Redness on the face is one of the signs most related to rosacea. Although it may seem simple, the condition can be more complex, depending on the degree of the disease.
Rosacea (ICD-10 L71) is a chronic inflammatory disease of the skin . Its main manifestation is a redness that affects the central region of the face, along with some lesions. It can also reach the cheeks, nose, forehead and chin.
It can also be mistaken for a sunburn or just a punctual skin sensitivity.
Both men and women can manifest the disease. Despite being more common in females, from 30 to 50 years old, it is in men that the most severe forms appear, which can develop into a rhinophyma (gradual enlargement of the nose due to thickening and dilation of follicles).
The presence of redness occurs due to the dilation of blood vessels. And this, in turn, is the result of inflammation of the vascular tissue of the face.
For a long time it was believed that rosacea was a type of acne . The reason for this misunderstanding occurred because rosacea is often accompanied by acne, which is a symptom of the disease.
And although the two conditions have many manifestations in common, they have significant differences:
- It usually manifests itself from the age of 30;
- There are no blackheads;
- More frequent in women, although it appears in men as well.
- It usually manifests at puberty;
- Blackheads are present.
- More frequent in men, although it also appears in women
However, the similarities allow some drugs to be the same for the treatment of both.
However, this approach can only be made based on medical advice, because there are also drugs that are used to treat acne and that should not be used in the treatment of rosacea, and may even worsen the disease.
Rosacea is a disease that has its exclusively physical manifestations. Check out some of the most common symptoms:
- Facial flushing: flushing in the face is a very common symptom in people who have rosacea and can last up to 5 minutes, and can extend to the neck and neck. Flushing waves are usually accompanied by heat waves as well. Recurrent cases can cause inflammation and small red bumps or papules.
- Hyperreactivity of the skin: another very common characteristic for those who have the disease is the sensitivity of the blood vessels that dilate very easily, with different stimuli, such as sunlight.
- Persistent redness: unlike flushing, the redness that can affect and settle on the skin in a more lasting way. This is because the blood vessels dilate. So the skin will look like a sunburn.
- Pimples, papules and pustules: blemishes and pimples can also occur on the skin of those who have rosacea. These spots and pimples are characterized by being inflammatory, but they are not pimples.
- Inflamed blood vessels: the sensitivity of blood vessels may worsen as the disease progresses and, thus, they swell and become increasingly visible (telangiectasias), especially in the nose and cheeks.
- Rhinophyma: more advanced cases of the disease can cause a thickening of the skin of the nose, in addition to deformation. This situation affects more men than women.
- Ocular: a less common symptom, but also existing, is the burning sensation in the eyes and the sandy sensation. This causes the inside of the eyelid to become inflamed (blepharitis) and scaly, causing conjunctivitis. In more specific cases, the vision may be blurred.
- Facial swelling: with the sensitization of blood vessels, they end up expelling excess fluids and proteins, resulting in an overload of the lymphatic system. Thus, drainage does not occur effectively, generating an accumulation of fluid that leaves the face swollen.
It is worth remembering that as rosacea is a chronic disease, symptoms can come and go throughout life, with peaks of crises and amelioration. That is, the skin can be normal for weeks, months or years and then erupt again.
The types of rosettes are defined based on the characteristic symptoms of each one. Altogether, there are 4 classifications and each one of them manifests itself and has different characteristics, check out:
Erythema telangectasia is the most common type of rosacea . In it, the skin is red and with vessels well dilated and apparent, but restricted to the central region of the face.
Still, it is very common for people with this subtype to feel the pinching, burning or burning sensation on the skin.
There are some situations that can show these symptoms, such as: alcohol consumption, excessive exposure to the sun, stress , physical exercises and heat. The most common signs are:
- Redness in the center of the face;
- Apparent blood vessels;
- Swollen, dry, rough, sensitive and scaly skin;
- Presence of hives and burning sensation.
In the pustular papule, besides the redness, there is also the appearance of lesions, which are characterized by the presence of comedones, red and inflamed papules and pustules (pimples) with pus.
For a long time this type of rosacea was mistaken for common acne and even became known as “acne rosacea”, but it is not acne precisely because it does not have some expressive characteristics, such as black and white spots of blackheads and pimples.
In this category, men are the most affected individuals, alternating between periods of improvement and worsening. Symptoms include:
- Inflamed acne;
- Redness in the same areas of acne (mainly in the nose);
- Oily skin;
- Sensitive skin;
- Apparent blood vessels;
- Presence of spots on the skin.
This type of rosacea causes an inflammation that results in a redder, thicker, harder skin and has many enlarged pores. In addition to being the least common type of rosacea, it is also considered a more advanced stage of the disease.
One of its main characteristics is the enlargement and infiltration of the sebaceous glands in the nose, being more present in men over 50 years.
In these cases, the nose may double in size, and surgical intervention may be necessary in order to remove excess skin. This growth can also affect the chin. Among the symptoms are:
- Irregular skin texture;
- Thick skin on the nose, chin, cheeks, forehead and ears;
- Marked growth of the nose;
- Enlarged pores;
- Apparent blood vessels.
Ocular rosacea is the most dangerous type of this disease, because, when left untreated, it can evolve and result in loss of vision.
Among the main manifestations, ocular rosacea is characterized by redness inside the eye and peeling of the eyelids near the eyelashes ( blepharitis ). In addition to these symptoms, others may also appear:
- Foreign body sensation, something like sand;
- Ocular dryness;
- Blurred vision;
- Swelling of the eyelids;
- Burning and burning sensation;
- Recurrent cyst on the eyelids.
Because it has symptoms similar to conjunctivitis , sometimes the diagnosis of the disease can take time. In addition, once the disease is suspected, it is also necessary to analyze whether there is a manifestation on the skin.
Granulomatous rosacea, also called lupoid rosacea, has as its main characteristic the appearance of immunological granulomas.
This type of rosacea is an aggravated variation of the pustular papule, so there is the appearance of red-brown papules, in addition to red and irritated skin.
In addition, the main peculiarity of this type is the location of granulomas, which usually appear on the lateral ends of the face and just below the mandible, at the beginning of the neck.
There are some symptoms that are decisive for pointing out the occurrence of rosacea or even its stage. If you have any of the following, it is important that you inform the doctor for a possible diagnosis, as rosacea can be easily confused with other skin conditions.
Appearance of pimples
The appearance of pimples concomitantly with apparent blood vessels and redness can be a sign that your rosacea is getting worse. In addition, it is also important to be aware of red, purple or blue lines on the face.
Symptoms in the eyes
Some people who already have rosacea on their skin may also develop eye disease. Thus, they can become dry, sore and irritated. In addition, the eyelids may become red and itchy.
Eye problems are always more serious, because their evolution can cause problems with vision.
There are some indications of when you may be developing rosacea in your eyes:
- Red and swollen eyelids;
- Red eyes and redness around;
- Burning sensation.
Swollen and red nose
The nose can be a very affected part of the body in cases of an already more developed disease, and rhinophyma may arise – an increase in the size of the nose and alteration of its texture.
There is no exact consensus on what are the causes of rosacea. However, the Brazilian Society of Dermatology (SBD) points out some factors as possible for its manifestation.
Among the possible causes, the genetic predisposition stands out . In addition, the disease can appear not only when there are cases of rosacea in the family, but also in people with certain skin tones – whites and Europeans are more likely to develop the disease.
SBD also raises the possible participation of the fungus Demodex folliculorum , which may be present in the skin flora, and of the bacterium Bacillus oleronius , which colonizes this fungus.
Although there is no consonance, there is a widely accepted theory. In it, the innate immune system reacts quite aggressively and abnormally when it is exposed to environmental factors, physical and chemical traumas or germs present on the skin.
To protect itself, the immune system causes inflammation, in addition to dilating the blood vessels that are on the surface of the skin. The physical signs of this response are redness, a feeling of heat and the appearance of facial vessels.
As there is no consensus on the real cause of rosacea, it is important for the patient to observe which habits trigger the improvement and worsening of the disease, from food to the activities he performs in his daily life. Among the possible triggers are:
- Stress, anger or shame;
- Hormonal changes;
- Sudden changes in temperature;
- Very hot or spicy foods;
- Exposure to sun, humidity or wind;
- Caffeine and milk products;
- Heat, cold, fever or even cough;
- Hot baths or saunas;
- Use of corticosteroids or vasodilator drugs.
There is no scientific evidence that rosacea can be transmitted, through the skin or even through personal objects.
Because it is related to hereditary factors, people who have cases of rosacea in their closest relatives may be more subject to the onset of the disease.
There is also an individual predisposition, more common in whites and Europeans. In addition, women are more likely to manifest the disease, especially in the 30 to 50 age group.
People who have more oily and sensitive skin can also develop the disease more easily. However, other types of skin, such as dry and combination, may also have rosacea.
The first step in diagnosis is to see a dermatologist . The professional will analyze the area and then reach a conclusion.
Usually, the diagnosis of rosacea is essentially clinical and very difficult, as the symptoms are similar to those of other skin diseases.
However, some doctors request some tests, such as biopsy, skin scraping or blood count , so that other possibilities are ruled out.
Because it is a chronic disease, rosacea has no cure , but it can be treated.
The treatment of rosacea varies according to the degree of evolution of the disease and, in some cases, it is even possible to reverse the main symptoms.
In addition to general treatments, there are also more specific ones, according to the type of rosacea the patient has.
Check now the most popular treatments for the disease:
Rosacea cases that have milder manifestations, usually can be treated only with the use of topics, such as ointments and creams. The components of these products have anti-inflammatory, microbiotic and antibiotic action.
Thus, the inflammation of the wounds caused by both rosacea and erythematous telangectasia as well as by the pustular papule may decrease or be smoothed according to the patient’s use.
For some cases, the doctor may find it necessary to use oral medications, either because he believes they will be more effective for treatment or because of the patient’s profile, who may prefer oral administration to topical administration.
However, the most common is that topical and oral treatments occur concurrently for a more significant result and reversal of the main symptoms, such as: redness, inflamed acne, apparent blood vessels, etc.
This type of treatment is usually used for cases of erythematous telangectasis and pustular papule.
Laser or light therapy
Typically, this treatment is used in patients who have very apparent blood vessels, along with thickening of the skin.
In addition, the technique can also help in reducing the redness present on the face and in the elimination of spots caused by acne.
The effects of this treatment can be seen in the first sessions, between the 1st and the 3rd. Patients who undergo treatment usually report an improvement of 50% to 75% of symptoms, with some identifying an improvement of up to 100%, although this is less common.
The sessions need to respect an interval of 3 to 4 weeks to be held and their results can last from 3 to 5 years, when associated with other care.
However, although existing blood vessels are eliminated, others can still form and become very apparent.
As for the thickening of the skin on the nose, the problem may return even after treatment. Once again, the solution to alleviate the symptoms is the combination of more than one type of treatment.
Know the differences of the techniques:
With the promise of reducing redness and softening dilated blood vessels, triniti SRA is characterized by having an intense pulsed light over these foci.
The number of sessions can vary between 2 and c5 per year, requiring an average interval of 2 months. Its cost ranges from 500 to 1000 reais.
For the cases of the most dilated spider veins that resemble microvarices, the v-beam perfecta is ideal. The technique consists of creating a vacuum inside the vessels, because in this way they close. This is done by means of a specific laser.
As with triniti SRA, 2 to 5 sessions are required throughout the year. Its cost is 1.5 thousand reais per session.
Multiwaves are low energy LED lights. These lights are able to soothe and reduce inflammation. For this technique, 2 applications per week are indicated until a series of at least 10 and at most 15 is completed.
The cost of each session varies between 120 and 300 reais.
Surgeon and dermabrasion
For more advanced cases of the disease, surgical intervention along with dermabrasion is required.
Surgery is the method used to redefine the deformed areas of the face. While dermabrasion consists of shaving the skin to remove the spots and superficial irregularities, caused by rosacea.
For the specific case of ocular rosacea , the most effective treatment is the use of eye drops and ointments with steroids that can help to reduce the irritability of the eye and its redness.
In addition, a “home” treatment can also be recommended by the doctor, in order to bring greater comfort to the patient. Thus, people with this disease should make compresses with warm water to keep the eyelid region clean.
There are some medications that can be prescribed by the doctor to start treatment with rosacea. They can be both topical and oral:
- Antibiotics ( metronidazole , hydrochloride tetracycline , doxycycline hydrochloride , minocycline hydrochloride ): treat inflammation of acne;
- Depigmenter ( Tretinoin ): acts in the lightening of the reddish areas;
- Anti-acne ( Benzoyl Peroxide , Acid Azelaic , Isotretinoin ): used to treat acne – some of these medications need prescription at the time of purchase .
NEVER self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained in this website is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.
Overall, the prognosis is positive. However, when the disease is not treated, it can progress and worsen in stages, and more than one type of rosacea may occur at the same time.
In these cases, the condition can make the carrier’s life more difficult, in the sense of leaving an even more negative burden on his self-esteem.
Because it is a disease that, although not curable, has many possibilities for treatment, people who have rosacea live well with the disease, but need to be careful.
In general, when our skin develops some kind of symptom, it may also be trying to alert us that there is an imbalance in our body or that it may be intoxicated in some way.
There are some precautions that we can take care of to reduce its manifestation or to prevent crises of the disease.
As the disease has its manifestation exclusively on the skin, especially on the face, the care that deserves more attention is with the skin. Check out some factors that should be taken into account:
It is always very important to be attentive to the composition of the cosmetics you use. This is because there are some components that can trigger or cause a new crisis.
See here which ingredients can work as triggers:
- Witch hazel;
- Eucalyptus oil.
Some products with astringents, exfoliating gels and other cosmetics can also make your skin even more sensitive.
In addition, fragrances in products are something that should always be avoided. That’s because perfumes are already known to work as a sure trigger for allergic dermatitis .
In the most sensitive skin, these effects can be even more expressive. Thus, fragrance-free and hypoallergenic cosmetics should always be preferred.
Testing is key
Another fundamental care for those who have rosacea skin is to test the products you want to use. That is, every time you start using a new cosmetic, it is important to try it on a small area, such as the neck, for example, and see how the skin will react.
If there is a reaction, it is important to see the composition of the product and take it to your dermatologist at the next appointment, so he will be able to raise the possible triggers of the reaction so that you avoid products that contain the component.
Less is more
People with rosacea need to be aware that the fewer products, which are not specific for the treatment of the disease, are used, the better it will be for their skin.
Therefore, it is essential that the patient always opt for multifunctional products.
Adopting a healthy diet is always a recommendation, regardless of whether you have any type of illness. However, when you have a dysfunction, this guidance becomes even more relevant.
In the case of rosacea, it is important that you consume more vegetables and dried fruits, as these foods are rich in nutrients and vitamins , in addition to both being sources of antioxidants and promoting cell regeneration.
Here are some good food options for you to include in your day to day:
- Alfalfa sprouts;
Garlic and onions can also be strong allies in the fight against rosacea, because both have antioxidant, antifungal, antibacterial and purifying properties.
What to avoid?
Just as there are foods that must be incorporated by people who have the disease, there are others that must be avoided so that there is no crisis. Are they:
- Dairy products;
- Soy sauce;
- Eggplant, avocado and spinach;
- Citrus fruits;
- Spicy and very hot food.
In addition to good nutrition, it is also essential to keep your body hydrated. For this, water intake is essential.
The lack of water, which is the main component of the skin, can leave it dry and thus it is more prone to develop diseases and infections.
Beware of stress
Stress is one of the main factors that can trigger more significant crises of the disease. So it is important, as far as possible, to prevent it from being present in your routine.
A good way to relieve, since it is easier to relieve than actually prevent stress, is to practice some physical activity of your choice.
Abuse of sunscreen
The use of sunscreen is essential. With it the skin will be very protected from the sun, which can be an enemy for sensitive and reactive skin.
In addition, sun exposure was identified as one of the most triggering factors. According to the National Rosacea Society , the sun’s rays are responsible for 81% of rosacea attacks.
Some people, usually before being diagnosed with rosacea, try to do some “tricks” in the hope that minor acne and other symptoms will go away.
Among them, the most common is the use of a sponge to exfoliate the skin. Although it is very important to keep the skin clean, the sponge and exfoliation form the perfect double villain.
This is because the skin that has rosacea is already very sensitive and reddish. Thus, the friction generated between the sponge and the skin will only make these symptoms worse.
The ideal is to use cottons to promote cleaning, as such product is soft and does not harm the region.
Bet on skin cleansing
Keeping the skin always clean and free from aggressive agents is always essential for people who have the disease. This care prevents worsening of the skin condition, as it prevents microorganisms from collaborating for the inflammatory process that already exists, for example.
In addition, cleaning is also important to remove oil spots, which can be one of the characteristics of this pathology.
It is always important to keep an eye out to choose products that meet the needs of each skin type, which even though they have rosacea, can differ, check out:
- Normal and mixed skin: prefer products that are not based on soap;
- Very dry skin: soap-based products should be avoided. Low-foam and creamy cleansers are ideal;
- Oily skin: for this type of skin, neutral soaps can be a good option, but always with great care not to rub the skin excessively.
In addition to the various types of treatments to reduce the symptoms of the disease, there are cosmetics that are also able to soothe them and leave your skin well hydrated, but without becoming oily. Check out some of them:
- Rosaliac AR Intense La Roche-Posay Rosacea Gel : treats the uncomfortable redness at its origin and also helps prevent its reappearance. Therefore, it is indicated for people with rosacea or sensitive skin with a predisposition to redness.
- Sensibio AR Anti-Redness Cream : acts biologically on one of the main factors responsible for redness. This redness in the skin can be caused by several factors such as rosacea, stress, weather, allergies and even due to food.
- Eucerin Anti-Redness Neutralizing Fluid : recovers your skin tone, softening redness, thanks to the presence of Licochalcona A and the green pigments responsible for neutralization.
Like the products mentioned above, makeup can be a great alternative to disguise the redness and pimples caused by rosacea.
It also helps to restore self-esteem to people with the disease, who often end up discouraged by their appearance because of the spots and reddish aspect of the face.
The first step is to have a very clean skin, so the oiliness will have been eliminated. Afterwards, hydration is also very important. This routine will prepare your skin for makeup and help prevent reactions that cause allergies or more sensitivity.
After this step, there are other tricks that can be done, see what they are:
Use concealer before foundation
That’s what you read! Although the normal rule is to first apply the foundation and only then use the concealer , in cases of rosacea skin, this sequence does not work.
Thus, the best alternative is to opt for the concealer before the base, in order to perfectly and more naturally neutralize the reddish areas. The green concealer is ideal to cause this effect, green bases are also a great option, although they are more difficult to find.
For this process to result in a good result, it is also important to know how to choose the best type of concealer. The best options are foundations and concealers that do not have oil in their composition.
When choosing a concealer, always choose a shade below your skin.
Oh, and when applying any makeup on skins with rosacea, it is also important to use an antibacterial brush so that your skin is always free of any invading agents.
Choose the best base color for your skin tone
At the moment of choosing the base, the ideal is to choose those that have a color close to “skin color” or, still, those that have more yellowish backgrounds. The main tip here is to avoid those that have more pink pigments, so as not to highlight the redness.
BB Cream or Base?
For women who are not so fond of the effect caused by the foundation, BB cream can also be a great choice. However, as in the case of the foundation, the concealer must be applied beforehand, so that the coverage of the red areas is more effective.
Bet on mineral powder
Mineral powder can be a great option for those with rosacea skin. This is because, in its composition, there are usually no ingredients that can be aggressive to the skin.
In addition, some technologies are specially formulated to reduce the characteristic redness of the disease.
Attention with eyes
When investing in makeup in the eye area, it is very important that you choose products that are not only dermatologically tested but also ophthalmologically.
When it comes to mascara or eyeliner, the best options are those that are washable. Waterproof versions can cause serious problems when removing them. As the area is already very delicate, rubbing or using other, more aggressive products is not welcome.
In addition to these recommendations, it is also important to select shadows that contain less pigment, as these are usually less irritating.
Beware of red lipstick
Red lipstick is often a great friend to most women. He is able to bring confidence, security and self-esteem, in general. However, for women who have rosacea he can be a great villain.
As the skin already has this reddish tone, using this color also on the lips, can give the impression that the face is still red. Thus, in these cases, this tone can bring insecurity and low self-esteem for women.
But don’t be discouraged, there are several options for nude lipsticks that can make you equally powerful!
The main complication that can be affected by the disease is self-esteem. When treatment is not done, or it is not known for certain what are the factors that trigger the crises, people with the disease usually have low self-esteem, due to the redness that settles on the skin, in addition to the lesions, in some cases .
The condition can get worse, as there is still the stigma that people who have a red face, especially the nose, which are characteristic of the disease, are alcoholics. This misunderstanding can trigger even greater problems in patients’ mental health .
Still, in phytose rosacea, the absence of an appropriate treatment can generate rhinophyma, which may further impair the patient’s self-esteem.
Given this situation, looking for a psychologist and making the most appropriate treatment are also extremely important, after all mental health is as important as physical.
In addition, there are other more specific conditions that can be considered complications of the disease: ocular rosacea, when not properly treated, can result in serious problems with vision, including blindness.
There are some studies that point to the relationship between rosacea and other diseases. Some of them are more consolidated, others less so.
Among the possibilities widely accepted by doctors, is the relationship between rosacea and seborrheic dermatitis . There are still those who defend its association with migraine , gastrointestinal or neurological disorders, including Parkinson’s disease.
In addition, recent studies have found that patients who had rosacea had a 41% higher risk of developing high cholesterol.
A relationship was also established that these patients had 35% more chances of manifesting arterial disease and 17% of presenting hypertension when compared to people who do not have the disease.
As the causes of the manifestation of rosacea have not yet been clearly defined, there is no way to talk about prevention in order to prevent the disease from appearing.
However, there are several triggers that can trigger it. So, the best way to prevent an even greater rosacea crisis is to be aware of these factors, which can interact differently from person to person.
That is, the same factor can be triggering for a person with rosacea, and not for another. So it is important to be aware and always pass this information on to your doctor.
When it comes to diseases it is normal for us to have some or many doubts, isn’t it? So here are some of the most recurring questions when it comes to rosacea.
Is rosacea contagious?
No. There is no indication that rosacea is an infectious disease, just as there is no evidence that it can be transmitted by contact or by air.
Does rosacea get worse with age?
There is no direct relationship between age and worsening of rosacea. However, in contrast, studies show that the lack of treatment for the disease causes it to evolve very quickly.
Both in the increasing frequency of crises and even in the incidence of more than one type of rosacea at the same time.
Can children have rosacea?
Although the percentage is minimal, children can develop rosacea. As the main cause of the disease is genetic predisposition, children who have characteristic symptoms should already start treatment, as the tendency is for the condition to worsen.
Can rosacea be diagnosed before an outbreak?
In some cases, it is possible to identify pre-rosacea symptoms in young people in their twenties, or even in adolescents. Typically, such patients go to dermatologists complaining of problems with acne and a persistent flush.
Once these symptoms are identified by the doctor, he will be able to give some instructions and medications to prevent them from turning into more significant crises.
I have acne and rosacea, is this common?
Usually, they appear separately, but there are reports of both occurring at the same time. But even if this happens, it is important to note that because they are different diseases, treatments must also be specific.
As already differentiated, common acne is associated with obstruction of the pores, of the sebaceous glands, while rosacea is a disease related to the facial vascular system, in most cases.
Therefore, the treatments need to be different, although they can happen concurrently.
Will physical activities trigger rosacea?
Any exercise or activity that requires a little more effort, resulting in facial overheating, can cause a rosacea crisis. This is because these activities already cause flushing, even in people who do not have the disease.
However, you do not need to stop exercising because of this. There are some recommendations for the crisis not to be as acute or even not to occur, such as:
- Perform activities in the early hours of the morning or during the night, when temperatures are milder;
- Take shorter breaks, but more often;
- Try to carry out the activity in airy places;
- During the activity, drink plenty of water and place a damp towel around your neck. You can also chew pieces of ice;
- Low-intensity exercises, such as water aerobics, can be a good option.
Although it is not a disease with many complications, rosacea deserves due attention, mainly because it greatly affects the social life of patients. In addition, being attentive and, above all, knowing what are the factors that can trigger crises is essential for the carrier to have a good quality of life.
If you have rosacea, tell us in the comments how your experiences have been or share product and care tips so that other people can also be reassured!