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Rosacea

What is Rosacea?
Rosacea (pronounced rose-ay-shah) is a disease affecting the skin of the face - mostly where people flush. Rosacea usually starts with redness on the cheeks and can slowly worsen to include one or more additional symptoms and parts of the face, including the eyes. Because changes are gradual, it may be hard to recognize rosacea in its early stages. Unfortunately, many people mistake rosacea for a sunburn, a complexion change, or acne and do not see a doctor. Rosacea cannot be cured, but it can be controlled.

What should I look for?
Many rosacea patients have only one or two symptoms, here is a complete list of the most common ones:

  • Redness - This looks like a blush or sunburn and it is caused by flushing (when a larger amount of blood flows through vessels quickly and the vessels expand under the skin to handle the flow). The redness gradually becomes more noticeable and will not go away. Facial skin may get very dry.
  • Pimples - Later, pimples may appear on the face. These pimples may be inflamed - small, red and solid (papules) or pus-filled (pustules) like teenage acne. Because they look alike, rosacea has been called "adult acne" or "acne rosacea." But people with rosacea do not normally have the blackhead or whitehead type of pimples (called comedones) that are usually seen in teenage acne.
  • Red Lines - When people with rosacea flush, the small blood vessels of the face get larger - eventually showing through the skin. These enlarged blood vessels look like thin red lines on the face, usually on the cheeks. These lines may be hidden at first by flushing, blushing or redness, but they usually reappear when the redness is cleared up. Doctors call these lines telangiectasia (tell-an-jek-taze-yah).
  • Nasal Bumps - When rosacea is not treated, some people - especially men - may eventually get small knobby bumps on the nose. As more bumps appear, the nose looks swollen. This condition is called rhinophyma (rye-no-feye-muh).

Who gets Rosacea?
Rosacea is usually seen in adults. It seems to affect fair-skinned people more often, though it can affect any skin type. Most people who get rosacea have a history of flushing or blushing more easily and more often than the average person (they are sometimes described as having "peaches and cream" complexions).

Why do I have to keep taking my medications after the rosacea has cleared?
Without regular treatment, redness and pimples can return. Studies of patients who stopped treatment after their symptoms were successfully cleared show that rosacea came back in many of the patients within a week to 6 months.

Can Rosacea be cured?
Not yet. But simple treatments can control rosacea, improve the skin's look, and maybe even stop or reverse progress of the disease. Getting medical help early and following the treatment program carefully are the keys.

Can anything make rosacea worse?
Facial flushing can make symptoms worse. It can even cause flare-ups in patients whose rosacea was under control with medications. Flushing can be triggered by many things....hard exercise, even menopause or some medicines. The most common trigger are hot drinks, alcohol, spicy food, stress, sunlight, extreme heat or cold. Experts say you should avoid anything that causes flushing. But what bothers one person may not cause a problem in another. You will need to find out what things affect you and decide if you want to change your habits to avoid them. Just remember - flushing may affect your success in controlling rosacea. Talk to your doctor about how you can learn to identify, and deal with, your own flushing triggers.

What about washing or moisturizing my face?
How and what you use to cleanse your face, and keep it moist, are important when you have rosacea. Rosacea sufferers can use a variety of skin-care products to their advantage. Moisturizers can reduce flakiness and makeup can camouflage symptoms and improve appearance. You may have to experiment until you find the products that work best for your individual condition. Following a regular cleansing and medication routine will make treatment easier and more successful. You should be careful about what products you use with rosacea medications.

  • Soaps/cleansers - only very mild products should be used on the face. Avoid products that contain alcohol or irritants (i.e. witch hazel, menthol, peppermint, eucalyptus oil or clove oil).
  • Moisturizers - apply a quality moisturizer as needed. When using with a topical medication, you can usually apply the moisturizer after the medication has dried
  • Sunscreens - use an SPF 15 or higher whenever you think you will be in the sun for a while.
  • In general, it helps to choose facial products that will not clog pores; they have the word "non-comedogenic" on the package. Avoid products that contain alcohol, acetone or oil.

Weather
Sun exposure, hot weather, humidity, cold and wind have all been known to aggravate rosacea for many individuals. The following are defense strategies you can use:

  • Always protect your face from the sun. Wear a sunscreen with an SPF of 15 or higher year round. If necessary, use a formulation developed for children to avoid irritation; Wear a broad-brimmed hat; Minimize midday exposure to the sun during summer months
  • Stay in a cool, air-conditioned environment on hot, humid days. If this is impossible, those affected should sip cold drinks and try not to overexert themselves. If necessary, chew on ice chips to lower facial temperature or spray the face with cool water.
  • Combat cold by covering your cheeks and nose with a scarf. In winter, rosacea sufferers also may don a ski mask when participating in outdoor sports or activities, as well as cover up on windy days; if these conditions aggravate your rosacea, limiting your time outdoors in cold weather may also help.
  • Use a moisturizer daily during cold weather. This protects against the naturally drying effects of cold and wind.

Stress
Stress ranks high on the list of tripwires for many rosacea sufferers. However, in a survey of rosacea patients affected by stress, most of those using stress management techniques said they had successfully reduced their flare-ups. When feeling overwhelmed, try some of the following stress reducers:

  • Take care of your whole self. Eat healthy, exercise moderately and get the right amount of sleep. It may also help to cut down on caffeine.
  • When under stress, try deep-breathing exercises. Inhale and count to 10, then exhale and count to 10. Repeat this exercise several times.
  • Use visualization techniques. Sit in a quiet place, close your eyes and visualize a beautiful vacation spot or favorite pleasurable activity or painting to reduce stress. Hold the image for several minutes to feel its peacefulness and beauty.

Exercise
Exercise is important in the stress relieving part of the process. Regular exercise will help reduce the feeling of being overwhelmed and contribute to the well-being of not only your body, but your mind as well.

  • When exercising outdoors during warm weather, choose early morning or early evening hours when it's cooler. No matter what time of day, protect your face from the sun and avoid hot weather exercise.
  • When exercising indoors, make sure the room is well ventilated. Run a face, open the window for a breeze or turn on the air conditioning to avoid overheating.
  • Try to stay as cool as possible when exercising. Drape a cool, damp towel around your neck, drink cold fluids or chew on ice chips. You can also keep a bottle filled with cool water to spray your face.

Bathing and Cleansing
Rosacea sufferers often must modify their approach to cleansing and bathing. The following tips can help you adopt a personal-care routine that soothes and calms your facial redness.

  • Avoid hot water, hot tubs and saunas. These can bring on flushing and aggravate your condition.
  • Begin each day with a thorough and gentle facial cleansing. Use a gentle cleanser that is not grainy or abrasive and spread it with your fingertips. Rinse your face with lukewarm water to remove all dirt and soap, and use a thick cotton towel to gently blot the face dry.
  • Never pull, tug, scratch or treat your face harshly. Avoid any rough washcloths, loofahs, brushes or sponges.
  • Let your face thoroughly air dry before applying any medication or skin-care products. Let your face rest for a few minutes before applying topical medication. Then allow the medication to dry completely for five to ten minutes before applying any moisturizer and makeup.
  • Men should use an electric shaver rather than a blade. If a blade is preferred, never use a dull blade that requires extra scraping for a clean shave. Avoid shaving lotions that burn or sting.
  • Repeat the cleansing process at night. Gently cleanse your face each night to remove any makeup or dirt accumulated throughout the day. Air dry and apply your topical medication