caused by inflammation from the rosacea. Here at Helendale Dermatology, we can improve the appearance of ruptured blood vessels with one of our cosmetic lasers (the VBeam® Perfecta, to be exact).

2.) Papulopustular Rosacea

Papulopustular rosacea is often confused with acne – understandable, due to the acne-like breakouts that are common with this type of rosacea. Of course, it is also accompanied with facial redness (characteristic of any type of rosacea) and swelling.

Patients with exceptionally oily skin frequently struggle with papulopustular rosacea. However, the bumps, pimples, and whiteheads are more consistent than acne, and must be treated persistently. The goal of treatment is dryness. We recommend a gentle, non-chemical moisturizer and cleanser, such as All Calm 3-1 from colorescience – this proprietary formula treats, covers, and protects.

3.) Phymatous Rosacea

Phymatous Rosacea specifically targets the nose and is found more commonly in men than women. You’ll know it by the skin on your nose thickening and acquiring a bumpy texture. An extreme case results in rhinophyma nose, recognized by a large mass at the end of the nose.

Excessive alcohol consumption does not cause Phymatous Rosacea, as was previously believed, although it may cause a flare-up typical to any type of rosacea. Instead, it is caused by an increase in tissue of the sebaceous glands.

The best way to treat depends on the degree of severity, but in most cases we recommend prescription acne medication, non-chemical based topical creams, and low doses of antibiotics. If severe enough, some patients resort to plastic surgery.

4.) Ocular Rosacea

As the name implies, this kind of rosacea affects the area around the eyes, leaving the eyes red, irritated, dry, or exceptionally teary. The eyelids may become swollen and develop what looks like a stye (a tender, red bump at the edge of the lid). In extreme cases, you might experience loss of vision and corneal damage.

Ocular Rosacea can be treated with gentle lid scrubs for teary eyes, warm compresses for dry eyes, and topical antibiotics or anti-inflammatories to address inflammation.

Steps for Treating Rosacea

If you’re worried about rosacea, take a moment to think about what you use on your skin that could be aggravating the condition. It might be time to switch to better makeup and skin products and get rid of chemical-based sunscreens.

Rosacea is not difficult to treat, so don’t hesitate to address it head-on. You have many different, individualized treatment options that are available for you. Not everybody needs anti-mite medication, but to some that’s all they need. It just depends on your specific type of rosacea.

We don’t use lasers to treat rosacea, but we can use them to treat damaged blood vessels that are caused by inflammation. You might not notice these ruptured blood vessels if you have a bright red, acne-prone type of rosacea. But once your condition starts to heal, you might see little capillaries, called telangiectasia, that look like red squiggly lines. We use the laser to get rid of those red lines.

Rosacea can happen to everybody, so we treat everyone – teenagers, adults, men, women. Some adults acquire it over time, most commonly at ages 30-50. Many women experiencing menopause will have rosacea flares due to hot flashes. We can help you understand what to look for and the best way to treat your specific type of rosacea.