Rosacea

The cause of rosacea is not fully understood. Genetics, immune system problems and environmental factors may all play a part. Factors that trigger rosacea cause the blood vessels in the skin of the face to enlarge (dilate). The theory that rosacea is due to bacteria on the skin or in the gut has not been proven. However, antibiotics have proved helpful to treat rosacea. This is because of their anti-inflammatory effect. Rosacea is not contagious.

There are many triggers that may make rosacea worse. These include alcohol, exercise, high and low temperatures, hot drinks, spicy foods, and stress. Rosacea patients can be sensitive to the sun.

Is rosacea hereditary?

Rosacea does seem to run in some families, but there is no clear genetic link.

The rash and blushing associated with rosacea can lead to embarrassment, lowered self-esteem and self-confidence, anxiety and even depression. Furthermore, the skin of the face is often sensitive, and the affected area can feel very hot or sting.

Some people affected by rosacea may develop eye problems such as painful inflammation involving the front part of the eye (rosacea keratitis) and this may cause blurred vision. If you develop symptoms affecting the eyes, it is important to consult a dermatologist or an optician.

What does rosacea look like?

Rosacea usually starts with a tendency to blush easily. After a while, the central areas of the face become a permanent deeper shade of red, with small, dilated blood vessels, bumps, and pus-filled spots.

Occasionally, there may be some swelling of the facial skin (lymphoedema), especially around the eyes. Occasionally, an overgrowth of the oil-secreting glands on the nose may cause it to become enlarged, bulbous and red (called rhinophyma). Rhinophyma is more common in men.

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Rosacea can be diagnosed by its appearance. Specific tests are not usually required.

Can rosacea be cured?

No, but long-term treatments can be helpful.

How can rosacea be treated?

The inflammation that accompanies rosacea can be treated with medications applied to the skin or taken by mouth; however, not all these will help the redness or blushing that may be associated with rosacea.

• Protect your skin from the sun before going out, by using a sun block with a sun protection factor (SPF) of at least 30. Apply the sun block on your face every day. It needs re-applying frequently when you are outdoors.
• Do not rub or scrub your face when cleansing as this can make rosacea worse.
• Do not use perfumed soap as this can make rosacea worse.
• Use a soap substitute (emollient) to cleanse your face.
• Use a non-perfumed moisturiser on regularly if your skin is dry or sensitive.
• Consider and avoid the lifestyle factors that can worsen rosacea; keeping a diary of what worsens rosacea may help.
• Sometimes cosmetics can be used to cover rosacea effectively, and some rosacea patients may benefit from the use of skin camouflage to help hide excessive redness. A skin camouflage consultation can be discussed with your healthcare professional or by contacting the organisations listed at the end of this leaflet.
• Unless specifically recommended by your dermatologist, it may be best to avoid some treatments for acne, as these can irritate skin that is prone to rosacea.
• Do not use creams and ointments containing corticosteroids, unless specifically recommended by your dermatologist as these may make rosacea worse.
• If your eyes are affected, do not ignore them – consult your GP, dermatologist, or an eye specialist doctor.
• Some drugs can aggravate blushing, and your doctor or dermatologist may make appropriate changes to your medication.

CAUTION: This leaflet mentions 'emollients' (moisturisers). Emollients, creams, lotions and ointments contain oils which can make it easier for dressings, clothing, bed linen or hair to catch fire. To reduce the fire risk, patients using these moisturising products are advised to be very careful near naked flames to reduce the risk of clothing, hair or bedding catching fire. In particular, smoking cigarettes should be avoided and being near people who are smoking or using naked flames, especially in bed. Candles may also be a fire risk. Daily washing is advisable for clothing which is in regular contact with emollients and wash bed linen frequently. More information may be obtained at https://www.gov.uk/guidance/safe-use-of-emollient-skin-creams-to-treat-dry-skin-conditions.