Understanding Rosacea: Symptoms and Management Strategies

Rosacea, a chronic skin condition affecting over 14 million people in the United States, often worsens with age. Symptoms like frequent flushing, acne-like breakouts, and dilated blood vessels typically become more pronounced for individuals in their 40s and 50s. According to Dr. Julie C. Harper, a dermatologist based in Birmingham, Alabama, many individuals do not notice symptoms until after age 30.

While scientists have yet to pinpoint the exact cause of rosacea, it is believed to be linked to an overactive immune response to environmental triggers. These can include sun exposure, spicy foods, alcohol, and even stress. The condition is more prevalent among women and those with fair skin, but it can affect anyone.

Why Rosacea Worsens with Age

Rosacea tends to run in families and can lead to various symptoms, including persistent redness, dilated blood vessels, and bumps on the skin. Dermatologists like Dr. Marie Leger from New York City note that the symptoms can also include skin dryness, tightness, and a burning sensation. Additionally, some individuals may experience grittiness or itchiness in their eyes, as well as thickening of the skin on the nose, according to Dr. Dina Elrashidy from Northwestern Medicine in Chicago.

As individuals age, chronic exposure to these triggers can lead to long-term inflammation, weakening the tissue surrounding blood vessels. This can result in increased flushing and persistent redness, as explained by Dr. Harper. Over time, the skin naturally thins and dries, making symptoms more visible. Dr. Elrashidy points out that many patients in perimenopause and menopause report exacerbated symptoms, though the exact hormonal connection remains unclear.

Strategies for Managing Rosacea

Managing rosacea often requires a multifaceted approach. Dermatologists recommend identifying and avoiding personal triggers, which can vary widely among individuals. For some, this may mean steering clear of alcohol or spicy foods, while others may find it challenging to avoid environmental factors like cold weather.

Using gentle skin care products is crucial. Moisturisers containing glycerin or dimethicone can soothe the skin, while cleansers with sulfur can help reduce inflammation. Dr. Leger advises against using scrubs or products with fragrances, as these can irritate sensitive skin.

Sun protection is essential, as exposure to UV rays is a common trigger for rosacea. Patients should apply broad-spectrum sunscreen with an SPF of 30 or higher daily, reapplying every hour or two when outdoors. Mineral sunscreens containing zinc oxide or titanium dioxide are often gentler on the skin and more effective for those with rosacea.

For persistent cases, prescription medications can be beneficial. Treatments like brimonidine gel and oxymetazoline cream work to narrow blood vessels, helping to reduce visible redness. Topical options such as azelaic acid and metronidazole can alleviate inflammation and clear up breakouts. Some patients may also be prescribed low-dose oral antibiotics for longer periods to manage their symptoms.

Laser therapy is another option for individuals seeking significant improvement. This treatment employs varying wavelengths of light to diminish blood vessels and reduce redness. Patients often begin with one to three sessions, spaced about a month apart, and may need maintenance treatments every six months to a year.

It is never too early or late to consult a dermatologist about rosacea symptoms. Identifying triggers and developing a tailored treatment plan can empower patients to take control of their condition. As Dr. Leger emphasizes, “Having a strategy can make patients feel much more in control.”