Rosacea

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Rosacea

Rosacea is a fairly common, annoying facial rash seen in adults. The rash of rosacea has red areas (erythema) and pimples (papules and pustules) with dilated blood vessels (telangiectasias). It affects the nose, mid-forehead and chin (mid-facial) areas. Rosacea resembles the acne of teenagers and used to be called acne rosacea. Rosacea is only a skin condition and does not affect your general health. Rarely, it may be associated with eye irritation (keratitis and conjunctivitis). In some individuals, mild itching or burning are symptoms. Most patients consult their doctor because of the appearance.

The cause of rosacea is unknown. Rosacea is stubborn and often lasts for years. Foods, beverages or activities that cause facial flushing may aggravate the condition. Many physicians recommend avoiding alcohol, spicy foods and hot soups or drinks.

Treatment

1. Antibiotics- Tetracycline is one type of antibiotic that is often prescribed and effective in treating rosacea. Antibiotics may need to be taken for years. Other antibiotics that may be beneficial include doxycycline, minocycline, Septra, amoxicillin.

2. Topical preparations-

Benzoyl Peroxide– Apply thinly once daily to dry skin. Different concentrations (2.5, 5 and 10%) and vehicles (gels, lotions) are available.

Metronidazole is a common topical. It has the advantage that it can be used once a day and has few side effects.

Topical steroid (Hydrocortisone 1-2% or other mild steroids)- Many patients benefit from the vasoconstriction induced by the low dose steroid. Fluorinated steroids may aggravate rosacea and have been a causative factor in some cases.

Finacea (azelaic acid)- is a natural compound that can be used, even in pregnancy.

Sodium Sulfacetamide (Klaron, Plexion)- A very mild preparation that may be beneficial.

3. Do not use any topical agents (soaps, creams, etc.) not prescribed.

Complications

1. 10-15% of patients may have associated eye problems. You should make your doctor aware or consult an ophthalmologist if any problem or discomfort of your eye(s) occurs.

2. The telangiectasias (dilated blood vessels) may persist even with successful therapy. Laser treatments can help make these vessels less visible.

3. A small proportion of rosacea patients (especially males) may experience enlargement of their nose (rhinophyma) due to an increased number and size of oil-secreting (sebaceous) glands. This condition may require surgical correction.

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