Rosacea: The red skin disorder

It has been stated that one out of 20 people have rosacea. Former US president Bill Clinton suffers from it.

My friend has been suffering from red patches on her face for a very long time. At first, she thought she was just flushed from the heat, but it persisted for a very long time. Then she thought she was going to develop pimples, but they never came on. Finally, she went to a skin doctor and she was told she has rosacea. I have never heard of this condition. What is it?

Rosacea (pronounced roh-zay-sia) is a very common red skin disorder around the world, though it affects primarily white people who have fair skin. It's estimated that at least 45 million people around the world suffer from it.

It's uncommon in people with dark skin. It usually affects people in their 30s to 50s. Women are primarily the victims, though if you are a man, you might have a very severe version of it.

People who have rosacea have red or pink patches. Sometimes, you can see small broken blood vessels on these. Occasionally, there can be acne-like red bumps which may or may not contain pus. There may also be red cysts. It can also affect the eyes.

An example of a famous individual who suffers from it is former US president Bill Clinton.

It is not contagious or infectious, and you won't get it if you are close to someone who has it or use a face towel of someone who has it.

Is it then not common in Malaysia?

It's more common than we think. A statistical website gave its prevalence around the world as one out of 20 people.

Most people who have rosacea don't know they have it. They just assume they blush very easily or are sensitive to the sun or allergic to something.

Some people think it's acne and attempt to treat it with acne medicine. Others think they have rosy cheeks and are proud of it.

Some people even mistake it for sunburn.

Is rosacea only found on the face?

Yes, it's a facial skin condition. It involves the central region of your face where you usually find flushing, such as your forehead, lower half of your nose and chin. It affects especially your nose.

It has flares and remissions, and it comes and goes.

Rosacea is aggravated by blushing. Over time, it may become worse, especially if you don't recognise it and treat it.

It must be noted that rosacea can coexist with acne. But unlike acne, rosacea is an adult disease, whereas acne is a disease of teenagers. But most teenagers grow up and their acne disappears. Rosacea cannot be outgrown.

What causes rosacea?

To this day, no one knows what causes rosacea. There seems to be genetics involved, as members of a family tend to get rosacea. It's certainly more common in people who blush easily.

Rosacea tends to flare up with anything that causes you to blush. Examples include emotional upsets, embarrassment, fear, anxiety and stress. Strong winds, sun exposure or a change in humidity may also aggravate the skin condition.

If you drink alcohol or eat spicy foods, this may also trigger rosacea.

Rosacea may be dormant for weeks or months, and then flare up again. As time goes by, your skin may fail to return to its normal colour. Then you start to see enlarged blood vessels on your skin.

My college-aged daughter has a very red face. How can I tell if it's acne or rosacea?

Acne has blackheads and/or whiteheads. Rosacea does not have these.

You cannot "squeeze" a red bump in rosacea or ask your facial consultant to "extract" it. If you try to squeeze that red bump, very little clear fluid will be expelled.

People with rosacea tend to have a pink tinge to their skin (called "rosy" skin). People with acne do not have skin that is so pink.

Can I just leave rosacea alone? I mean, it's not exactly life-threatening, right? I kind of like being called 'rosy-cheeked'.

No. You can't leave rosacea alone. You have to treat it, because if you don't, it will get worse.

When it is in its advanced stage, it can disfigure your nose. Your nose may become very red and grow bulbous and enlarged. This is called rhinophyma, and it occurs especially in men.

Your cheeks may become puffy. You may look as though you have ingested too much alcohol. There may be thick, ugly bumps on your nose and cheek.

Advanced rosacea can also affect your eyes. There can be burning, dryness and grittiness, which usually means conjunctivitis. You may be sensitive to light. If left untreated, rosacea can impair your vision.

Is there a cure for rosacea?

Rosacea cannot be cured. But it can be controlled with laser therapy, intense pulse light, photodynamic therapy, antibiotic creams and a drug called isotretinoin.

You need to see a dermatologist for these options. Some acne medications also work for rosacea since there is an overlap.

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