Why you need to know about rosacea
Sally thought it was sunburn when she noticed red patches developing on her skin while she was on holiday.
The 35 year old dismissed it, making a mental note to wear a hat and use a stronger sunscreen.
But the reddened look didn’t go away and a few days later Sally began to develop painful pus-filled spots, dry eyes and swollen eyelids.
Sally’s ‘peaches and cream’ skin seemed to be turning against her and she had no idea why.
Diagnosing the problem
Sally could not predict when she would have an episode of inflamed skin, but she noticed it often occurred after she had been drinking wine or exercising at the gym.
As these outbreaks became more regular and intense she tried a variety of skin remedies for adult acne and completely stopped wearing her usual make-up, instead turning to concealers, though these did little to hide the reddened skin or disguise the acne-like outbreaks.
After a few weeks with no improvement, she started to feel anxious about her appearance, and colleagues would sometimes joke that she looked like she had been drinking heavily before coming into the office.
Gradually she began to stop going out after work and would make up excuses as to why she couldn’t see her friends. A couple of times she even called in sick and worked from home.
Finally, in desperation, she went to see her doctor, who after some discussion of her symptoms, told her: “I think you’ve got rosacea.”
“Rosacea?” Sally replied. “What’s that?”
Sally was fortunate. Rosacea (pronounced rose-A-sha) is often misdiagnosed.
Like Sally, people sometimes mistake its effects for acne or other medical conditions including lupus or, in women, menopause.
Despite this, it is fairly common – by some estimates, 10 % of people worldwide suffer with the condition – and it is not unusual for people who have it to experience periods of low self-esteem and increased anxiety.
As well as affecting self-image and mental wellbeing, rosacea can worsen if not treated, so it is important to get it diagnosed early and correctly.
What you need to know
Rosacea is most common in fair-skinned people with Celtic or North European heritage, although it can also be found in people with skin of color. While it tends to affect people aged between 30 and 50 and seems to be rather more common in women, men often have more severe symptoms.
A family history of rosacea puts people at greater risk of developing the condition themselves.
Rosacea typically affects the central face, but other frequently affected areas include the nose, cheeks, forehead and chin.
The most common symptoms are red blotches and bumps or pimples. Other signs that you may have rosacea include pronounced follicles on – and swelling of – the nose, or symptoms in the eyes, such as foreign body sensation, stinging, redness, dryness.
Although it is not known precisely what causes rosacea, many factors can trigger or aggravate it by increasing blood flow to the surface of the skin.
Triggers will vary from person to person, but frequently cited factors include: emotional stress, temperature changes, overexposure to the sun, spicy or hot foods, make-up, tanning products and skin creams.
Alcohol, particularly red wine, and physical exertion may also play a role.
While rosacea is not currently curable, it can be easily treated and managed if correctly diagnosed. Treatments vary according to the type of rosacea, and range from topical creams to oral capsules and, depending on the presented features, device treatments or surgery.
Avoiding the triggers
Sally’s facial rosacea was treated with a topical medicine cream once daily at bedtime. Within a few weeks this had cleared up, but she was advised to avoid triggers and over time she got to know which ones were most likely to affect her. She also began using a sun protection cream of SPF30 as part of her daily skincare routine, as too much ultraviolet light can cause outbreaks.
On her next foreign holiday she took care to avoid too much sun exposure, especially at midday, and upped the SPF of her sun screen to a factor 50.
While she still enjoys the gym and jogging, Sally exercises for shorter, less-intensive bursts that do not exacerbate the condition. She also still enjoys a glass of red wine, but limits drinking to special occasions.
This story is part of a series of articles aiming at illustrating how healthy skin makes a positive impact on people’s lives. It has been developed with the contribution of our scientific and medical experts and is intended for a general public.