ACNE ROSACEA

General Information

DEFINITION--Chronic inflammation of skin of the face. Severe nose involvement, mostly in men, is called rhinophyma.

BODY PARTS INVOLVED--Face, especially the nose, and surrounding areas.

SEX OR AGE MOST AFFECTED--Adults; it is more common in women, but more severe in men.

SIGNS & SYMPTOMS

• Flushing of the nose, cheeks and forehead that may last a few minutes or hours. In most cases, the flushing becomes permanent.
• Facial tenderness.
• Papules (small raised bumps) and pustules (small, white blisters with pus) on the affected skin (sometimes).
• Unsightly red, thickened skin (excess tissue) on the nose and cheeks. Small blood vessels are visible on the skin surface.

CAUSES

• Unknown. Some evidence suggests an underlying vascular disorder. Another factor may be a microscopic mite called Demodex folliculorum (a normal resident in human skin) that is more numerous on the skin of people with rosacea.
• The condition is worsened by stress (worry and anxiety), hot drinks, spicy foods, smoking, alcohol, exposure to temperature extremes, excessive sunlight and cosmetics or skin products containing alcohol (or other irritating ingredients).

RISK INCREASES WITH

• People who flush easily.
• Fair complexion.
• Family history of acne rosacea.
• Overuse of corticosteroid creams or ointments in treatment of other skin disorders.

HOW TO PREVENT--No specific preventive measures.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor. There is no specific test to diagnose the disorder.

APPROPRIATE HEALTH CARE

• Self-care after diagnosis.
• Doctor's treatment with medications.
• Steroid-induced rosacea is treated first by stopping the steroid drug.
• Destruction of large vessels with electric needle or a laser.
• Excess tissue removal with electric needle or a laser; or sometimes with a scalpel or rapidly rotating wire brush. The nose may be red for up to a year and then assumes a normal color.
• Psychotherapy or counseling, if disfigurement causes distress.

POSSIBLE COMPLICATIONS

• Psychological distress caused by an unsightly appearance.
• More likely to suffer from migraines.
• Autoimmune eye disorders (rare).

PROBABLE OUTCOME--Symptoms can be controlled with treatment. Acne rosacea is a disease of remissions and frequent flare-ups.

How To Treat

GENERAL MEASURES--

• Seek care early if you notice evidence of acne rosacea.
• Use water-based cosmetics instead of oil-based products.
• See How to Cope With Stress in Appendix.

MEDICATION--

• Your doctor may prescribe: Oral antibiotics, such as tetracycline or erythromycin. Topical antibiotics. Topical antiprotozoal and antibacterial medications, such as metronidazole. Isotretinoin (Accutane), an oral drug, may succeed where other measures fail.
• Don't use cortisone preparations, including non-prescription medicines, without doctor's approval.

ACTIVITY--No restrictions except to avoid factors that may cause a flare-up (see Causes).

DIET--No special diet. Avoid spicy foods, alcohol or anything that causes the face to flush.

Call Your Doctor If

You have symptoms of acne rosacea. This condition can be helped with treatment.