Rosacea: symptoms, causes, and prevention
Dr. Amina Bougrine, Dermatologist, Medisys Montreal
Did you know that nearly 3.6 million Canadians suffer from rosacea? Rosacea is a common condition in both men and women and is often under-diagnosed. This chronic inflammatory dermatitis causes significant discomfort for those who suffer from it, and is commonly mistakenly associated with alcoholism. People who suffer from rosacea are impacted both physically and emotionally; nearly 75% of people who have rosacea report that this condition has a negative impact on their self-esteem and on their careers.
WHAT ARE THE SIGNS AND SYMPTOMS OF ROSACEA?
The first signs of rosacea often appear in adulthood, typically between the ages of 30 and 50. At first, the symptoms may be intermittent, with periodic redness and a burning sensation in the face. Over time, the redness becomes more permanent and dryness of the skin typically follows. There are four subtypes of rosacea, the severity of which may be variable: (1) erythemato-telangiectatic rosacea (often called “couperose”) which is characterized by permanent redness and dilated blood vessels; (2) papulo-pustular rosacea (or acne rosacea) characterized by lesions similar to acne; (3) phymatous rosacea, a rare form of rosacea characterized by thickening of the skin; and (4) ocular rosacea, which involves the eyelids and/or conjunctiva, typically causing burning and itchy eyes, and is often accompanied by rosacea of the skin.
WHAT CAUSES ROSACEA?
The origins and causes of rosacea are only partially understood; rosacea is a complex disease and active subject of scientific research. Rosacea is not caused by alcoholism – a common and unfair misconception. Alcohol is, however, one of many triggers that can prompt or aggravate rosacea flareups in some patients (other triggers being sunlight, heat, and environmental stress, for example). We now know that rosacea is caused, in part, by a genetic predisposition. This genetic predisposition can lead to a defective skin barrier and a complex inflammatory cascade involving several naturally occurring skin microorganisms. The origins and causes of rosacea are only partially understood; rosacea is a complex disease and active subject of scientific research. Rosacea is not caused by alcoholism – a common and unfair misconception.
IS THERE A CURE?
There is no cure for rosacea; however, fortunately there are several effective measures for both rosacea prevention and treatment. If you have rosacea, dermatologists recommend gentle skin care with an emphasis on year-round sun protection and voidance of possible triggers such as stress, exposure to extremes of temperature (hot or cold), prolonged sun exposure, spicy foods, coffee, alcoholic beverages, and very hot drinks. The impact of these lifestyle factors on rosacea vary from person to person. Many topical cosmetic products are available over the counter that aid in rosacea management. Mild, fragrance-free, alcohol-free, skin products are recommended for rosacea sufferers and products with abrasive or skin-irritating ingredients should be avoided. “It is important to keep the skin well moisturized, especially during the winter,” says Dr. Amina Bougrine, a leading dermatologist based out of the Medisys preventive health clinic in Montreal. Since sun exposure can worsen the symptoms of rosacea, it is recommended that rosacea sufferers use a broad spectrum sunscreen with an SPF of 30 or more on a daily basis. “For those suffering from rosacea, it’s important to stay cool when it’s hot outside. In extreme weather conditions, I recommend keeping the face covered and protecting the skin with a good moisturizer,” continues Dr. Bougrine. Stress management and a healthy, balanced diet also play a role in preventing rosacea flare-ups.
There are also several effective medical treatments for rosacea including 1) topical treatments (ivermectin, metronidazole, azelaic acid, and brimonidine), 2) oral treatments (antibiotics of the tetracycline family, isotretinoin), and 3) laser therapies. Consult a dermatologist for proper diagnosis and treatment of any skin condition, including rosacea.
• Asai Y, et al. Canadian Clinical Practice Guidelines for Rosacea. Journal of Cutaneous Medicine and Surgery. 2016;20(5):432-45.
• Canadian Dermatology Association. (2016). Rosacea: Living with Rosacea, http://www.dermatology.ca/skin-hair-nails/skin/rosacea/#!/skin-hair-nails/skin/rosacea/living-with-rosacea/. Accessed October 16, 2016.