Definition of Rosacea Acne

rosaceaAn inflammatory condition that produces acnelike outbreaks and erythema (redness) on the face. Rosacea, sometimes incorrectly called adult acne, occurs primarily in people over age 40 and becomes more common with advancing age.

Dermatologists do not know what causes rosacea, though believe it is an interaction between genetic and environmental factors.

About 14 million Americans have rosacea. Though more women than men have this condition, men tend to have more severe symptoms.

Symptoms and Diagnostic Path

The symptoms are mild and general at first, often starting with increasingly frequent blushing. Dermatologists believe this early stage of rosacea may persist for years, though not many people seek medical care for it alone. Eventually the condition progresses to outbreaks of pimplelike pustules and other lesions that appear to be acne but resist conventional acne treatments. Most people seek a doctor’s evaluation at this stage.

The typical symptoms that bring people to the dermatologist include

  • Extended flushing of the face and neck that may persist for hours after onset
  • Papules that erupt in clusters across the cheeks, on the chin and forehead, around the base of the nose, and sometimes around the eyelids
  • Itching and burning of the face, particularly in areas where papules have erupted
  • Patches of dry flaky skin when the papules retreat
  • Telangiectasis (fine blood vessels that appear as red lines beneath the surface of the skin)
  • Conjunctivitis and itchy, dry eyes
  • Rhinophyma (enlarged and bulbous nose) in advanced or severe rosacea

The dermatologist generally can make the diagnosis on the basis of the appearance and history of the symptoms and the person’s age. Other factors that support a rosacea diagnosis include a personal or family health history of autoimmune disorders or rosacea symptoms.

Treatment Options and Outlook

Effective treatment for rosacea varies widely; what works for some people may have no effect for others. Dermatologists generally offer a combination approach of topical products and oral antibiotic medications that are effective in controlling skin conditions. Most people who have rosacea try a number of treatments to find those that are the most effective.

Common Treatments for Rosacea
azelaic acidbenzoyl peroxide
clindamycin topicalerythromycin topical
glycolic acidmetronidazole
sulfacetamidesulfuric solutions

Laser therapy becomes a treatment option for rhinophyma and can reduce the size and shape of the nose to normal. Laser therapy is also useful for controlling telangiectasis. Treatment for eye symptoms may include ophthalmic moisturizing solutions and corticosteroid medications to reduce inflammation and irritation. As rosacea is a chronic condition with no known cure, treatment is ongoing.

Risk Factors and Preventive Measures

People who are fair-skinned, blond, and blue-eyed seem most likely to develop rosacea. Because dermatologists do not know the precise mechanisms of rosacea, there are no known preventive measures. Factors that can sometimes trigger outbreaks of rosacea, though do not cause rosacea, include

  • Spicy foods
  • Caffeine and alcohol
  • Heat and strenuous physical exercise
  • Unprotected sun exposure
  • Strong emotional reactions such as anger, fear, or embarrassment
  • Hot showers or baths, hot tubs, saunas
  • Hormones (menstruation, pregnancymenopause)

Actions such as avoiding circumstances that trigger rosacea outbreaks, using sunscreen with a high sun-protection factor (SPF) when outdoors, and maintaining diligent therapeutic approaches can keep rosacea in check for many people who have the condition.


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