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What are these red spots on my face?
Rosacea was made popular by actors W.C. Fields and Karl Malden, who manifested end-stage rosacea with rhinophyma.
Rosacea is a common
face rash of adults.
Rosacea is only a skin
condition and is not
related to your general
health. Rosacea has three
stages. In the first stage
the face gets red. This
redness sometimes
merges into the normal
variants of ruddy or
blushy complexion types.
The redness often
persists after cold exposure or after exposure to irritants like soap. With time,
small blood vessels develop making the redness more noticeable. Many patients
will develop stinging or burning sensations and the skin will often feel tight. The
skin feels like a mild sunburn with smiling, frowning, or squinting.
Sometimes this progresses to the point that everything the patient puts on his or her face stings,
burns, and irritates. In the second stage of rosacea, the redness covers a larger area of the face. Slight
swelling, pimples, and pustules develop. This is especially noticeable on the nose,
mid-forehead, and chin. As the condition progresses, prominent facial pores can
develop.
The third stage, most notable by examining the bumps on W.C. Fields, is characterized by swelling and growth of the nose and central facial areas. At times the ears may be involved as well. This can be very disfiguring. This stage is known as rhinophyma. Most patients do not progress to the third stage of rosacea. Rhinophyma is more common in men.
What causes it?
The cause of rosacea is unknown.
Rosacea is stubborn and often the
condition will last for years.
Foods or beverages that cause
facial flushing, such as alcohol,
spicy foods, hot soups, coffee,
and tea, may make rosacea
temporarily more noticeable.
Sunlight is a major trigger factor
for rosacea and may be a cause of
this condition.
How is it treated?
Laser treatment can be very effective in treating the blood vessels of rosacea.
Antibiotics such as MetroGel, Nortate,
MetroCream and sulfur preparations applied to the skin
one to two times a day work well for many people with rosacea.
Retin-A and Differin are effective treatments for only Rosacea and can decrease the number of small blood vessels.
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Use of sunscreen and avoidance of sunlight will help to prevent flares.
Antibiotics taken by mouth are usually effective in controlling rosacea, and
can be used for people not controlled by topical antibiotics. Tetracycline is
the most common antibiotic used for treating rosacea.
Treatment only controls rosacea. There is no cure for this condition. Most
people with this condition need to continue applying Metrogel and Retin-A
or taking antibiotics for months to years.
I heard Accutane was good for Rosacea, is this true?
Accutane is a drug taken by mouth which is reserved for severe rosacea.
Accutane has many side effects and if taken during pregnancy will cause
birth defects. Patients taking Accutane must have periodic blood tests and
The red face of rosacea can often be improved with tunable dye and KTP laser
treatments. This type of treatment is effective. It is not covered by insurance. It generally requires more than one treatment (usually 3) for the best results.
Rhinophyma (nose swelling and tissue over growth) can be treated with the
CO2 laser, or surgery, or a combination of both. This is often covered by insurance because it is so disfiguring.
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