Four subtypes of rosacea
- Ocular rosacea
Rosacea is a chronic and common skin disorder causing redness, flushing, and acne-like lesions on the face. Occasionally it can affect the eyes, causing redness and eye irritation.
People with fair skin are most commonly affected by rosacea, but it can occur in any skin type. Most often rosacea is an adult-onset condition, with most cases seen in adults over 30 years old. However, the condition can also start in adolescence or childhood.
The cause of rosacea is not well understood, and researchers believe that there may be many contributing factors including immune dysfunction, reactions to microorganisms, sun damage, and vascular dysfunction. Immune system dysfunction can increase inflammation and blood vessel abnormalities due to being more susceptible to sun damage and microorganisms over time. Microorganisms that are believed to be related to rosacea include mites and several bacteria.
Demodex mites, which are present on almost all normal skin, have shown to be increased in patient’s with rosacea. Bacillus olenorium is another type of bacteria which may cause inflammation with rosacea. Other bacteria such as staph epidermidis have been linked to rosacea in a few studies, but this has not been fully proven. Increased UV damage increases risk for disease severity and is a common exacerbating factor.
Vascular hyperreactivity (increased blood flow to the skin) is a possible cause of rosacea. This contributes to increased flushing in rosacea patients. Lastly, rosacea can also be genetic. People with family history of rosacea are much more likely to develop it over time.
There are several different features of rosacea. Patients may have:
Triggers for rosacea vary based on the individual, but common triggers include extremes of temperature, sunlight, spicy foods, alcohol, chocolate, exercise, emotions, medications, and hot beverages. Paying attention to what triggers your rosacea will be important for management over time. It is recommended to avoid triggers when possible, but all triggers will not be able to be avoided.
There is no definitive cure for rosacea, but there are treatments that can improve existing symptoms and ease disease progression.
Avoiding triggers whenever possible is one of the most important treatments for rosacea. We encourage patients to keep a diary of their flare-ups in order to identify possible triggers so that they can be avoided in the future.