Rosacea – Facial Flushing

Primary Signs of Rosacea
Rosacea Triggers
Rosacea Treatment
What Rosacea Looks Like

Rosacea (pronounced “roh-ZAY-sha”) is a chronic and potentially life-disruptive disorder primarily of the facial skin, often characterized by flare-ups and remissions. Rosacea affects mostly adults, usually people with fair skin, between the ages of 30 and 60. Many have observed that it typically begins any time after age 30 as a redness on the cheeks, nose, chin or forehead. It typically first appears as a flushing or redness that comes and goes. In some cases, rosacea may also occur on the neck, chest, scalp or ears. Sometimes referred to Acne Rosacea or misdiagnosed as adult acne, Rosacea has no specifically known cause.


Rosacea Video – Warning Signs

I’d like to thank Dr. Pilest for treating the most severe case of Rosacea I’ve seen and experienced. He treated me with such understanding and had me ready for a very important “Generation” family photo in just 1 week. I am very impressed. Dr. Pilest can help anyone in the war on this painful and unsightly problem. The pictures turned out great!”
Joyce McBroom

Over time, the redness becomes ruddier and more persistent, and visible blood vessels (telangiectasia) may appear. Bumps (papules) and pimples (pustules) often develop, and in some people the eyes feel irritated and appear bloodshot. In other cases, the nose may become swollen and enlarged from excess tissue. Without treatment, each of these potential signs and symptoms may progress from mild to moderate to severe.


Photo Source Candela
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Primary Signs of Rosacea

  • Flushing
    Many people with rosacea have a history of frequent blushing or flushing. This facial redness may come and go, and is often the earliest sign of the disorder.
  • Persistent Redness
    Persistent facial redness is the most common individual sign of rosacea, and may resemble a blush or sunburn that does not go away.
  • Bumps and Pimples
    Small red solid bumps or pus-filled pimples often develop. While these may resemble acne, blackheads are absent and burning or stinging may occur.
  • Visible Blood Vessels
    In many people with rosacea, small blood vessels become visible on the skin.
    To remove these blood vessels, Dr. Pilest will use the Vbeam laser. Vbeam affects the vessels within the skin and does not affect the surface skin.

Other Potential Signs and Symptoms

  • Eye Irritation
    In many people with rosacea, the eyes may be irritated and appear watery or bloodshot, a condition known as ocular rosacea. The eyelids also may become red and swollen, and styes are common. Severe cases can result in corneal damage and vision loss without medical help.
  • Burning or Stinging
    Burning or stinging sensations may often occur on the face. Itching or a feeling of tightness may also develop.
  • Dry Appearance
    The central facial skin may be rough, and thus appear to be very dry.
  • Plaques
    Raised red patches, known as plaques, may develop without changes in the surrounding skin.
  • Skin Thickening
    The skin may thicken and enlarge from excess tissue, most commonly on the nose. This condition, known as rhinophyma, affects more men than women.
  • Swelling
    Facial swelling, known as edema, may accompany other signs of rosacea or occur independently.
  • Signs Beyond the Face
    Rosacea signs and symptoms may also develop beyond the face, most commonly on the neck, chest, scalp or ears.

Common Rosacea Triggers and How to Manage Rosacea Symptoms

  • Culprit #1. Avoid sun exposure, which adversely affects more than 80 percent of Rosacea sufferers. Minimize exposure from 10 a.m. to 2 p.m. When you do go out, use a UVA sunscreen with an SPF of 30 or higher. Physical sunscreens with zinc and/or titanium oxide are less irritating and work instantly.
  • Avoid Stress. Expect the unexpected. Also, don’t try to do too much in a day.
  • Staying Cool. Retreat to air-conditioning when temperatures rise.
  • Dress “Cool.” Keep it light, loose and topped with a broad-brimmed hat.
  • Stay Hydrated. Drink plenty of cold liquids. You may also want to mist your face when you are outside in the heat.
  • The Spice Connection.¬† Steer clear of spices, hot drinks and foods that may cause you to flush.
  • Choose your Workout Time. Early or late in the day is best, when it’s cooler outside.
  • Umbrellas in the Sun. A must at the beach…anywhere without shade.
  • Keep Your Routine. Don’t sporadically start and stop your treatment. Successful management of Rosacea only happens when you follow your treatment program.
  • Avoid Harsh Products. Your skin care routine should consist of mild cleansing products and your prescribed topical medication. Don’t add scrubs or glycolic acids which will only irritate already sensitive skin.

Rosacea Treatments

Because the signs and symptoms of Rosacea vary from one patient to another, treatment must be tailored by a physician for each individual case.
Typical Rosacea treatment options and program.

Various oral and topical medications may be prescribed to treat the bumps, pimples and redness often associated with the disorder. Dermatologists usually prescribe initial treatment with oral antibiotics and topical therapy to bring the condition under immediate control, followed by long-term use of the topical therapy alone to maintain remission.

When appropriate, rosacea treatments with a Vascular laser (Vbeam), intense pulsed light sources or other medical and surgical devices may be used to remove visible blood vessels, reduce extensive redness or correct disfigurement of the nose. Ocular rosacea may be treated with oral antibiotics and other therapy.

In addition to medical treatment, Rosacea sufferers can improve their chances of maintaining remission by identifying and avoiding lifestyle and environmental factors that trigger rosacea flare-ups or aggravate their individual conditions. The National Rosacea Society offers a free Rosacea Diary Booklet to assist patients in identifying factors that may affect their individual cases, as well as a booklet called “Coping with Rosacea” that provides tips on lifestyle management. Rosacea Q and A’s.

What Rosacea Looks Like

 

Subtype 1: Facial Redness (Erythematotelangiectatic Rosacea)
Rosacea sufferers typically experience flushing and persistent facial redness.Small blood vessels may become visible in some patients, and stinging, burning, swelling and roughness or scaling may also occur.
Subtype 2: Bumps and Pimples (Papulopustular Rosacea)
In addition to persistent redness, bumps (papules) and/or pimples (pustules) are common in many rosacea sufferers.Some patients may also experience raised red patches known as plaques.
Subtype 3: Enlargement of the Nose (Phymatous Rosacea)
Rosacea may be associated with enlargement of the nose from excess tissue, a condition known as rhinophyma.This may include thickening of the skin and irregular surface nodules, which in rare cases may also develop in areas other than the nose.
Subtype 4: Eye Irritation (Ocular Rosacea)
Rosacea affects the eyes in many patients, and may result in a watery or bloodshot appear-ance, irritation and burning or stinging.The eyelids may also become swollen, and styes are common.

 

Acknowledgements: Patient photos were supplied by Dr. Joseph Bikowski, assistant clinical professor of Dermatology, University of Pittsburgh; and Dr. Jerome Z. Litt, assistant clinical professor of Dermatology, Case Western Reserve University thru the National Rosacea Society.

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