Rosacea: Understanding and Treating Facial Redness

Rosacea is a chronic inflammatory skin disease of the face. It manifests as redness, flushing, and sometimes papulopustules resembling acne.

The four stages

1. Erythema: diffuse redness on the cheeks and nose
2. Telangiectasia: appearance of visible small dilated blood vessels
3. Papulopustular phase: inflammatory bumps without blackheads
4. Rhinophyma: thickening of the skin of the nose (rare, especially in men)

Common triggers

• Alcohol, spices, hot drinks
• Temperature variations, cold wind
• Emotional stress
• Certain cosmetics (especially those containing alcohol)
• Sun exposure

Therapeutic approaches

• Topical treatments: metronidazole, azelaic acid, topical ivermectin
• Vascular laser: to treat established telangiectasias
• Antibiotics: doxycycline at anti-inflammatory dose for papulopustular forms

Rosacea is not linked to poor hygiene. It is a vascular and inflammatory predisposition that can be acted upon.