Author: Dr. Luis Sevinsky, Dermatologist
R osacea is an inflammatory skin condition that primarily affects the face, though it can also spread to the chest and, in some cases, the scalp. It is estimated that between 30% and 50% of patients may also experience eye symptoms. While it is more common in fair-skinned women over the age of 30, men can also develop it. In men, it tends to manifest more severely, especially around the nose, a condition sometimes referred to as "drunk nose," although this term is both incorrect and stigmatizing.
The classic presentation of rosacea in women includes reddened skin with small bumps that may resemble acne, but it's important to note that these are not comedones (blackheads or whiteheads). It is believed that a common skin parasite, called Demodex, may play a role in the disease, causing increased inflammation in some patients.
Causes and Triggers
Although the exact cause of rosacea is not fully understood, we do know that it triggers an inflammatory process that leads to its characteristic symptoms: reddened skin, a persistent warm sensation, and, in some cases, pustules or pus-filled bumps. Some of the most common factors that trigger flare-ups include:
- Sun exposure
- Hot environments or direct heat exposure, such as from an oven
- Hot beverages
- Spicy foods
- Alcohol consumption
These factors can worsen the condition, so avoiding them is essential for managing the disease.
Treatment Options: Relieving Symptoms and Preventing Flare-ups
It’s important for patients to understand that rosacea has no cure, but it can be controlled with proper treatment, allowing for long periods without flare-ups. In most cases, we combine oral and topical treatments. Antibiotics, although not used for their antibacterial properties, work as anti-inflammatory agents in low doses over extended periods. These treatments are generally well tolerated and help keep rosacea under control.
Topical treatment includes anti-inflammatory, antiparasitic, and moisturizing products designed specifically for sensitive skin. A key aspect of managing rosacea is sun protection. I recommend using a sunscreen with an SPF of 50 or higher, applied every morning, to minimize sun damage, which is one of the main triggers.
It’s also essential to follow a personal care routine that includes a balanced diet, avoiding spicy foods, alcohol, and extreme heat. Rosacea-prone skin tends to be very sensitive, so it’s important to use moisturizers that won’t irritate the skin.
Aesthetic Treatment: Intense Pulsed Light (IPL)
In cases where rosacea primarily presents as redness and dilated blood vessels, I recommend using intense pulsed light (IPL). This in-office treatment is an excellent cosmetic option that significantly improves the skin’s appearance. IPL is particularly effective for erythematotelangiectatic rosacea, where redness is the predominant feature.
It is important to note that although patients may see a significant improvement in redness with IPL, this does not guarantee that they won’t develop pustules later on. Rosacea is a condition that progresses with flare-ups, and these may occur regardless of the severity or type of rosacea the patient initially had.
Controlling Flare-ups for a More Comfortable Life
Rosacea can be a frustrating condition, but with the right treatment, patients can enjoy long periods of control. The key is to identify triggers, follow an appropriate skincare routine, and choose medical and cosmetic treatments that help keep inflammation and redness in check.
If you believe you may be suffering from rosacea or want more information about available treatments, I invite you to visit our treatment page or schedule a consultation here.