Rosacea is sometimes known by the misleading name of adult acne. It is not acne, symptoms and treatment are quite different, and traditional acne treatments may worsen the condition, as will sun exposure, wind, spicy foods, alcohol and medications like vasodilators (that cause blood vessels to widen). All of these have been thought to bring out rosacea.
A hair mite and H. pylori, a bacterium often associated with stomach ulcers have been implicated but the exact cause is not known. Rosacea is a demonological condition most often seen in fair skinned people that is a result of vasodilatation, or blushing. It results in an embarrassing permanently red face, and untreated rosacea can cause a disfiguring nose condition called rhinophyma (ryno-fee-ma), literally growth of the nose, characterized by a bulbous, enlarged red nose and puffy cheeks ala W.C. Fields. Severe rhinophyma can require surgical repair.
The most serious complication involves the eyes; nearly half of all people with rosacea experience burning and grittiness of the eyes (conjunctivitis) and recurrent sties. If this is not treated, rosacea keratitis, a chronic condition occurs that may impair vision. Treatment involves preventative skin care and both oral and topical medicines. Oral antibiotics (such as tetracycline) are commonly prescribed, especially where there is eye involvement; the dose may be initially high and then be tapered to maintenance levels.
A topical antibiotic cream such as metronidazole (Metrocream) reduces the inflammation and the redness. Other topical antibiotic creams include erythromycin and clindamycin (Cleocin). Anti-inflammatory creams are also effective. In the short term, topical cortisone (steroid) preparations are used to reduce local inflammation. Smoking, spicy food and drink, not only alcohol but also hot beverages, really anything that causes the skin to flush, should be avoided. This includes exposure to sunlight and to extreme hot and cold temperatures.
Skin care begins by washing the face and eyelids carefully with baby shampoo or an alcohol free cleanser that will not irritate the eyes, followed by thoroughly drying with absorbent paper towels or tissue. Avoid cream cleansers and heavy moisturizers as well as cortisone medications. Always pat the skin gently when applying creams or drying, as rubbing the face will irritate the reddened skin. Choose cosmetics and hair sprays carefully.