Understanding Rosacea - the Basics

What Is Rosacea?

Rosacea is a relatively common, chronic skin disorder believed to affect 14 million Americans. Its classic symptoms are patchy flushing (redness) and inflammation, particularly on the cheeks, nose, forehead, and chin. It typically appears between the ages of 30 and 50 and affects more women than men. Because the symptoms emerge slowly, rosacea may be mistaken at first for sunburn, leading to a delay in treatment

As the condition progresses, flushing becomes more persistent and noticeable. Some people also notice stinging or burning sensations in the affected areas. Small, red, solid bumps (called papules) and pus-filled pimples (called pustules) may appear on the skin. Because these appear similar to acne, rosacea is sometimes called acne rosacea.

Small, enlarged blood vessels (telangiectasias) may become visible, too. Often, when people with rosacea blush, the enlarged blood vessels in their faces look like thin red lines. In some cases, the eyes also may become involved -- and may become red, irritated, and may burn (ocular rosacea). This may happen in up to 50% of people with rosacea.

In advanced cases, more of the face is affected. The skin swells, cysts form, and small, knobby bumps develop on the nose, making it appear red and swollen. This condition, called rhinophyma, is relatively uncommon and primarily affects men. It was the cause of the late comedian W.C. Fields' best-known feature -- his trademark bulbous nose.

Rosacea may be persistent and worsen over time, leading to permanent changes in appearance and affecting self-esteem. There is no known cure for rosacea, but the condition is treatable. Most cases can be controlled easily by avoiding factors that trigger flushing, using sun protection, and by using medication.

What Causes It?

No one knows for certain what causes rosacea. Researchers have suggested several theories that may be related to its development:

• A disorder of the blood vessels that causes them to swell, leading to flushing.
• A genetic predisposition combined with certain environmental factors that may irritate the skin.
• Clogging of the sebaceous gland openings with skin mites called Demodex folliculorum, which live in facial hair follicles.

Rosacea seems to affect fair-skinned people more often, though it can affect any skin type. Often several people in a family have the condition, so researchers think it may be at least partly genetic. In some cases, rosacea may be associated with migraine headache, other skin disorders, and certain eye disorders, including blepharitis and keratitis.