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2017 Essential guide on rosacea causes and treatments

What is rosacea?

Rosacea is a skin condition which will become worse if it is not treated at an early stage. The National Rosacea Society states that “well over 16 million Americans have rosacea - and most don’t know it.” Rosacea is still not well-understood, and there are no guaranteed ways to control it. In a National Rosacea Society survey of 1,459 rosacea patients, 47% of the patients responded that they did not know about rosacea before their diagnosis, and 95% of the patients responded they had little knowledge about rosacea symptoms. Rosacea can also cause devastating psychological and social problems in addition to its physical effects. In other National Rosacea Society surveys, 90% of rosacea patients said rosacea’s effect on personal appearance had lowered their self-confidence, and 52% stated that they had avoided face-to-face contact.


Rosacea is most commonly seen after age 30, and may first look like a minor sunburn. Out of nowhere, a redness appears on the face usually on the forehead, chin, cheeks and nose. The skin under the eyes of sufferers is in stark contrast to the redness in the cheeks, where there is often a butterfly pattern.  Then just when you start to feel concerned, the redness disappears. Unfortunately, this happens repeatedly, becoming redder and lasting longer each time, and eventually, visible blood vessels may appear. The bottom line is that it is progressive, so it is here to stay and will likely get worse if you do not carefully manage it.


What are the typical rosacea symptoms?

Dermatologists commonly define rosacea as a vascular disorder that manifests as reactions on the skin:

  • Flushing redness on cheeks, nose, forehead and chin
  • Erythema (swelling) and inflammation
  • Tightness
  • Small blisters, red bumps and pimples
  • Watery and itchy eyes
  • Bulbous nose, noticeable pores, fibroplasia and distorted facial features
  • Sensations include; stinging, burning and hot, itchy rashes


What are the types of rosacea?

Rosacea is an inflammatory condition. While the skin looks inflamed, it is not infected. The location and pattern of the inflammation determine the type of rosacea. There are four different types of rosacea. It is also common to have more than one rosacea type.


Erythematotelangiectatic rosacea

Flushing and persistent central facial erythema or swelling are signs of erythematotelangiectatic rosacea (Figure 1). There is often a history of flushing episodes lasting over ten minutes and occurring from various stimuli such as emotional stress, exercise, hot baths or showers. The skin is often finely textured with scaling and roughness of the central face, which is a strong indication that the facial skin may also be very sensitive. The facial redness, scaling and discomfort could also be a sign of past irritation from skin care products and harsh climates.


Papulopustular rosacea

Papulopustular rosacea is the classic rosacea type (Figure 2). It manifests in the centre of the face in the form of a constant facial swelling along with papules and pustules. Unlike acne, there are no comedones, but burning and stinging may be present. This type of rosacea is often seen in combination with or develops after erythematotelangiectatic rosacea.


Glandular rosacea

Glandular rosacea is a deep sebaceous rosacea type (Figure 3). Men with a history of acne in their teens are most likely to have this rosacea. Broken capillaries along with redness are less pronounced. The skin is thick and sebaceous and is not easily irritated. The pores are clogged with dead skin cells and sebum. Sufferers exhibit a larger rounded nose due to the swelling and enlargement of the oil glands.


Ocular rosacea

Swelling of the oil glands along the eyelash line is a sign of ocular rosacea. Demodex mites are linked to ocular rosacea by some studies. Up to 70% of patients with rosacea can have ocular rosacea. One-third of these patients may develop corneal involvement, which is potentially sight-threatening.


What triggers or causes rosacea?

Several factors are known to cause Rosacea. You have a greater chance to be affected if you are light-skinned female between the ages of 30-50. At present, researchers believe that hereditary, as well as environmental factors, are to blame:



Multiple family members can suffer from rosacea. Distinct genetic profiles for each rosacea type have been found by recent medical studies.



Triggers such as sun exposure, stress, alcohol, spicy foods and hot beverages are known to cause a rosacea flare-up. Flare-ups can also be triggered by medications and cosmetics with irritating ingredients. Stress is a contributing factor as elevated levels of cortisol over a prolonged period suppresses the immune system. Everyone has a different trigger ingredient for his or her rosacea flare-ups, and we recommend keeping a food/lifestyle diary. The specific triggers which contribute to your rosacea flare-ups will be learnt with time and patience. 



Helicobacter Pylori bacterium, the bacteria that gets in the gut and causes stomach ulcers, has been detected in rosacea. The face mite Demodex folliculorum, which lives in hair follicles, has been identified in high numbers in patients with rosacea. The mite penetrates the dermis due to an immune defect which stimulates an immune response, causing rosacea. However, there is still controversy surrounding the link of Demodex mites and rosacea.


What are skin conditions confused with rosacea?

Other skin conditions can be easily mistaken for rosacea and vice versa. The most common reason for this confusion is that rosacea appears similar to other skin conditions. For example, raised spots, cysts and general redness is characteristics of both rosacea and acne.


Non-rosacea forms of acne

Rosacea and acne can easily be confused with each other. Rosacea is often referred to acne rosacea as it closely resembles acne vulgaris, the correct name for acne. Acne is more prevalent in adolescents and young adults than older adults. Rosacea is more common in young and older adults, and the risk of rosacea increases with age. Also look for blackheads as they are more common in acne. Female hormonal acne, another form of acne that can develop in adult women, usually manifests as big, painful cysts along the jaw. The jaw is not a common site for the pimple-like lesions or rash of rosacea.


Facial dandruff (seborrheic dermatitis)

Dandruff can be harder to distinguish as similar to rosacea; it often involves the mid-portion of the face. With dandruff, there is scaling and a salmon-coloured redness of the skin. Involved areas are often sensitive as well. While it is often present along with rosacea, the treatments are similar.


Skin rashes of allergic and irritant dermatitis

An allergy or irritation from products is located only in the area of product application at the start. The rash first appears where the product was applied and may eventually spread out. This rash is often accompanied by itching, stinging and a dry, chapped appearance to the skin. Products which can cause such rashes include AHA or acne products (benzoyl peroxide) that are too harsh for a person’s skin.


What is the best treatment for rosacea?

Early treatment is essential. Rosacea cannot be cured, but it can be controlled. In general, rosacea is controlled by various methods such as antibiotic creams (Rozex), oral medication, laser treatment and specialist skin revision facials. We advocate treating rosacea through expert skin revision facials. Effective treatment and home care products will dramatically reduce the symptoms and signs of rosacea. Traditional style facials that focus on just calming the skin attempting to reduce the redness do not give a long-term resolution. Effective treatment needs to get to the core of the problem and addresses all the contributing factors that cause rosacea. We treat rosacea through a combination of DMK Therapy Facials. The key characteristics and benefits of DMK Therapy Facials are:

  • Bacterial fighting agents work immediately to kill bacteria and also the Demodex mite.
  • Reduces inflammation, heat and swelling in the skin.
  • Re-establishes the skin's barrier defence lines.
  • Enhances the functioning of the skin, boosts the function of the immune system of the skin, increasing the resilience of the skin.
  • Strengthens the skin's structures. Encourages repair and restoration of cellular integrity. A stronger healthier skin can hold water and has a better defence system.

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