Rosacea: FAQs

As a medical spa, we run into complicated skin issues all the time, one of those being rosacea. Here are a few FAQs about trigger factors and treatment options from the National Rosacea Society.

Trigger Factors

Q. What are the most common lifestyle and environmental factors that aggravate rosacea or trigger flare-ups?

A. According to a National Rosacea Society survey, some of the most common rosacea triggers include sun exposure, emotional stress, hot or cold weather, wind, alcohol, spicy foods, heavy exercise, hot baths, heated beverages and certain skin-care products. For a list of common triggers, visit the Rosacea Triggers section.

Q. How effective is avoiding lifestyle and environmental factors?

A. In a survey of 1,221 rosacea sufferers by the National Rosacea Society, 96 percent of those who believed they had identified personal trigger factors said avoiding those factors had reduced their flare-ups. Full survey results are available in the Rosacea Review archives.

Q. How long after a rosacea trigger will a rosacea flare-up occur?

A. Although there are no data available on how quickly a rosacea trigger may lead to a flare-up, the time is likely to vary depending on the individual and the nature of the trigger. Try monitoring your individual case to see how quickly your rosacea has responded. And remember, while a wide range of factors has been identified as potential triggers, not every trigger affects every individual every time.

Q. Is there any relationship between rosacea and allergies?

A. Allergies may cause an altered reaction of the body that includes flushing, which frequently triggers rosacea symptoms. As with more common rosacea triggers, identifying and avoiding allergens -- the substances you are reacting to -- may also help control your rosacea.

Q. Will exercise cause my rosacea to flare up?

A. Any activity such as exercise that causes flushing or overheats the face has the potential to spark a rosacea flare-up. The good news is that signs and symptoms may be avoided or reduced by managing your workout. Ways to help reduce the incidence of flare-ups include working out in the early morning or late evening when weather is cooler; working out more frequently but for shorter intervals; keeping cool indoors by running a fan or opening a window; and cooling off by keeping a damp towel on your neck, drinking cold fluids or chewing on ice chips. Choosing low-intensity exercise or water aerobics may also be useful.

Q. How do I determine what causes a flare up?

A. Rosacea signs and symptoms may be prompted by a vast array of environmental and lifestyle factors that differ from one individual to another. Some of the most common factors are listed here. As with an allergy, it is useful to keep a diary to pinpoint the particular elements that may prompt a flare-up in your individual case. The National Rosacea Society publishes a booklet, "Rosacea Diary," designed to help patients identify and avoid their individual rosacea triggers.

Treatment

Q. Can rosacea be cured?

A. While rosacea cannot be cured, medical treatments are available that can control or eliminate its various signs and symptoms.

Q. How is rosacea treated?

A. The signs and symptoms of rosacea vary substantially from one patient to another, and treatment must therefore be tailored by a physician for each individual case. Some patients are troubled by redness and flushing, while others have bumps and pimples, thickening of the skin, or eye rosacea or combinations. For patients with bumps and pimples, doctors often prescribe oral and topical rosacea therapy, and a topical therapy to reduce facial redness is now available.

When appropriate, laser treatment or other surgical procedures may be used to remove visible blood vessels, reduce extensive redness or correct disfigurement of the nose. Eye symptoms are commonly treated with oral antibiotics and ophthalmic therapy.

In addition, rosacea patients are advised to identify and avoid lifestyle and environmental factors that may aggravate their individual conditions. Patients may also benefit from gentle and appropriate skin care, and cosmetics may be used to reduce the effect of rosacea on appearance.

Q. Why are antibiotics prescribed for rosacea? Is it a bacterial infection?

A. It is unknown exactly why antibiotics work against rosacea, but it is widely believed that it is due to their anti-inflammatory properties, rather than their bacteria-fighting capabilities.

Q. What about bacterial resistance from antibiotic use?

A. Topical antibiotics result in such minimal levels of medication in the bloodstream, if any, that there is virtually no risk of developing bacterial resistance at sites other than where the topical antibiotic is being applied. A version of an oral antibiotic with less risk of microbial resistance has been developed specifically for rosacea.

Q. What medications are used for rosacea besides antibiotics?

A. Colloidal Silver which is an all natural replacement for antibiotics.

Q. What about long-term side effects?

A. Topical therapy results in such minimal levels of medication in the bloodstream, if any, that there is virtually no risk of systemic side effects except allergic reactions. Possible side effects associated with oral antibiotic therapy include upset stomach, sensitivity to sun exposure, tooth discoloration, diarrhea, allergic reactions and vaginal yeast infections.

Q. If I take long-term medication consistently, will it lose its effectiveness?

A. Topical therapy usually controls rosacea on a long-term basis, without loss of effectiveness.

Q. Should I still use my medication between flare-ups?

A. Rosacea is characterized by flare-ups and remissions, and a study found that long-term medical therapy significantly increased the rate of remission in rosacea patients. In a six-month multicenter clinical study, 42 percent of those not using medication had relapsed, compared to 23 percent of those who continued to apply a topical antibiotic. In general, treatment between flare-ups can prevent them.

Q. How should I care for my skin?

A. A rosacea facial care routine recommended by many dermatologists starts with a gentle and refreshing cleansing of the face each morning. Sufferers should use a mild soap or cleanser that is not grainy or abrasive, and spread it with their fingertips. A soft pad or washcloth can also be used, but avoid rough washcloths, loofahs, brushes or sponges. Next, rinse the face with lukewarm water several times and blot it dry with a thick cotton towel. Never pull, tug, scratch or treat the face harshly. Sufferers should let their face air dry for several minutes before applying a topical medication. Let the medication soak in for an additional five or 10 minutes before using any makeup or other skin care products.

Q. What skin-care products are appropriate to use with rosacea?

A. The skin of many rosacea sufferers may be sensitive and easily irritated. Patients should avoid using any products that burn, sting or irritate their skin. In a National Rosacea Society survey, many individuals with rosacea identified alcohol, witch hazel, fragrance, menthol, peppermint, eucalyptus oil, clove oil and salicylic acid as ingredients that irritated their individual cases, and many also avoided astringents and exfoliating agents. A useful rule of thumb may be to select products that contain no irritating or unnecessary ingredients.

Sunscreens or sunblocks effective against the full spectrum of ultraviolet A and B radiation can be especially important for rosacea patients, whose facial skin may be particularly susceptible to sun damage and consequent rosacea flare-ups. An SPF of 15 or higher is recommended, and physical blocks utilizing zinc or titanium dioxide may be effective if chemical sunscreens cause irritation.

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