When Acne isn't Acne: an Introduction to Rosacea

Acne is a well-known and extremely common skin disease that affects millions around the world. Although this disorder generally begins during the teenage years, it can persist or even start in adulthood. Symptoms of acne depend on the general type, of which there are two. Non-inflammatory acne is apparent only close to the skin where blackheads and whiteheads can be seen. Inflammatory acne, on the other hand, is characterized by red pimples and pustules, and sometimes even inflamed cysts and nodules. When the skin starts to change, get red, and show bumps, the immediate perception is that this is acne. When acne treatment fails, however, it sometimes turns out that the skin change was due to another, less understood skin condition called rosacea.

Rosacea is a progressive vascular skin disorder that starts as a flush on the central part of the face and across the cheeks. Sometimes the flush is found on the neck, chest, ears, or scalp, but this is less common. Other early rosacea symptoms include persistent redness, red bumps on the skin, burning sensations, and small blood vessels that can be seen just under the surface of the skin.

There are four main subtypes of rosacea. Just as rosacea can coincide with acne, the subtypes are not mutually exclusive. These four subtypes are:

(1) Erythematotelangiectatic rosacea--persistent redness along with easy flushing or blushing. Small blood vessels are often visible under the skin.

(2) Papulopustular rosacea--easily confused with acne, this subtype has persistent redness accompanied by red bumps, some of which may contain pus.

(3) Phymatous rosacea--thickened skin, nodules on the surface of the skin, and enlargement of the nose, including small blood vessels near the surface of the skin.

(4) Ocular rosacea--eyes and eyelids become dry and irritated. There may also be itching, tearing, burning, and other strange bodily sensations.

As a disorder, experts still know relatively little about rosacea. One common theory about its origin is that it's a consequence of damaged blood vessels that were weakened by repeated dilations, such as that caused by blushing, strenuous exercise, and stress. This fits with the subpopulations that are generally most affected with rosacea; many are fair-skinned with European or Celtic origins, and most between 30 and 60 years of age. Women develop rosacea more frequently than men, although it is generally less severe.

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Although rosacea is not yet curable, it can certainly be treated and controlled to a large degree. Controlling the disorder usually involves preventing flare-ups. Heat, exercise, spicy foods and drinks, alcohol, wind, menopause, stress, and harsh facial products can all trigger rosacea symptoms. Sunlight is another well-known irritant, so wearing a good sunscreen is a key preventative measure. Dermatologists can recommend several courses of treatment for rosacea, including oral antibiotics, topical antibiotics, and eye drops. A gentle cleansing regimen is also suggested.

Over 45 million people worldwide suffer from some form of rosacea, yet despite these statistics, the disorder is still relatively unknown. Part of this problem is that the more obvious symptoms are sometimes shared with other skin disorders, including acne. Many people take a wait-and-see approach to skin disorders, assuming that they will get easier with time. Since this is not the case for rosacea, the condition may get much worse before treatment is sought, and the skin may take longer to recover. The important thing to note about rosacea is that it can be treated and the earlier the treatment the better. If you think there is a chance that you may have rosacea, make sure you talk to your doctor to rule out this disorder.