About 16 million Americans have rosacea, a chronic inflammatory skin condition characterized by recurrent flushing and redness of the face. It may be accompanied by broken blood vessels on the nose and cheeks; bumps and pimples (different from adult acne); and red, itchy, dry eyes and swollen eyelids (ocular rosacea). In severe cases, men in particular may develop a red, bumpy, bulbous nose (rhinophyma).
Rosacea typically begins in middle age and occurs more often in fair-skinned people and in women. It may have a genetic component. Though the damage can be progressive, the symptoms tend to wax and wane, and what sets them off differs from person to person. Alcohol often induces flare-ups, but does not cause rosacea. It’s a myth that people with rosacea are more likely to have an alcohol problem.
Rosacea can't be cured, but it can be controlled. Here's how:
See your doctor to confirm the diagnosis. You may be given oral antibiotics (which may reduce symptoms due to their anti-inflammatory action) and/or topical medications or other drugs, such as retinoids. Various light and laser procedures may reduce redness and visible capillaries, as well as remove excess tissue from the nose to improve its appearance. These treatments usually require several sessions.
Identify your triggers. Common rosacea triggers are hot or cold weather, sun exposure, emotional stress, spicy foods, alcohol, wind, exercise, hot baths and hot beverages. The National Rosacea Society provides a diary that helps you track your triggers, along with tips on how to avoid them. If you are sensitive to extreme temperatures, protect your face in cold weather with a scarf or ski mask, and avoid getting overheated when exercising by switching to a lower-intensity activity or doing shorter workouts. Ask your doctor if any drugs you take can cause flushing.
Take self-care steps. Wash your face with a gentle cleanser and lukewarm water; pat dry. When outside, use a broad-spectrum sunscreen with titanium dioxide or zinc oxide, which are less irritating than other chemicals in sunscreens. Avoid skin-care products with alcohol, menthol, peppermint, eucalyptus oil, sodium lauryl sulfate or anything else that may sting or burn. Use products marketed for sensitive skin; some are designed specifically for rosacea. Cosmetics with a green tint can help counter the appearance of the redness and cover visible blood vessels.
If you have eye symptoms, see an eye specialist. Left untreated, ocular rosacea can affect the cornea and lead to vision loss. Artificial tears and washing your eyelids with diluted baby shampoo can help, but some cases may require oral antibiotics or other medical treatment.
Get support. Rosacea can be unsightly and embarrassing. People with severe cases may become socially isolated and depressed. Support groups may help.
Should you go alternative? Oregano oil, emu oil, colloidal silver, laurel wood, cucumber, red clover and aloe are some of the many “natural” remedies touted for rosacea—with little or no evidence that they work. However, green tea extracts, topical licorice, chamomile and oatmeal may have anti-inflammatory or other skin-protective effects that can help rosacea, according to a review in the Journal of Drugs in Dermatology. If you want to try an alternative remedy, talk to your doctor first, since some things may worsen rosacea. And don’t believe claims that any product or treatment can cure the condition.