Rosacea

Key Points
Common skin condition which primarily affects the face of middle aged and older adults
Exact cause is unknown
Components include facial flushing, redness, telengectasia (dilated capillaries) and red bumps/pustules which resemble acne.

Rosacea is a skin condition which typically affects the face, though rarely it may involve the scalp, upper limbs and/or torso. The condition consists of a red, papular rash which may accompanied by Telangiectasia, flushing, skin redness, dryness, flaking and increased skin sensitivity. Additionally, affected persons may experience eyelid involvement (ocular rosacea), rhinophyma (nose deformity), and blepharophyma (firm swelling in varying areas of the face). The condition may be worsened by exposure to sunlight or spicy foods, which cause flushing, and topical creams, especially steroids. Rosacea may recur in some cases, or may persist for years.

The exact cause of rosacea is unknown. The condition is due to the inflammation of overactive blood vessels in the affected area. This inflammation has been theoretically linked to genetic, vascular, inflammatory and environmental causes. Additionally, the existence of mites in the hair follicles of the affected area may be involved. The condition may affect anyone, but persons of Celtic background, fair skin and light eyes are at increased risk of its development.

Differential Diagnosis (Other conditions with similar appearance)
Lupus erythematosus, Acute
Perioral Dermatitis
Sarcoidosis
Seborrheic Dermatitis

Diagnosis
Key Points
Diagnosis based on the characteristic appearance of the affected area
Skin biopsy may be performed to rule out other conditions

Rosacea is typically diagnosed based on the characteristic appearance of the affected area. A skin biopsy may be performed to rule out similar appearing conditions.

Treatment
Proper care of the affected area is imperative in controlling the condition
Various treatments may be utilized
Surgical therapies may be necessary in some cases
OTC Options: sunscreen, water-based cosmetics, protective clothing

Proper care of the affected area is imperative in controlling rosacea. It is recommended that affected persons protect against sun exposure, avoid irritants such as oil-based facial creams and topical steroids, and reduce the risk of flushing by avoiding heat, spicy or hot foods, and alcohol. Additionally, health care professionals may prescribe oral Antibiotics, Isotretinoin, anti-inflammatories, and topical treatments such as metronidazole or azelaic acid preparations. Laser therapies may be used to treat telangiectasia which persists, and rhinophyma may be resolved through surgical reshaping.