So, you are in your 40s, your face is breaking out again and it’s driving you crazy. You are not alone. Nearly 13 million Americans suffer not from acne but from rosacea — a chronic inflammatory skin condition that is characterized by redness, small bumps and pustules on the cheeks, chin, nose and forehead. It is most common in fair-skinned people between the ages of 30 and 50. When men are affected, the cases appear to be more severe. In fact, this is the condition that (in its latter stages) accounted for W.C. Fields’ red, bulbous nose.
Rosacea is an inflammation of the blood vessels and hair follicles and has nothing to do with blackheads and pimples associated with acne. Rosacea also doesn’t go away on its own. Instead, it gradually develops and worsens over time. The condition cannot be cured, but can be controlled with regular treatment.
The actual cause of rosacea is unknown. A commonly found mite in hair follicles may play a role in the development. The bacteria Heliobacter pylori that is associated with stomach ulcers and medication like vasodilators and topical steroids have also been linked. Rosacea is also more common in people who flush easily, so emotional factors like stress, fear, anxiety and embarrassment may trigger flushing. A flare-up may be cause by changes in the environment, such as strong winds or a change in humidity. Spicy foods, hot beverages, alcohol, and skin care products with alcohol or witch hazel may exacerbate the problem. Rosacea has even been associated with menopause because of the hot flashes.
The current treatment involves both oral and topical medications. Oral antibiotics with initial high doses that are tapered to maintenance levels are the first route. Topical antibiotic creams like erythromycin or clindamycin may help. Recently, the FDA approved Noritate (metronidazole cream) for treating rosacea. It primarily reduces the inflammation and the redness. Some doctors also suggest trying Retin-A or Accutane, the advanced medications for acne or Elimite cream, which is used for scabies. You and your doctor may need to try several things and even rotate them to control your rosacea. The most important thing is to be consistent in your treatment.
Rosacea certainly isn’t life threatening, but it can be embarrassing and hurt one’s self-esteem. It bothers some people that it has been associated with alcoholism in the past. Nothing could be further from the truth. The condition needs to be properly diagnosed and the correct medications prescribed. Then, rosacea can be controlled and should not limit a person from continuing to have an active and fulfilling life.