What it is
Rosacea is a common rash occurring on the face in middle-aged people. It is more common in women, but tends to be more severe in men. It is a chronic condition with frequent flares. The rash affects the cheeks, forehead, chin and nose, and causes flushing, redness, visible blood vessels (telangiectasia), tiny red bumps (papules) and pus-filled spots (pustules).
The redness sits in the central part of the face and comes with a feeling of heat or burning that comes and goes. In some people rosacea affects the eyes, making them dry, irritated and swollen. Over time the skin over the nose can thicken and look bulbous — rhinophyma — especially in men.
What causes it
The exact cause is unknown, but it could be a combination of inherited and environmental factors. Risk factors are female sex, light skin (particularly if sun-damaged), age over 30, smoking and a family history of rosacea. There are mainly three triggers — sunlight, spirits and spicy foods. Other factors are hot beverages, exercise, emotions, extreme temperatures and some cosmetic products.
How we treat it
There is no specific test for rosacea. Your skin doctor relies on your history and the clinical findings to make the diagnosis, and may refer you to an eye specialist if you have eye symptoms.
Treatment depends on how severe the symptoms are. Moisturisers and sunscreens should be used during the day. Ivermectin or pimecrolimus based creams may be given to apply at bedtime. When treatment by mouth is indicated, doxycycline, an antibiotic, may be prescribed for a few months. Lasers or intense pulsed light therapy may be advised to reduce visible blood vessels or to correct the change in the shape of the nose.
What you can do
Avoid your triggers, especially sun, spirits and spices. Apply a broad-spectrum sunscreen of SPF 30 or higher daily, wear a hat, and avoid harsh sunlight and windy, cold weather. Do not rub, scrub or touch your face too much; use a gentle cleanser, rinse with lukewarm water and moisturise regularly. Avoid perfumed products and anything containing alcohol or irritants. Make-up can cover rosacea and reduce the look of redness.