rosacea
ROSACEA
Rosacea is a chronic inflammatory cutaneous disease of the convexities of the central face (cheeks, chin, nose and central forehead) and eyes with periorbital and perioral skin sparing. This condition is attributed to chronic vasodilation.
Remissions and exacerbations are common.
It typically begins after 30 years of age but may occur at any age.  It commonly affects fair-skinned individuals.
The common presenting symptoms are facial flushing, stinging/burning erythema, telangiectasia, edema, papules, pustules, ocular lesions, and hypertrophy of the sebaceous glands of the nose with fibrosis (rhinophyma).
A history of episodic flushing often heralds onset of rosacea.

Rosacea Management

Prevention

Aggravating Factors

  • Sun exposure
    • Use sunscreens with combined ultraviolet-A and ultraviolet-B with a sun-protection factor 30+
    • Sunscreen formulations with Dimethicone and Cyclomethicone, zinc oxide or titanium dioxide may be less irritative
    • Micronized, nanoparticle and clear formulation sunscreens are options for patients with darker skin  
    • Use wide-brimmed hats
  • Hot or cold weather, wind, humidity
    • Application of cool compresses and staying in air-conditioned room during hot and humid days
    • Cover face with scarf and use moisturizer on cold days 
  • Stress
    • Use stress reduction techniques and exercises
  • Exercise
    • Avoid high-intensity workouts that cause flushing and overheating
    • During warm weather, exercise early or late in the day in a cool environment
    • Exercise for shorter, more frequent intervals
    • Place ice chips in mouth immediately following exercise
  • Spicy foods, marinated meats, certain fruits and vegetables, dairy products, alcohol, hot beverages
    • Identify and avoid foods and beverages that worsen facial redness
    • A study has found that caffeine does not increase the risk of rosacea
  • Hot baths, skin care products
    • Avoid hot water
    • Use hypoallergenic, non-irritating, noncomedogenic skin products and avoid heavy cosmetics
    • Apply soap-free cleansers, silicone facial foundations and film-forming moisturizers
    • Men may benefit from use of electric razor 
  • Medication
    • Avoid use of topical corticosteroids on the face: Fluorinated topical steroids produce rosacea-like syndrome while non-fluorinated low-potency steroids may worsen preexisting rosacea and delay the resolution of flare-ups from steroid use
    • Avoid medications that may aggravate flushing (eg vasodilators, Nicotinic acid, amyl nitrite, calcium antagonists, opiates)
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