Acne and Rosacea

Rosacea, or acne rosacea, is a skin disorder leading to redness and pimples on the nose, forehead, cheekbones, and chin. Rosacea is a chronic and potentially life-disruptive disorder primarily of the facial skin, often characterized by flare-ups and remissions. Rosacea strikes both sexes. It tends to be more frequent in women but more severe in men. It is affects an estimated 14 million Americans. Adults, especially those between 30 and 50 years of age who have lighter skin, blonde hair and blue eyes, are most likely to suffer from rosacea. People with rosacea often find that certain lifestyle and environmental factors trigger a flare-up or aggravate their individual conditions. Rosacea can affect the eyes. Symptoms that suggest ocular rosacea include a feeling of dryness and grittiness in the eyes and inflamed bumps (chalazions) on the lids. The eyelashes may develop scales and crusts, often misdiagnosed as seborrheic dermatitis.

Rosacea sufferers often report periods of depression stemming from cosmetic disfigurement, painful burning sensations, and decreases in quality of life. Rosacea does not cause the blackheads and whiteheads that are in common acne. Acne vulgaris is a common self-limited disease that presents with a variety of lesions, including open and closed comedones, pustules, nodules, and inflammatory papules. Oil is a natural substance which lubricates and protects the skin, and under certain circumstances, cells that are close to the surface block the openings of sebaceous glands and cause a buildup of oil underneath. Smoking, food and drink (such as hot beverages and alcoholic drinks) that can cause flushing should be avoided. Exposure to sunlight and to extreme hot and cold temperatures should be limited. Tetracycline antibiotics including doxycycline and minocycline reduce inflammation.

Camouflage creams can help to cover and conceal erythema and telangiectasia. Mild cases can be controlled by gels or creams such a Metrogel, Cleocin-T, Azelex, or sulfa. Oral antibiotics may also help to relieve symptoms of ocular rosacea. Oral tetracycline antibiotics (tetracycline, doxycycline, minocycline) and topical antibiotics such as metronidazole are usually the first line of defense prescribed by doctors to relieve papules, pustules, inflammation and some redness. CO2 lasers can be used to remove excess tissue caused by phymatous rosacea. CO2 lasers emit a wavelength that is absorbed directly by the skin. Metronidazole cream or gel can be used intermittently or long term on its own for mild cases and in combination with oral antibiotics for more severe cases. Azelaic acid cream or lotion is also effective, applied twice daily to affected areas.