As the summer heat intensifies, many people find their cheeks or nose taking on a rosy glow. That facial redness may actually be a warning sign of rosacea.

Rosacea is a very common acne-like skin disease affecting an estimated 14 million Americans. Skin affected by rosacea has one or more of the following features:

  • a redness that looks like a blush
  • pimples
  • lumps on the nose
  • thin red lines due to enlarged blood vessels

Beyond its physical effects, rosacea often inflicts significant emotional and social damage because of its conspicuous impact on personal appearance.

Rosacea typically first appears after age 30 as a flushing or redness on the cheeks, nose, chin or forehead that may come and go. Over time, the redness becomes more persistent, and small, dilated blood vessels (telangiectasia) may appear. Because it can look much like teenage acne, it has been called “adult acne” or acne rosacea. Without treatment, bumps and pimples often develop, and in severe cases, the nose may become swollen from excess tissue. This condition is called rhinophyma. (The most famous rosacea sufferer with rhinophyma was W.C. Fields, the comedian.)

The cause of rosacea is unknown. Foods and beverages that cause facial flushing, such as alcohol, spicy foods, hot soups and drinks like coffee, may make rosacea temporarily more noticeable. Additionally, since the sun is a strong trigger for many rosacea sufferers, a non-irritating sunscreen used daily is important. I encourage my patients with rosacea to identify their own aggravating factors and attempt to avoid them whenever possible.

In rare cases, rosacea can be confused with other skin diseases. An excellent example of a skin condition mimicking rosacea is the severe infestation of microscopic skin mites known as Demodex folliculorum.

These tiny mites are normal inhabitants of human skin. Studies have found an elevated incidence of Demodex in rosacea patients. The diagnosis can be confirmed with a brief scrape test, and eradicating the mites can clear the condition.

Rosacea develops slowly over time and will often gradually worsen, but it can be treated. Antibiotics taken by mouth are usually effective in controlling rosacea. Treatment may also need to be changed over a period of time depending on the response. Treatments such as topical Metrogel and systemic low dose Accutane are available when needed. Adjusting medications periodically may be necessary for best control. Once clear on medications, adjustment of the medications is usually best to attempt to remain clear on the least amount of medicine possible.

I now use ILP laser treatment to can easily erase the red blood vessels and the facial reddness that most rosacea patients want removed. IPL also stimulates new collagen to form in the skin thereby reducing fine lines, minimizing pore size and acne scars, and reducing wrinkles.

Remember: The good news is that, while rosacea cannot be cured, it can be markedly improved with medical therapy and IPL laser treatments.

John J. Jones, M.D.

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