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Rosacea is a common
chronic skin disorder of the
central face that is estimated
to affect more than 16 million
Americans. It is a syndrome
that consists of various signs
and symptoms including skin
redness, telangectasias (red
dots), swelling, papules and
pustules (pimples), eye le-
sions, and rhinophyma (ex-
cess growth of skin on the
nose). Also included may be
burning and stinging of the
skin and the feeling of some-
thing in the eye. Rosacea typi-
cally first appears between the
ages of 30 to 60. In addition,
people with rosacea often re-
port lowered self-esteem and
embarrassment at their phys-
ical appearance. For example
rhinophyma, which causes
redness and bulbous enlarge-
ment of the nose, used to be
slangly referred to as a “beer
Recent medical research
has suggested that rosacea
may have deeper connections
with general health as it has
been linked to an increased
risk of serious systemic disor-
ders. A recent study done in
Taiwan found that those with
rosacea were more likely to
have hypertension, elevated
lipid levels, coronary artery
disease, and peripheral ar-
terial disease. Other studies
have found links to thyroid
cancer, skin cancer, allergies,
respiratory diseases, female
hormone imbalances, GERD,
and urinary diseases.
There is no diagnostic test
for rosacea. Rather the diag-
nosis is usually based on the
presence of primary and sec-
ondary symptoms. Rosacea
may be confused with acne,
sun-related skin damage, and
the skin changes found in lu-
pus. Age is the key factor in
differentiating between acne
and rosacea. ANA (anti-nu-
clear antibody) testing was
often used to differentiate
between lupus and rosacea,
however people with rosacea
were often found to also have
elevated ANA levels, making
differentiating between the
two more difficult. A history
of extensive sun exposure can
differentiate between rosacea
and sun-damaged skin.
The natural history of rosa-
cea is characterized by periods
of remission alternating with
periods of exacerbation. This
often makes treatment prob-
lematic. Treatment consists of
oral and topical medications
including antibiotics, light
therapy, laser therapy, and
skin surgery. Lifestyle modi-
fications need to be made as
rosacea can be triggered by
factors such as sun exposure,
emotional stress, hot and cold
weather, wind, heavy exercise,
and alcohol consumption.
Skin care is important as well.
Consistent, gentle skin care is
important. Skin irritation can
be triggered by (topical) al-
cohol, witch hazel, fragrance,
menthol, peppermint, euca-
lyptus oil, or harsh scrubbing.
Definitive diagnosis of rosa-
cea is usually made by a der-
matologist. If you have been
diagnosed with rosacea, it is
important to get to your med-
ical doctor to be sure that you
do not have any of the other
diseases that have been linked
to it.
For more information go to
Please direct questions and
comments to editor@rocka-
By Peter Galvin, MD