Causes and Treatment for Rosacea

" Rosacea is a very common skin condition that resembles acne. This benign skin problem, which causes the face to appear red, affects about 16 million people in the US and about 45 million people worldwide. Most people who have rosacea also have fair skin, which appears to flush easily or blush, with small blood vessels in the face dilating. Women in their 30s to 50s are more likely to have it. Many people who have the condition are not aware of it and may think that their skin is just sensitive to the sun, while others may think they have acne. When not treated, symptoms can get more chronic over time. Although it is a chronic skin problem that may come and go, it is not contagious and it is easily diagnosed and managed with prescription medications. In most patients the problem will be limited to the face."  

What Causes Rosacea?

The exact cause of rosacea is still unknown but studies suggest that it may have a genetic component because it tends to run in families. Other risk factors include overreaction of the immune system, H. pylori infection in the gut, presence of mites in the skin, sun-exposure, or changes in weather, menopause, and long-term treatment with steroids. Some things may also trigger flare-ups such as emotional stress, alcohol, hot or spicy foods, and heavy exercise. 10% of people with fair skin have the condition with the first signs appearing between age 30 and 50. Acne may have preceded the first rosacea outbreak by several years, although the appearance of acne earlier in life is not necessary to get the condition later on.

Rosacea Skin Outbreak
Source: Finacea/Bayer

People can have their own personal triggers that cause the condition to flare up such as stress or certain spicy foods or condiments. After a flare up review foods and particularly condiments consumed the day before that may have caused the condition to worsen. According to the National Rosacea Society the most common triggers are:

  • Sun Exposure, Tanning
  • Hot baths and showers
  • Heavy exercise
  • Humidity
  • Alcoholic Beverages
  • Beer, Red Wine, White Wine
  • Other Beverages
            o Caffeinated soda, coffee, decaffeinated coffee, decaffeinated tea, hot chocolate, tea • Cold or hot weather
  • Stress (emotional stress)
  • Hot beverages
  • Spicy Food/Ethnic Foods
  • Asian, Indian, Mexican, Thai • Some skin care products
  • Chocolate
  • Spinach, Yeast, Yogurt


Rosacea on Face
Source: Meisenhiemer Clinic

Newer research indicates that this condition may be caused by an immune disorder or response with the substance cathelicidin as a trigger. Individuals with rosacea have higher levels of cathelicidin. More research is need to fully understand the role this substance may have in triggering skin inflammation.


The diagnosis of this condition is often made from the typical facial skin redness and symptoms such as easy blushing or flushing. However, it is usually under-diagnosed and many people are not aware they have the condition, especially when facial redness is transient.

Dermatologists are specially trained to diagnose rosacea. No specific tests are required except in some cases when a skin biopsy or skin scraping can help identify the presence of mites or bacteria on the skin.

Blood tests are not required except when they are used to help exclude other possible causes of facial flushing such assystemic lupus, dermatomyositis, orother autoimmune conditions.


There are several symptoms which are warning signs that you might have the condition. These include:

  • Eye Irritation
  • Watery Eyes
  • Pimples or Bumps on Face
  • Redness on the forehead, chin and/or nose

It also has many symptoms and dermatologists have classified the condition into four subtypes. People can have one or more subtypes and treatment varies with these.

The first type is marked by frequent flushing, mostly at the center of the face,including the forehead, cheeks, nose, and chin. One may experience slight swelling and a burning feeling. Red blood vessels are visible under the skin.

rosacea nose

Rosacea on Nose
Source: Meisenhiemer Clinics

The second type is characterized by acne-like breakouts, frequently where the skin is quite red. People with this type have oily skin, which is very sensitive.

The third type is rather rare, where the skin begins to thicken around the nose, chin, forehead, cheeks, and ears. The skin is oily and has a bumpy texture.

The last type involves the eyes, which appear watery or bloodshot, feeling gritty, burning, stinging, and itchy. The eyes may be very sensitive to light and very dry. Vision may be blurred. The condition can be dangerous to eyesight in some cases and should be treated aggressively by a Dermatologist.

ocular rosacea

Ocular Rosacea In Some Cases Can Lead to Blindness. If Rosacea Causes Any Eye Symptoms be Sure to Work Closely with an Eye Doctor and a Dermatologist
Source: NRS

Aside from these, flare-ups can cause frustration, embarrassment, anxiety, and low self-esteem.



Mild skin flushing may not need any treatment if the individual is not bothered by it. However, for people who have oily skin with acne-like eruptions and thickened skin, a combination of treatments may be necessary, including facial washes, antibacterial creams, sunscreen protection, topical steroids, glycolic peels, and tretinoin preparations. In severe cases, oral antibiotics may be prescribed.Topicals include Metronidazol gel .75%, 2x daily (Metro Gel), Metronidazole cream 1x daily, Sodium sulfacetamide and topical antibiotics. The prescription topical Finacea(azelaic acid) combined with Metro Gel is a popular and effective approach for controlling mild rosacea.

Some dermatologists also recommend laser and intense pulsed light therapy, photodynamic therapy, electrocautery, and dermabrasion. Reducing alcohol consumption helps in some patients.

Do not use acne mediations to treat this condition since many can irritate the sensitive skin found in patients.

Home Remedies

Rosacea patients should establish a daily skin care routine that works to gently clean and protect the face.

Morning Routine

When washing the face in the morning, use quality fragrance free and dye free products such as: 

  • Cetaphil
  • Dove Sensitive Skin Bar
  • Eucerin Redness Relief Cleanser

After washing the face using any of the above, apply prescription medications and allow them to dry. Wash your hands after using prescription topicals. Next, apply a high SPF moisturizer for sun protection and skin care. Suggestions include:

  • Aveeno Ultra Calming Daily Moisturizer SPF 15
  • Eucerin Sensitive Facial Skin Extra Protective Moisture Lotion with SPF 30

Rosacea Creams

There are over the counter Rosacea Creams that help to reduce skin inflammation and improve appearance. One product made specifically to help rosacea patients is Revitol Cream.

The product is formulated to reduce the appearance of redness and visible blood vessels, and it diminishes the appearance of bumps and pimples. Revitolin particular offers a money back guarantee, so there is no risk to determine if it will work in your particular case. Click here to learn more about the ingredients.

Other Skin Care Tips

Use brushes instead of sponges when applying makeup. Always choose rosacea based skin care products and use a mineral based foundation to cover-up any redness. Avoid pinks and reds and instead use bronze or peach in order to call less attention to any redness.

Avoid trigger foods and when cooking, use clean fats such as extra virgin olive oil or extra virgin coconut oil.

Although there is no cure for this condition, various skin treatments can help reduce its symptoms during flare-ups and prevent them from getting worse. After several years the condition can disappear on its own, although in most patients it is a life long problem. The disorder subsides in some women after menopause.

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National Rosacea Society


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