Rosacea - what is it and how can you treat it?

mature woman red skin

Have you spotted any angry-looking red patches on your face? It may be possible that you are suffering from rosacea, a skin condition that affects many older people, particularly women. While it is extremely common, there is still a lack of medical information surrounding it. So in order to shed some light on this widespread but little talked about issue, we answer three vital questions: what is rosacea, what are the main symptoms, and how can it be treated?

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What is rosacea?

Rosacea is a common long-term skin condition that typically occurs after the age of 30. It usually affects the face, although symptoms can also appear on the neck, ears, chest, scalp and back. It is ultimately a physical condition, but it can also have a psychological effect on those who suffer from it as it can result in changes to physical appearance, which many people may find difficult to adjust to.

It is typically characterised by red flare-ups on the face, and can include bumps, pimples, eye problems and skin thickening, particularly around the nose. Over time, blood vessels in the skin may start to become visible.

While the exact cause of rosacea is at present unknown, there are a variety of treatments available that can help to reduce symptoms.

What are the causes?

Research is still ongoing to find the exact causes of the condition, but possible triggers, ranging from genetics, biological abnormalities to lifestyle factors, could include:

Abnormalities in facial blood vessels
A reaction to microscopic mites found on the face
Over-stimulation in the production of cathelicidins (molecules that help to combat illness) through irritation or infection, which may cause bumps and pimples
Exposure to ultra-violet radiation (i.e. sunlight)
Changes in temperature, and hot and cold weather
Exposure to skin irritants
Stress or other strong emotions
Strenuous exercise
Alcohol
Caffeine
Spicy foods

Are there different types ?

Most commonly, rosacea affects older women, especially those with fair skin, although it does also affect men. Each case may differ from individual to individual (regardless of gender), and rosacea can harbour itself in different forms. The four types are:

Erythematotelangiectatic rosacea - usually facial redness and visible blood vessels
Ocular rosacea - solely affects the eyes
Phymatous rosacea - causes an enlargement of the nose due to excess tissue (also known as rhinophyma) and usually affects more men than women
Papulopustular rosacea - usually includes bumps, spots (pus filled papules or pustules) and red patches, and may resemble acne

What are the symptoms?

four types of rosacea

Depending on the type of rosacea (and on the individual), it can manifest in mild, moderate or severe forms. Symptoms include persistent redness, skin thickening, a burn or sting sensation and many more.

Erythematotelangiectatic rosacea

Persistent facial redness
Swelling (known as edema)
Rough or dry skin
Scaling
Burn or sting sensation
Visible blood vessels
Flushing or blushing

Ocular rosacea

Stinging eyes
Watery eyes
Bloodshot eyes
Swollen or irritated eyes
Styes

Papulopustular rosacea

Solid red bumps
Spots
Red patches (plaques)

Phymatous rosacea

Skin thickening around nose

Can menopause cause or affect the development of rosacea?

Hot flushes associated with menopause can trigger the onset of symptoms, but the two are not mutually exclusive. If you are experiencing facial redness and approach your GP for a diagnosis, they may examine a potential relationship between menopause and rosacea if you are going through the change or if you are in the early post-menopause stages. They may also ask you to undergo a couple of routine tests to rule out any other conditions with similar symptoms, such as psoriasis.

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The best treatments

For people with rosacea, the first port of call is to see your GP or a dermatologist to get veritable medical advice. Once they have diagnosed your symptoms, starting some form of long-term treatment programme will help to reduce your current symptoms and delay the onset of any further ones. At present, there is no cure for rosacea, but treating it as soon as possible after diagnosis will ensure that any current symptoms don't get worse.

Identifying a treatment that will actually work for you may be tricky to start with as symptoms do differ for each individual, but it is important to know and understand your options and choose a treatment that will suit you best. Here are a variety of different ways that you can control the worst of it:

Self-help treatments

Identify potential triggers and do your best to avoid them
Invest in a thorough skincare regime
Avoid wearing makeup, reduce the amount you wear, choose a different product that will better suit sensitive skin, or choose fragrance-free makeup products
Keep your eyelids clean to avoid eye symptoms
Take care of your mental wellbeing, especially if you are feeling stressed, which could involve taking some time off work or talking to family and/or friends
Practice a healthy, anti inflammatory diet and limit sugar intake
Avoid or limit alcohol and caffeine consumption
Avoid other common rosacea irritants, such as witch hazel, menthol, peppermint, eucalyptus oil and exfoliating products that may be too harsh on the skin

Skin expert Caroline Hirons says: "To help the rosacea itself, I would ask what your current routine is and recommend that you stay away from alcohol, sugar and dairy to start with."

Topical medication

Incorporate topical medication (i.e. prescribed creams or gels) into your skincare regime. Work these into your routine after cleansing and before moisturising or applying makeup. Please note that they will need to be recommended and prescribed by your GP. Topical medication includes:

Metronidazole cream or gel
Azelaic acid cream or gel
Ivermectin cream

Oral medication

Take oral medication, such as prescribed oral antibiotics, suitable for patients with rosacea, to reduce skin inflammation. These will also need to be prescribed by your GP. Types of antibiotics include:

Tetracycline
Oxytetracycline
Doxycycline
Erythromycin

Other treatments

Laser treatment and intense pulsed light (IPL) treatment can help to shrink blood vessels if they are overly visible. Be sure to consult your GP first and go over any possible side effects before undergoing this treatment.

Advice from those who are suffering

While professional help and support is ultimately the key, it is also important to get health advice from those who are experiencing this condition first-hand. Some of our users are suffering from rosacea symptoms, so here is some impartial advice from them to you...

How should I go about seeking treatment?

"Ask your GP to refer you to a dermatologist. If it is rosacea, you need it treated properly."

Which topical medication would you avoid?

"A lot of people react badly to Aqueous cream, which is odd as doctors recommend it."

Which topical treatment would you recommend?

"I have very sensitive skin. I get flare-ups around the nose, can't wear any makeup and have to use face cream very sparingly - either Avene or Yves Rocher for sensitive skin. And Rosalox (prescription only) really does help when I have flare-ups."

"If it does turn out to be rosacea, another topical treatment is Finacea. Excellent!"

What triggers rosacea for you?

"I found it hugely embarrassing when working and persevered with GPs until I found a sympathetic and knowledgeable one. I have a prescribed cream when it is needed, but find Avene products work very well - they calm and reduce redness almost immediately. Triggers for me are red wine, spicy foods, stress and water, so I use a cleanser that doesn't need to be washed off and drink white wine [grin].

Can I use makeup to cover facial redness?

"There are moisturisers and light foundations available to counteract the redness - they have a slight green tinge to them. I'm pretty certain Boots do one in their own brand."

If you'd like to know more about this condition, visit the NHS and National Rosacea Society websites and be sure to consult your GP or dermatologist if you are concerned.

Disclaimer: The information on our health pages is only intended as an informal guide and should not be treated as a substitute for medical advice. Gransnet would urge you to consult your GP before you begin any diet if you're concerned about your weight, have existing health conditions and/or are taking medication.