What is rosacea?

Rosacea (row-zay-sha) is a chronic skin condition that affects mainly the face. The first signs of rosacea may be redness or blushing that comes and goes initially. Over time, the redness may become persistent and more visible. The most common sites for symptoms are the cheeks, nose, chin, and forehead. Sometimes, rosacea may involve the eyes as well, and include symptoms such as blood-shot eyes that feel gritty. Over half of rosacea sufferers may experience eye symptoms.

Bumps, tiny pus-filled pimples, and enlarged blood vessels can also appear, giving skin a rough, uneven appearance. Rosacea symptoms can vary from one person to another, and there is no predicting severity. There is no known cure for rosacea, although it can be managed with appropriate treatment and lifestyle changes.

Rarely, rosacea symptoms can be severe enough that the skin tissue of the nose becomes thick, swollen, and bumpy (called rhinophyma). It is characterized by thick, red bumps around and on the nose, which develop when the oil-producing glands and the surrounding connective tissues becoming enlarged.  This is a more severe form of rosacea that occurs mostly when it remains untreated. Rhinophyma develops in some men who have rosacea, and very rarely in women with rosacea.

Who is at risk?

Rosacea usually develops in adults between ages 30 and 50. It affects both men and women, although it seems to affect more women and more severe cases seem to occur in men. It tends to affect people with fair skin, such as those of northern and eastern European descent (for example Celtic, English, and Scottish), although rosacea can develop in those of any skin type.

Signs and symptoms

• Frequent flushing or blushing on cheeks, nose, chin, forehead
  
  
• Persistent redness
  
  
• Red lines, due to enlarged blood vessels becoming visible
  
  
• Dry skin
  
  
• Burning, stinging, or itching
  
  
• Pimple-like bumps without blackheads or whiteheads

Quick facts about rosacea

• Rosacea affects over two million Canadians.
  
  
• It is a chronic skin condition that does not go away but can be controlled.
  
  
• It typically develops between ages 30 and 50.
  
  
• It usually occurs more often in women than men.
  
  
• It is often misdiagnosed as adult acne.
  
  
• In about half of cases, rosacea symptoms involve the eyes.

What causes it?

Experts are not certain about what specifically causes rosacea but they believe that it is due to a combination of genetic and environmental factors. There are several theories about a potential cause:

The immune system appears to be involved in rosacea’s development.

Being fair-skinned and of Irish, Scottish, English, or of Eastern or Northern European descent seems to increase the chances of developing rosacea.

A family history of rosacea is considered a risk factor.

Chronic sun exposure is a known risk factor for rosacea.

A skin mite called Demodex folliculorum may contribute to rosacea. The theory is that the mites block oil glands and cause the inflammation that underlies rosacea.

A bacterium associated with gastrointestinal ulcers, called Helicobacter pylori, may play a role.

Living with rosacea

Rosacea can feel a lot worse than it looks. Like other chronic diseases, it is difficult psychologically to deal with a condition that persists for many years. Because of the physical symptoms, many patients with rosacea feel self-conscious and embarrassed about the redness and bumps that occur primarily on their face, making it more difficult to hide than clothed areas. In addition, they may be affected negatively by the common misconceptions about rosacea, such as the belief that it is a sign of alcohol abuse or poor hygiene.

Nearly three quarters of rosacea patients have reported low self-esteem. An equal proportion of patients have felt that rosacea adversely affects their career opportunities. Because of the social and psychological impact of rosacea, it is imperative to receive a diagnosis and treatment for this chronic skin condition. Successfully controlling symptoms through treatment has been shown to improve the mental and emotional well-being of rosacea patients.