Rosacea: Facts and Myths

This April is the first ever Global Rosacea Awareness Month and I am pleased to support it. Rosacea is one of my sub-specialties and my interest in this area led me to co-found the Vancouver Acne & Rosacea Clinic with Dr. Shannon Humphrey. Millions of people suffer from rosacea, a chronic skin disorder that primarily affects the face, and the most important first step in dealing with it is knowledge. 

The onset of rosacea is typically after age 30, with symptoms appearing as redness or blushing that comes and goes initially. Over time, the redness tends to become persistent, and visible blood vessels may appear. Rosacea always includes at least one of the following primary signs: flushing, persistent redness, bumps and pimples, and/or visible blood vessels. Various secondary signs and symptoms may also develop. These include eye irritation, dry skin, thickening of the skin, red patches or plaques, and swelling.

The severity of rosacea can vary significantly from one person to another, and in most cases some rather than all of the potential symptoms appear. Many people with rosacea have a history of blushing or flushing. This is often the earliest sign of the disorder.

Rosacea may be mistaken for acne but while the two may look similar acne has a different underlying cause and needs to be treated differently. The cause of rosacea remains unknown, and while there is no cure, medical therapy is available to control, and sometimes reverse, the symptoms.

Prescription oral and topical medications are often used to treat the bumps and pimples associated with rosacea. Treatments with lasers, intense pulsed light sources or other medical and surgical devices may also be used to remove visible blood vessels, reduce extensive redness or correct disfigurement of the nose.

Topical ivermectin is a new treatment for rosacea that has shown promising results for treating inflammation in papulopustular rosacea. There are two other relatively new medications on the market as well. Onrealtea is a topical prescription specifically designed to treat the facial redness of rosacea. Apprilon is an oral, once-daily treatment designed to treat the bumps and pimples associated with rosacea. To find out whether any of these treatments may be right for you, speak with your dermatologist.

Rosacea is not related to hygiene but it is important to treat skin affected by rosacea gently. I recommend using a mild skin cleanser and products that are non-drying and free of alcohol or astringents. When washing your face, do not scrub, rinse with lukewarm water and pat dry. It is a good idea to moisturize your skin and use a sunscreen (SPF 30 or higher) every day.

A number of lifestyles factors may cause rosacea to flare up. Research has disproven some myths, such as caffeine and coffee causing flare ups (it was determined that it was in fact the thermal temperature of the beverage). Common triggers thought to affect rosacea include hot and cold weather extremes, sun exposure, mental stress, spicy foods and hot beverages. These triggers vary from person to person, so it is important to find out which ones make your rosacea symptoms flare up. This can help you to better manage your condition by avoiding things that may potentially aggravate your skin. 

If you have other questions about rosacea the National Rosacea Society is a great resource.