A rosy complexion is often thought to be a sign of good health. But red patches on the face may be a sign of something more troubling — rosacea, a common inflammation of facial skin caused by the swelling of blood vessels close to the skin’s surface.
Rosacea is a chronic skin condition that causes redness; small, spider-like blood vessels; small, red, puss-filled bumps on the nose, cheeks, chin and forehead; and sometimes burning and soreness in the eyes.
If left untreated, rosacea can worsen over time. But for most people, rosacea is cyclical, with symptoms flaring up for weeks or months, and then diminishing before flaring up again.
Although many people — often mistaking rosacea for acne and other skin problems — may not even realize they have the condition, rosacea affects approximately 14 million Americans, according to the National Institutes of Health.
Causes and Risk Factors
The exact cause of rosacea is unknown, but researchers believe it results from a combination of hereditary and environmental factors.
It tends to affect those between the ages of 30 and 50 who have fair skin, light hair and eyes, and who experience frequent flushing or blushing.
However, a number of factors can aggravate rosacea by increasing blood flow to the surface of the skin, causing blood vessels in the face to expand. Common triggers include hot foods or beverages, spicy foods, alcohol, extreme hot or cold temperatures, sunlight, stress, strenuous exercise, hot baths or saunas, corticosteroids, and drugs that dilate blood vessels, including some blood pressure medications.
Signs of rosacea include red areas on the face; small, red bumps or pustules on the nose, cheeks, forehead and chin; a red, bulbous nose (rhinophyma); small, visible, spider-like blood vessels on the nose and cheeks (telangiectasia); a burning or gritty sensation in the eyes (ocular rosacea); and a tendency to flush or blush.
But these symptoms don’t appear all at once and they don’t always get worse. Rosacea typically appears in phases. The first stage, sometimes called pre-rosacea, usually begins with a tendency to flush or blush easily, and then progresses to persistent redness in the nose or central part of the face. As symptoms worsen, vascular rosacea may develop, revealing small, swollen blood vessels on your nose and cheeks (telangiectasia). Inflammatory rosacea may follow, revealing small, red bumps or pustules across the nose, cheeks, forehead and chin. And, in some cases, ocular rosacea may develop, resulting in burning and soreness of the eyes.
In rare cases, untreated rosacea may cause permanent effects, such as thickening of facial skin, loss of vision or a swollen, waxy-looking nose.
Prevention and Treatment
There is no cure for rosacea, but symptoms can be controlled with a combination of lifestyle changes and prescription treatments or oral antibiotics.
First, it’s important to identify your triggers and try to avoid them. Although triggers vary from person to person, this likely means using sunscreen every day; avoiding sun exposure and activity in hot weather; reducing stress; and limiting spicy foods, alcohol and hot beverages.
Redness and breakouts can be treated with prescription skin creams containing such medications as azelaic acid or metronizadole or with oral antibiotics, such as doxycycline, minocycline or tetracycline. Redness and tiny blood vessels can be treated with laser or intense pulsed light (IPL) treatments. To protect dry, sensitive skin, your provider may recommend using certain cleansers, moisturizers and sunscreens. Dry, red and irritated eyes can be treated with prescription eyedrops containing cyclosporine.
If you experience persistent facial redness or other rosacea symptoms, consult your health care provider for diagnosis and proper treatment.