Do you flush or blush more easily than most people? Does the flushing happen when you feel stressed, drink alcohol, become too warm, or eat spicy food? Has your skin become more sensitive? Does your skin burn or sting whey you blush? These are early indications that you could have rosacea.
Rosacea is a skin condition that often begins with a tendency to blush or flush more easily than other people. With time, that warm feeling on the face tends to last longer and may eventually become constant. The redness can slowly spread beyond the nose and cheeks to the forehead and chin. Even the ears, chest, and back can be red all the time. With time, people who have rosacea often see permanent redness in the center of their face.
Women are a bit more likely than men to get rosacea. Women, however, are not as likely as men to get severe rosacea. Some people are more likely to get rosacea, but anyone can get this skin disease. People of all colors get rosacea. Children get rosacea.
According to the U.S. government, more than 14 million people are living with rosacea. Most people who get rosacea are:
- Between 30 and 50 years of age
- Fair-skinned, and often have blonde hair and blue eyes
- From Celtic or Scandinavian ancestry
- Likely to have someone in their family tree with rosacea or severe acne
- Likely to have had lots of acne — or acne cysts and/or nodules
While rosacea is common, many people are unaware that they have it. Because treatment can reduce the discomfort and prevent rosacea from worsening, it’s helpful to know the signs such as:
- Flushing and blushing
- Redness lasts longer
- Permanent redness
- Acne-like breakouts
- Visible blood vessels
- Skin is easily irritated
- Sun-sensitive skin
- Thickening skin
- Eye problems
Most people who have rosacea develop some — but not all — of these signs and symptoms. Many signs and symptoms come and go. If you have any of these signs or symptoms, a dermatologist can tell you whether you have rosacea. An accurate diagnosis and treatment can prevent rosacea from worsening.
There are so many signs and symptoms that rosacea has four subtypes:
- Erythematotelangiectatic rosacea Redness, flushing, visible blood vessels
- Papulopustular rosacea Redness, swelling, and acne-like breakouts
- Phymatous rosacea Skin thickens and has a bumpy texture
- Ocular rosacea
- Eyes red and irritated, eyelids can be swollen, and the person may have what looks like a stye
If you have rosacea, you may notice that it worsens at certain times of the year or when you do certain things. In the winter, your face may feel raw and irritated when you’re outside on a cold, windy day. After drinking a glass of red wine, your face may feel hot and uncomfortable.
Anything that worsens your rosacea is called a trigger. Many things can be a trigger, and triggers tend to vary from person to person. Some of the most common rosacea triggers are:
- Alcohol, especially red wine
- Spicy foods
- Hot beverages
- Some skin care or hair care products
If your dermatologist suspects you have rosacea, you won’t need medical tests. To diagnose rosacea, your dermatologist will examine your skin and your eyes. Your dermatologist will also ask questions. Before giving you a diagnosis, your dermatologist may want to make sure you don’t have another medical condition. Sometimes, another medical condition can look a lot like rosacea. Your dermatologist will want to rule out these conditions. Medical tests can help rule out conditions, such as lupus and an allergic skin reaction.
No matter what the cause, you don’t have to live with the redness. If the redness bothers you, a dermatologist can create a treatment plan. Rosacea is a chronic skin disease with no cure, but you can successfully control it. Making some lifestyle changes and treating rosacea can prevent flare-ups. It can also prevent the rosacea from worsening. Many people find that by doing these things, living with rosacea becomes a lot easier. They also say they feel and look better
When it comes to treating the redness of rosacea, you have options. A dermatologist can explain which options can work best for you.
A treatment plan for rosacea usually involves being gentle with your skin, using rosacea friendly skin care products, applying medication to your skin, and avoiding your triggers to help reduce flare-ups, as outlined below. The rest of your treatment plan will be tailored to treating your rosacea.
Trigger management. Many things you do can cause rosacea to flare. Dermatologists call these tripwires “triggers.” Common triggers for rosacea include becoming overheated, having cold wind blowing on your face, and eating spicy foods. These may — or may not — cause your rosacea to flare. People have different triggers. It’s important to find out what causes your rosacea to flare and avoid those triggers.
Think sun protection 24/7. People who have rosacea often find that their skin is quite sensitive to the sun. To protect your skin from the sun, you’ll want to:
- Apply a broad-spectrum sunscreen with an SPF 30 (or higher) every day before you head outdoors
- Avoid the midday sun
- Seek shade when outdoors
- Slip on a wide-brimmed hat when outdoors to protect your face and neck from the sun
- Wear sun-protective clothing and sunglasses
Practice rosacea friendly skin care. Many skin care products can irritate skin with rosacea. Some skin care habits, such as scrubbing your skin clean, can cause rosacea to flare. Using mild skin care products and being gentle with your skin can help prevent flare-ups. If you have trouble finding mild skin care products, ask your dermatologist for recommendations.
Green-tinted makeup: This cannot reduce the redness, but it can hide it. Some companies make green-tinted makeup specifically for people with rosacea.
Lasers and other light-based treatments: For people who have a constantly red face or visible blood vessels, a laser or other light-based treatment can be effective. Some patients see complete clearing of their redness. This clearing can last for years.To find out if this type of treatment could help clear your redness, it is recommended to see a dermatologist to discuss if you would be a good candidate. Not everyone who has rosacea is.
Brimonidine gel and oxymetazoline hydrochloride cream: These prescription medications can reduce the redness on your face caused by rosacea. They work for up to 12 hours. Once the effects wear off, the redness returns. With daily use, you can have reduced facial redness for up to 12 hours a day.
Rosacea makes the skin extremely sensitive. Because the skin is so sensitive, many things can cause rosacea to flare. If you notice that something irritates your skin, find out what happens when you avoid it. Does your skin feel better or look clearer?
For instance, time spent in the sun can lead to unexpected flushing that lasts for hours. Any number of skin care products may cause your face to sting, burn, or itch for what seems an eternity.
Anything that causes your rosacea to flare is called a trigger. Sunlight and hairspray are common rosacea triggers. Other common triggers include heat, stress, alcohol, and spicy foods. Triggers differ from person to person.
Rosacea flares are more than a minor inconvenience. Each time your skin flushes, it can stay red a little longer. Rosacea may start to appear on more of your skin. In some people, repeated flushing leads to skin that stays permanently red. Visible blood vessels may start to appear. Skin can thicken.
With repeated flushing, treatment can also become more difficult. Treatment that may have worked earlier is no longer effective. Your dermatologist may need to prescribe stronger medicine or talk with you about an in-office treatment like laser therapy. Therefore, dermatologists often ask patients to find their triggers before beginning treatment. Even when treating rosacea, triggers can cause rosacea flare-ups.
You can find your own rosacea triggers by doing a bit of detective work. A good place to start is by looking at common rosacea triggers such as:
- Alcohol, especially red wine
- Spicy foods
- Some skin and hair care products
- Some makeup
- Wind and cold
- Some medicines
Do you think any of the trigger below could be causing your rosacea to flare?
ROSACEA IN KIDS
Few children and teens develop rosacea, but it’s worth considering if your child frequently has any of the following:
- Red, irritated eyes
- Styes or pinkeye (especially if your child received treatment)
- Red, swollen eyelids that may itch and can look greasy or crusty
- Long-lasting flushing on the face
Left untreated, rosacea can worsen. In children, the long-lasting flushing can progress to permanent redness in the middle of the face. Some children develop acne-like breakouts.
When rosacea affects the eyes, a child may continue to get styes and pinkeye. Even when you treat these, new styes and cases of pinkeye develop. Your child’s eyes may become extremely sensitive to light or feel gritty most of the time. This is often a warning sign of ocular (affects the eyes) rosacea, a condition that is often missed in children. As the rosacea progresses, an open sore can develop on an eye. This is a serious medical problem because an open sore can lead to partial or complete loss of eyesight.
To find rosacea early, it helps to see a doctor who has expertise in diagnosing skin conditions, such as a board-certified dermatologist.
Your dermatologist will carefully examine your child’s face and eyes, looking for signs of rosacea. When a child has signs of rosacea on the skin, a dermatologist will want to rule out more common childhood diseases that can look like rosacea. This list includes acne, skin infections, and allergic skin reactions. To rule out other conditions, your child may need a medical test, such as a blood test.
If you don’t see redness or eye problems, your child can still have rosacea. Be sure to keep your dermatology appointment. Without treatment, rosacea can worsen.
If your child or teen has rosacea, your dermatologist will tell you:
- Where the rosacea appears (skin, eyes, both)
- What treatment is recommended
When rosacea affects the skin, your dermatologist will talk with you about treatment. A typical treatment plan for a child or teen typically consists of lifestyle changes, medication to get the rosacea under control, and follow-up appointments.
If your child has mild ocular rosacea, your child’s dermatologist may treat that, too. For more severe ocular rosacea, your dermatologist can refer you to an eye doctor for treatment.
Getting rosacea under control can prevent it from progressing. The good news is that with treatment, rosacea can often be under control within a few weeks to months. Getting the disease under control helps to prevent it from progressing and allows your child to feel better.
ROSACEA AND SKIN COLOR
Studies show that when people of color develop rosacea, the early signs, such as flushing, can be missed or mistaken for another condition.
In skin of color, rosacea can look like many other conditions, including acne, seborrheic dermatitis, an allergic reaction, or lupus. Dermatologists receive more training in diagnosing and treating conditions that affect the skin than other doctors.
Without treatment, rosacea can worsen. Your face may burn and sting every time water touches it or you apply a skin care product. Some people develop acne-like breakouts. When rosacea affects the eyes, it can cause problems with your eyesight.
Even when it worsens, rosacea can be missed in people who have skin of color.
If you have skin of color, dermatologists recommend that you make a dermatology appointment if you notice any of the following on your face:
- A warm feeling most of the time
- Dry, swollen skin and patches of darker skin
- A dusky brown discoloration to your skin
- Acne-like breakouts that acne treatment won’t clear
- Yellowish-brown, hard bumps around your mouth, eyes, or both
- Burning or stinging when you apply skin care products
- Swelling and thickening skin on your nose, cheeks, chin, or forehead
When rosacea affects the eyes, it’s called ocular rosacea. Here are signs that rosacea may be affecting your eyes:
- Swollen, warm eyelids
- Red, bloodshot eyes
- Pink eye (also known as conjunctivitis)
- Crusty eyelids or eyelashes
- Tearing (or dry eyes)
- A feeling you have something in your eye
- Burning and stinging in your eyes
- Itchy, irritated eyes
- Sensitivity to light
Even when the rosacea on your skin is mild, you can develop eye problems. If you have any of these signs or symptoms, see a board-certified dermatologist or ophthalmologist.