Understanding rosacea

After the hormone storms of adolescence, most adults consider complexion problems a thing of the past. Then along comes the flush and sting of rosacea. But, with the right drugs and lifestyle changes, your skin can regain its normal, healthy glow. Read on to find out more.

Your rosacea probably started innocently enough, as a simple tendency to blush easily. Then came the harder-to-ignore signs: persistent facial flushing, visible spidery blood vessels, an un­­comfortable stinging in your face — all typical early symptoms. If your rosacea has progressed, you've probably also noticed small red bumps (papules) and pus-filled blemishes (pustules) on your face as well.

A few people go on to develop severe rosacea, with its overall facial inflammation, growth of excess skin tissue or enlarged nose (called rhinophyma, mostly found in men). Half of those with rosacea also develop a burning or gritty feeling in their eyes. While experts agree that rosacea is caused by dilated blood vessels in the face, they've been unable to pinpoint the precise reason why the dilation endures.

What triggers rosacea varies from person to person, but certain situations in daily life predictably set the inflammatory process in motion: hot drinks, alcohol, spicy foods, caffeine, stress, bright sunlight, extreme heat or cold, wind or vigorous exercise. Medications, especially niacin and blood pressure drugs, are common culprits as well. And some cases are associated with the hormonal changes of menopause. Rosacea is a chronic condition that tends to progress gradually, with flare-ups and periods of remission.

Most common in women between ages 30 and 60, it tends to run in families and favors the fair-skinned — the "curse of the Celts," it’s been called. Thanks to W. C. Fields and what he called "gin blossoms" on his bulbous nose (caused by advanced rosacea), many people believe rosacea indicates alcoholism. Not true. In some people, alcohol triggers flare-ups, but many people with rosacea are teetotalers.

1. Topical drugs to reduce redness and blemishes.
2. Identifying triggers and making lifestyle changes to avoid them.
3. Oral antibiotics or anti-acne medicine for more advanced cases.
4. Laser surgery or other procedures, if needed.

1. Become a sleuth. People react differently to common rosacea triggers. To identify your personal flushers, keep a diary of episodes and what preceded them.
2. Chill out. If heat is a rosacea trip wire for you, keep the temperature on the cool side at home and dress lightly. Take warm (not hot) showers, have frequent sips of ice water as you exercise, and keep your (fragrance-free) facial moisturizer in the refrigerator so it cools your face when you apply it.
3. Avoid topical acne drugs. Most topical medicines for teen-style acne (acne vulgaris) don't work for rosacea and may make it worse. (Acne is caused by hormones and bacteria, while rosacea is a vascular disorder.)
4. Try cold-water soaks. During flare-ups, press a cloth soaked in cold water against your face for 10 minutes to constrict blood vessels.