What causes rosacea and is there a cure?
No one knows what causes rosacea, a common skin disease that produces facial redness and acne-like breakouts, occasionally affecting the eyes or causing the nose to become red and bulbous. There is no cure for this “chronic, frustrating” condition, said Dr. Richard Odom, who serves on the National Rosacea Society’s expert committee, but patients can manage it by avoiding triggers that set off flare-ups and using appropriate medications. Triggers vary by the individual but include sun, stress, extreme heat and cold and alcohol as well as hot drinks, exercise, cosmetics and skin care products.
“If you know alcohol will set you off, you try to avoid it; if you know spicy food sets off a flare-up, you avoid that,” said Dr. Odom, a professor of dermatology at the University of California, San Francisco.
Genes contribute to nearly half the risk of rosacea, but environmental and behavioral factors like sun exposure, smoking and alcohol play a role as well, according to a recent study of twins.
One possible explanation for rosacea is that patients’ immune systems overreact to a common bacterium, Bacillus oleronius, or to a mite called Demodex that lives on everyone’s skin and particularly likes the nose and cheeks.
Sunscreen, moisturizer and sulfa-based cleansers may reduce flare-ups, but the skin of rosacea patients is sensitive, so it is important to use non-irritating products. Doctors may prescribe topical creams or gels as well as oral medications, including antibiotics to be taken at sub-therapeutic levels and drugs that target the flushing and redness.
Laser and other light treatments may be used to reduce the fullness of rhinophyma, the fibrous thickening of the nose associated with rosacea, as well as background redness caused by broken blood vessels.