Rosacea: Types, Triggers and Treatment

Rosacea: Types, Triggers and Treatment | Dr. Ali Ghahary

Rosacea is a common chronic inflammatory condition that affects the skin. It affects more than 3 million Canadians, and an estimated 45 million people on a global scale. While there is no specific cure for rosacea, it can usually be controlled with various measures such as avoiding certain triggers (which we will delve into further later) as well as certain medications.

There are different types of rosacea that one can be diagnosed with, including:

• Neurovascular rosacea
• Inflammatory rosacea
• Phymatous rosacea
• Ocular rosacea
• Combination rosacea

Neurovascular rosacea: This typically appears as facial redness or flushing on the central areas of the face, and is usually described as burning, stinging, itching, dry, or even swelling. You may also notice the appearance of tiny blood vessels on the face.

Inflammatory rosacea: This is often easily mistaken for adult acne due to the appearance of specific areas of persistent redness in addition to bumps and pimples on central parts of the face (such as cheeks, chin, forehead, around the mouth, eyes or nose.) Similar to neurovascular rosacea, you can also experience symptoms such as burning, stinging, or itching.

Phymatous rosacea: A less common type of rosacea to be diagnosed with, phymatous rosacea appears as thickened, bumpy, red skin in addition to the appearance of small blood vessels. The most common area of the face affected by this particular type of rosacea is the nose, although it can also affect the chin, cheeks, forehead, and even ears, and will have symptoms similar to other types of rosacea as well as general tenderness. Phymatous rosacea also tends to affect more men than women.

Ocular rosacea: Sometimes mistaken for an eye infection, ocular rosacea typically occurs in combination with neurovascular or inflammatory rosacea. Your eyes may be red, sore, develop styes, conjunctivitis, as well as appear to look irritated, bloodshot, watery, or you may notice a grit-like sensation or dryness. You may also find that your eyes are sensitive to light, and you may also have blurred vision.

Combination rosacea: It’s also possible to develop more than one of the aforementioned types of rosacea at once, which is then referred to as “combination rosacea.” This will usually be treated with a combination of therapies.

While the exact cause of rosacea is unknown, there are several things that can trigger a flare-up – including both lifestyle and environmental factors.

Lifestyle triggers, for example, can include alcohol consumption (particularly red wine), spicy foods (such as curries or foods and sauces that contain peppers), vigorous exercise, hot baths/showers/saunas, certain skincare products, some medications (such as long-term use of steroids, or medications used to treat high cholesterol), as well as hot beverages. These are all things you can change on your own, however, by avoiding many of these things or finding alternatives (such as skincare products designed for sensitive skin) to prevent flare-ups from occurring.

Environmental triggers are usually things that you cannot control as easily. The weather, for example, is known to be a common trigger for a flare-up of rosacea symptoms. When you are exposed to cold weather, this dry, cold air can be harsh on the skin. On the flip-side, hot weather or being inside hot indoor spaces can also just as easily trigger a flare-up, so it’s important to find a comfortable balance. If you’re going to be outside in cool temperatures for a prolonged period of time, it’s important that you dress appropriately and keep your face protected either by wearing a jacket with a collar, or a scarf. If you’re in warmer weather or a warm indoor space and feel your face start to flush, try sipping on a cool drink or move to an area that is cooler or air conditioned. It’s also important to wear an SPF 30 or broad-spectrum sunscreen, as this is also crucial if you suffer from rosacea.

If left untreated, rosacea can worsen over time. If you think you have rosacea or notice any skin changes, it’s important to let your physician know. When it comes to treating rosacea, there are several treatment methods that can be used, such as topical drugs to help reduce redness (such as a cream or gel), or oral antibiotics. If your rosacea persists without relief, you may also benefit from being referred to a dermatologist.