According to the National Rosacea Society (NRS), rosacea affects more than 16 million Americans and more than 415 million people worldwide. The inflammatory condition—it’s usually hereditary—can look a little different in every patient, but experts agree the primary signs of rosacea include redness of the skin or flushing, increased appearance of blood vessels, acne, stinging, burning and hypersensitivity to various skin-care products.
“The main signs of rosacea begin before the disease takes over the skin with frequent flushing and irritation of the face that eventually leads to permanent redness, acne and in more severe cases, bulbous changes of the skin, especially the nose,” explains New York dermatologist Orit Markowitz, MD.
“Patients can often develop redness, itching of the eyes and textural abnormalities on the nose called rhinophyma,” adds Bay Harbor Islands dermatologist Stacy Chimento, MD. Ahead, what to know about the condition and how to best care for it.
Typically, rosacea symptoms will flare when exposed to certain triggers such as sunlight, alcohol, hot drinks and soups, spicy foods, caffeine, heat and stress. “However, your trigger may be unique to you, so it’s always best to observe what makes your rosacea flare and then try to cut out or cut down on whatever the inciting trigger is,” adds Fort Lauderdale, FL dermatologist Dr. Matthew Elias.
While Dr. Chimento notes the exact pathophysiology of rosacea is still unknown, there are genetic and environmental contributors. “[Rosacea] is a chronic condition that often waxes and wanes, likely secondary to the body’s immune system and hypersensitivity of the blood vessels in the skin,” she adds.
The Acne-Rosacea Connection
Acne may mimic rosacea in the red-and-sensitive department, but there are a handful of main differences to look out for between the two conditions.
Redness associated with acne is usually concentrated around the acne itself, while redness associated with rosacea is typically found across the face, along with visible blood vessels. Dr. Chimento adds that acne is also associated with whiteheads, blackheads, papules, pustules and large inflammatory cysts. “Acne can also be found on other areas than the face, including the chest, back, shoulders and buttocks,” she says.
Additionally, Dr. Elias explains that acne typically occurs in adolescents and young adults while rosacea is more common in adults as they get older. According to the NRS, rosacea typically starts after age 30.
Biologically, Dr. Chimento says acne typically has a bacterial component (proprionibacterium acnes) associated to it, “and while both conditions are inflammatory in nature, rosacea is more prone to endogenous and environmental stressors.”
Rosacea can’t be cured, but it can be managed. Aside from taking precaution and limiting exposure to your specific rosacea trigger(s)—proper sun care is also a must—Dr. Chimento notes that treatment options for rosacea are vast. “Topicals such as azeleic acid, ivermectin (used to treat demoted mites that can trigger rosacea), metronidazole, dapsone, niacinamide, sulphur washes and topicals, green tea products, and oral antibiotics such as tetracyclines can all help improve rosacea,” she says. “Laser treatments with intense pulsed light and pulsed dye laser are great for rosacea as well.”
“Typical treatments for rosacea include sunscreen, sunscreen, sunscreen,” adds Dr. Elias. “Sunscreen is the most important product for rosacea because UV exposure is the number-one cause of flare up,” adds Dr. Markowitz. As such, the AAD recommends using a broad-spectrum sunscreen with an SPF of at least 30 every day; Dr. Alias offers up Alastin Hydratint ($55) and ISDIN Eryfotona Actinica ($55) as two derm-approved sunscreens for rosacea-prone skin.
“A basis of good skin care and protecting the barrier is very important with rosacea, so using gentle cleansers in combination with moisturizers will help tremendously,” Dr. Elias advises. Some over-the-counter favorites include Dove, Cetaphil and CeraVe products. “I also like Eucerin Redness Relief Night Creme ($13) and skin-care products with a slight green [tint] that helps mask redness,” adds Dr. Markowitz.
If you suspect you might have rosacea, reach out to your doctor. The sooner the condition is diagnosed and treated, the easier it can be to manage long-term.