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What is rosacea, and how is it treated?

Rosacea (rose-AY-sha) is a chronic skin disease that causes varying degrees of redness and swelling, primarily on the face, but also at times on the scalp, neck, ears, chest, and back. It is considered a vascular disorder (a disorder of the blood vessels).
The condition can develop over a long period of time and is more common in adults, particularly those with fair skin. More women get it than men, though in men the condition is often more pronounced. Severe, untreated rosacea can lead to a disfigurement of the nose called rhinophyma.
There are four grades of rosacea:
Grade 1: Mostly redness.
Grade 2: Pimples and other blemishes.
Grade 3: Edemas (swelling due to fluid retention) and inflammatory bumps on the nose.
Grade 4: Symptoms affecting the eyes.
No one knows the cause of rosacea, but it is thought to run in families and can be aggravated by environmental factors and diet. Although rosacea can be accompanied by pustules, it is not acne. Researchers believe rosacea might be caused by several things: abnormal function of the blood vessels, sun damage, and an abnormal inflammatory reaction.
People with rosacea often learn that certain things trigger their flare-ups. It is believed that fluctuations in temperature (especially extreme heat or cold) is a common trigger. Spicy foods and alcohol consumption can also cause flare-ups.
How is rosacea treated?
The key to rosacea treatment is to catch it early. It may start with skin that merely flushes red. Reducing skin temperature and calming the skin is usually the first objective. Once inflammation is under control, other treatments follow. There are many treatments, including topical agents containing azelaic acid or the antibiotic metronidazole. Both have proven helpful in relieving the symptoms of rosacea. Your physician may also prescribe internal antibiotics in the tetracycline family. Esthetically, rosacea is treated with chemical exfoliation, ultrasonic treatments, and calming, soothing, hydrating treatments.
While not a cure, any of these treatments can help control symptoms, sometimes for several years. Self-treatment is not advised, beyond a simple and gentle cleansing routine. Some over-the-counter remedies may actually worsen symptoms, as will aggressive scrubbing and rubbing. Your licensed esthetician may refer you to a dermatologist for evaluation and medical support.
What to expect from a rosacea treatment
Be ready to fill out a medical questionnaire and describe what medications and skin care products you are using. Your therapist will do an analysis of your skin, look for any interactions between products and medications, and devise a treatment plan that’s suitable for your unique needs. Be prepared to commit to a series of treatments and a home care regimen.
After your professional treatment, your skin care therapist can recommend a home treatment plan, as well as follow-up professional treatments. Your skin may be more sensitive after treatment. Many professional skin care lines provide specialized products that sooth the inflammation of rosacea. Your esthetician will carefully choose products for you that are least likely to irritate your skin.
What about home care?
Your esthetician can provide the best guidance on caring for your skin after a treatment. In general, people with rosacea should keep a diary of things that trigger their condition: environmental factors such as sun, wind, stress, exposure to heat or severe cold, alcohol or spicy food consumption, and irritating face products. Responses to treatments vary widely; trial and error is unfortunately part of the process when working with rosacea.