What Is Rosacea?
Rosacea is a long-term disease that affects the skin and sometimes the eyes. Its symptoms include redness, pimples, and, in later stages, thicker skin. In most cases, rosacea only affects the face.
Who Gets Rosacea?
About 14 million people in the United States have rosacea. This disease is most common in:
# Women (especially during menopause)
# People with fair skin
# Adults between the ages of 30 and 60.
What Does Rosacea Look Like?
Rosacea has many symptoms, including the following:
# Frequent redness (flushing) of the face. Most redness is at the center of the face (forehead, nose, cheeks, and chin). There may also be a burning feeling and slight swelling.
# Small red lines under the skin. These lines show up when blood vessels under the skin get larger. This area of the skin may be somewhat swollen, warm, and red.
# Constant redness along with bumps on the skin. Sometimes the bumps have pus inside (pimples), but not always. Solid bumps on the skin may later become painful.
# Inflamed eyes/eyelids.
# A swollen nose. In some people (mostly men), the nose becomes red, larger, and bumpy.
# Thicker skin. The skin on the forehead, chin, cheeks, or other areas can become thicker because of rosacea.
How Are the Eyes Affected?
Up to 50 percent of people who have rosacea get eye problems. Eyes can have redness, dryness, itching, burning, excess tears, and the feeling of having sand in the eye. The eyelids may become inflamed and swollen. The eyes may become sensitive to light, and the person may have blurred vision or some other kind of vision problem.
What Causes Rosacea?
Doctors don't know the exact cause of rosacea. Some doctors think rosacea happens when blood vessels expand too easily, causing flushing. People who blush a lot may be more likely to get rosacea. It is also thought that people inherit the likelihood of getting the disease.
Though not well-researched, some people say that one or more of these factors make their rosacea worse:
# Heat (including hot baths)
# Heavy exercise
# Very cold temperatures
# Hot or spicy foods and drinks
# Drinking alcohol
# Emotional stress
# Long-term use of steroids on the face.
People with rosacea and pimples may think the pimples are caused by bacteria. But no one has found a clear link between rosacea and bacteria.
Can Rosacea Be Cured?
There is no cure for rosacea, but it can be treated and controlled. In time the skin may look better. A dermatologist (a doctor who works with diseases of the skin) often treats rosacea. There are several ways to treat rosacea.
# Sometimes antibiotics can be put right on the skin. Other times, oral antibiotics can be used. The skin bumps may get better quickly, but redness and flushing are less likely to improve.
# Small red lines can be treated with electrosurgery and laser surgery. For some people, laser surgery improves the skin without much scarring or damage.
# Patients with a swollen, bumpy nose can have extra skin tissue taken off to make it smaller. Usually patients feel this process helps their appearance.
# Some people find that green-tinted makeup is good for hiding the skin's redness.
For the eyes:
# Most eye problems are treated with oral antibiotics.
# People who get infections of the eyelids must clean them a lot.The doctor may say to scrub the eyelids gently with watered-down baby shampoo or an over-the-counter eyelid cleaner. After scrubbing, you should apply a warm (but not hot) compress a few times a day.
# If needed, the doctor may prescribe steroid eye drops.
What Can People With Rosacea Do to Help Themselves?
You play a key role in taking care of your rosacea. Here are a few steps to take:
# Keep a written record of when flareups happen. This can give you clues about what bothers your skin.
# Use a sunscreen every day that protects against UVA and UVB rays. Make sure it has a sun-protecting factor (SPF) of 15 or higher.
# Use a mild moisturizer if it helps. Don't put irritating products on the face.
# If your eyes have problems, follow your doctor's treatment plan, and clean your eyelids as told.
# Talk with a doctor if you feel sad or have other signs of depression. Some people with rosacea feel bad because of the way their skin looks.
What Research Is Being Conducted to Help People With Rosacea?
Research is being done on:
# Ways to stop dry eyes and help other eye problems
# Drugs that can help treat rosacea
# Ways to reduce scarring after extra skin on the nose is removed.
For More Information about Rosacea and Other Related Conditions:
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)National Institutes of Health1 AMS CircleBethesda, MD 20892–3675Phone: 301–495–4484 or 877–22–NIAMS (226–4267) (free of charge)TTY: 301–565–2966Fax: 301–718–6366E-mail: NIAMSInfo@mail.nih.govwww.niams.nih.gov
The information in this publication was summarized in easy-to-read format from information in a more detailed NIAMS publication. To order the Rosacea Q&A full-text version, please contact NIAMS using the contact information above. To view the complete text or to order online, visit http://www.niams.nih.gov.
Natural Treatments for Rosacea
The following natural treatments have proven to be effective in various studies of different individuals with ROSACEA. Any alternative treatment should be discussed with your doctor and a practitioner certified in CAM treatments.
Conventional treatments for rosacea include avoiding triggers that worsen rosacea symptoms and the use of medications. Laser therapy has been used to reduce flushing and the appearance of blood vessels.
The following are some of the most frequently used natural treatments for rosacea.
1) Chrysanthellum Indicum Cream
A cream containing an extract of the herb Chrysanthellum indicum has been tested for the treatment of rosacea. Compounds in the extract appear to strengthen capillaries. A large study involving 246 people with rosacea examined the safety and effectiveness of a cream containing one percent Chrysanthellum indicum extract (applied twice a day) or placebo.
After 12 weeks, the Chrysanthellum indicum cream significantly improved rosacea symptoms, including facial redness, compared to placebo. Adverse reactions were mild and did not differ compared with the placebo group.
2) Green Tea Cream
One small study, presented as an abstract at the 2005 American Academy of Dermatology annual meeting, found evidence that a green tea cream may help people with rosacea.
The green tea cream (containing 2% polyphenone) was applied twice a day. After four weeks, women using the green tea cream had a significant reduction in the number of red bumps and pustules compared to those applying a placebo cream.
3) Niacinamide Cream
Niacinamide, a form of vitamin B3, has been used topically for rosacea. It is thought to improve the skin barrier, improve the skin’s moisture level, and reduce inflammation. One study looked at a niacinamide-containing facial moisturizer (applied twice daily) or a placebo moisturizer in 50 people with rosacea. After four weeks, the niacinamide-containing moisturizer was found to improve the skin barrier. Niacinamide taken orally has also been explored for rosacea.
Another topical treatment used for rosacea is the herb licorice. One study examined the effect of a topical licorice skin regimen in 62 people with mild to moderate facial redness. There was significant improvement in redness at the four and eight week assessments.
5) Digestive Enzymes
Some people with rosacea have indigestion, especially after eating fatty foods. One study found a deficiency of the pancreatic enzyme lipase, an enzyme that helps to digest fat.
When the rosacea patients in the study were given pancreatic enzyme supplements with meals, their symptoms of indigestion and rosacea both improved.
6) B Vitamins
Inadequate riboflavin, caused by insufficient dietary intake or poor absorption in the digestive tract, may be associated with rosacea.
One study found that Demodex folliculorum mites, which are normally found on the skin but more in larger numbers on the skin of rosacea patients, are more likely to affect the skin of animals in riboflavin. An increased number of mites may cause blockage of the pores from inflammation or may allow for the growth of bacteria on the skin.
7) Azelaic Acid Cream
Azelaic acid cream is derived from wheat, rye and barley. It appears to have antimicrobial action that slows the growth of skin bacteria and appears to be effective at reducing skin redness and papules and pustules associated with rosacea.
One study conducted by the University of British Columbia found that azelaic acid 20 percent cream was as effective as topical metronidazole 0.75 percent cream in reducing the number of papules and pustules on the skin. Azelaic acid also appeared to be slightly more effective at reducing redness.
In addition, overall improvement was rated by physicians as higher with azelaic acid. Both creams, however, showed equal improvement in the symptoms of dryness, burning, telangiectasia and itching. The most common side effect of the azelaic acid cream was stinging on application, but the patients still had a better overall impression of azelaic acid than the metronidazole cream.
Besides stinging, side effects of azelaic acid may include lightening of darkened areas of skin, although the skin does not appear to lighten beyond its normal color.
8) Food Intolerances
Some alternative practitioners have found clinically that certain foods may be associated with rosacea symptoms. Foods may cause the release of chemicals that dilate blood vessels and cause flushing.
An inexpensive and effective way of identifying food intolerance is through an elimination and challenge diet, which involves removing allergenic foods from the diet for one to two weeks then systematically introducing them into the diet to isolate the foods that cause reactions. Supervision by a health practitioner is recommended.
9) Apple Cider Vinegar
Apple cider vinegar taken orally is used as a home remedy for rosacea. It is thought to stimulate the release of digestive enzymes and help normalize the bacterial balance in the intestines. Consult a health practitioner before trying apple cider vinegar. Apple cider vinegar is available in liquid and tablet form. There have been reports linking use of the tablets with esophageal injury.
Other Natural Treatments for Rosacea
* Betaine hydrochoride
* Red clover
* Rose hips
* B vitamins