BY CLAUDIA M. CARUANA
YOU COULD have tiny red bumps and
lumps or sometimes broken blood vessels
on your face and nose but nowhere else on
your body. Perhaps your face always looks
red or flushes easily.
These can be symptoms of a little-understood chronic inflammatory disease
called rosacea (ros-ay-sha). At least 16 million Americans experience some or all of
these symptoms, according to the Rosacea
Society ( rosacea.org), and currently there
is no cure.
Rosacea usually appears in one’s 30s
and lasts a lifetime. Although many fair-skinned people with strong northern
European heritages develop it, darker-skinned individuals and African Americans can also develop rosacea.
Dr. Dendy Engelman, a dermatologist
and surgeon with Medical Dermatology &
Cosmetic Surgery Centers in New York
City says, “Rosacea is more frequently
diagnosed in women, but tends to be more
severe in men.”
Rosacea has been around for a long
time—the condition can be traced back to
at least the 14th century. In those days, the
condition was usually blamed on drinking
alcohol in large quantities.
A very strange disease
Despite rosacea being around for a
long time, researchers still do not know
what causes it.
There may be a genetic component,
says Dr. Adam Friedman, a dermatology
professor at the George Washington
Researchers also believe there may be
a potential link to autoimmune diseases,
as many individuals with rosacea have
other autoimmune conditions, such as
Crohn’s or celiac disease.
Friedman says rosacea comes in several types, with different symptoms.
Blush and flush. Individuals with the
erythematotelangiectatic (ET) form of
rosacea can have a persistent ruddy complexion. There may be small, dilated blood
vessels on the face. Numerous triggers,
including stress, alcohol, sun exposure,
caffeine and physically hot foods, have
been blamed for this.
Acne-like or papulopustular. This form
of rosacea can look like acne, but it isn’t
acne and can be more resistant to standard treatments.
Rhinophymatous or lumpy/bumpy. In
this form of rosacea, the texture and architecture of the skin becomes very thick and
lumpy, especially on the nose.
Ocular. Patients with rosacea of the
eyes often complain of a “sand in the
eye” feeling, but the symptoms can be quite diverse,
including redness, burning and itching.
Rosacea sufferers can have prescriptions
filled at Costco pharmacies. Over-the-counter creams can be
found at Costco and on
“More often than not,” Friedman says,
“individuals have an overlap among the
different forms. Because there are many
forms, rosacea easily can be confused for
anything from conjunctivitis to lupus.”
That’s why individuals who notice
redness or pimples on their face should
consult with a dermatologist for an
accurate diagnosis and treat-
ment plan (see “Cosmetic treat-
There is no way to prevent
rosacea. Engelman says, “
Rosacea has triggers such as alcohol,
caffeine, sun and stress, and because
they vary from person to person, it is
wise to recognize early on what triggers
make your rosacea worse.”
While there is no vaccine for rosacea, there are some older prescription
drugs, including low-dose topical
antibiotics and antimicrobials, that
In addition, “newer prescription
medications are more personalized to the
condition in that they target various biological issues that ultimately result in
rosacea,” Friedman says.
He adds that rosacea is not something
to dismiss or ignore: “Chronic inflammation in the skin can lead to inflammation
elsewhere in the body.” C
Claudia M. Caruana is a New
York–based health and
Identifying and treating rosacea
All fıred up ˙
FOR YOUR HEALTH
MANY DERMATOLOGISTS specializing
in treating people with rosacea use a
pulsed dye laser to treat telangiectasia,
visible blood vessels and facial redness.
According to Dr. Dendy Engelman, this
laser is absorbed by red blood cells and
destroys the lining of inflamed and visible blood vessels.
“At least three treatments are re-
quired at six-week intervals, depending
on the severity of redness and telangi-
ectasia,” she says. “Over two to three
weeks, the visible blood vessels will
Vascular lasers can also help to
stunt the advancement of rhinophyma,
or nose swelling, she adds. “Laser
treatment for rhinophyma is a one-time
procedure that may cost between
$1,500 and $3,000.”
Engelman stresses that it is important
to choose a board-certified specialist
who is well-versed in laser medicine.—CC