This month, we are inaugurating a new section of our newsletter, the “Question of the month.” In this section, we will discuss common skin conditions so that our patients can familiarize themselves with disorders of the skin that occur frequently.


Rosacea is a skin disease that causes red patches, bumps, and broken capillaries on the face. Although it can occur at any age, it is most likely to start in fair skinned people in their thirties and forties. Often, the first symptom noticed by people with rosacea is a tendency to blush (facial flushing), which becomes more frequent and noticeable over time. Eventually, the redness of the face becomes permanent, although it can vary in intensity. Small dilated blood vessels, known as telangiectasias, may appear in the affected areas. Small white bumps, called milia, and red bumps may also occur. Although rosacea is frequently mistaken for acne, rosacea does not cause the blackheads and whiteheads that are common in acne. The most likely areas to be affected by rosacea are the nose and cheeks, but in more severe cases rosacea can affect the entire face and neck.


Doctors grade the severity of rosacea on a mild-moderate-severe scale. If left untreated, rosacea may progress over time from mild to moderate disease, and eventually to severe disease. The severe form of rosacea is characterized by intense bouts of facial flushing, swelling, facial pain, and debilitating burning sensations. At this stage, some patients may also develop a rhinophyma (rino-fi-ma), a bulbous enlargement of the nose. It is said that W.C. Fields developed his famous nose as a complication of rosacea.


Some patients with rosacea may also develop eye problems. Commonly occurring symptoms include dry eyes, itchy or burning eyes, gritty eyes, and a sensation of a foreign body in the eye. Redness and swelling of the eyelid may also occur. Rosacea patients with eye involvement should see an ophthalmologist.


Although there are many theories, the cause of rosacea is still unknown. Genetic and environmental factors probably play roles in the development of rosacea.


The treatment of rosacea begins with sun protection. Patients who have rosacea should carefully monitor their exposure to the sun and routinely use sunscreen. Antibiotics, either taken orally or applied topically to the affected areas, are also regularly used to treat rosacea. Topical azaleic acid may also be used, especially if antibiotics do not give sufficient improvement. The redness and dilated blood vessels associated with rosacea are best treated with either laser therapy or intense pulsed light. The good news is that by combining several skin care modalities, an experienced skin care professional will be able to control nearly every case of rosacea.