A Side-by-Side Look at the Most Common Rosacea Treatments

Side Effects, Effectiveness, Dosage, and Costs

Elizabeth Szaluta, MPH

Disclosures

May 17, 2017

Background

Well known to dermatologists, rosacea is a common inflammatory skin disorder that presents as facial redness, dilated blood vessels, and sometimes pimples. The condition becomes more noticeable when a patient blushes or in those who become flushed easily. Redness appears most often on the nose and cheeks, but it may spread to the forehead and chin. The ears, chest, and back may be affected as well.[1,2]

Rosacea may cause more than a red face; patients can experience symptoms beyond those that affect appearance, such as burning, stinging, tightness, swelling, tenderness, and tingling. Having rosacea may also contribute to anxiety and depression, as well as low self-esteem.[1,2]

People who develop rosacea tend to be between 30 and 50 years of age, fair-skinned, and have blonde hair and blue eyes. Women are slightly more likely than men to have rosacea, but people of all ages and ethnicities can develop the condition. Often, there is a history of acne.[2]

Presentation

Some patients report a family history of rosacea, and there is a growing body of research suggesting that a defect in the cutaneous innate immune system (toll-like receptors) may play a role.[2] Researchers have found that most people with acne-like rosacea react to a bacterium called Bacillus oleronius, which causes the immune system to overreact. Whether this causes rosacea has not yet been determined. A protein that normally protects the skin from infection, cathelicidin, may malfunction and become overstimulated in individuals with rosacea, leading to redness and swelling.[2]

There are four kinds of rosacea: erythematotelangiectatic (redness, flushing, visible blood vessels); papulopustular (redness, swelling, and acne-like breakouts); phymatous (thickened skin with a bumpy texture); and ocular (red and irritated eyes; eyelids can be swollen; patient may have what looks like a stye).[2]

Treatment

There is no cure for rosacea, but treatments can minimize flare-ups. Medications reduce inflammation and control bumps, lesions, swelling, and redness. Lasers, dermabrasion, electrocautery, peels, and light therapy remove excess skin and may improve contours of the nose.[1] "When treating rosacea, I always prescribe topical agents first and, if necessary, add an oral medication. I wean my patients off of oral medication as soon as possible and use a maintenance topical regimen to keep their skin clear," says Carin H. Gribetz, MD, assistant clinical professor of dermatology at Mount Sinai Hospital in New York.

Comments

3090D553-9492-4563-8681-AD288FA52ACE
Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as:

processing....