Rosea

[Belinda27]

I have Rosea on my nose and face and it seems to be spreading up into my eyebrows. I have tried creams from the doctor but they seem to have steroids in them and i tend to put on weight. It didn't seem to work either. Is there anything else that i can try its especially bad when i am hot and people keep asking me if its sunburn.

[Sarah Buchan]

Dear Belinda,

thank you for posting your question - I wonder if I could begin by clarifying your diagnosis.

The rosea you detail is a temporary skin rash or raised, red scaly patches on the body. The face is not usually affected and although it can be itchy, the condition usually clears within 2-12 weeks.

Rosea occurs in 3 stages:
1) initial symptoms - e.g. fever, indigestion, loss of apetite, upset stomach, headache or joint pain
2) herald patch - the appearance of a pink/red oval patch of scaly skin which grows over a period of days. This usually presents on the tummy, chest, back or neck
3) rash - this rash develops after the appearance of the herald patch and may spread over the next 2-6 weeks. The rash usually occurs across the chest, back, tummy, neck and upper arms but the face is usually unaffected.

Another common skin condition is Rosacea - this is a long term skin condition which mainly affects the face.
Rosacea symptoms often begin with episodes of flushing, where the skin turns red usually for a few minutes. Rosacea is a relapsing condition which means that sometimes the symptoms will be particularly bad and other times they will be less severe.
Symptoms of Rosacea include; flushing, persistant facial redness, visible blood vessels, papules (red bumps on the skin), pistules (pus-filled bumps on the skin) and may also affect the eyes causing dryness and irritation.

Belinda could I ask that you confrim which of these conditions you have before I proceed with advice for the correct follow up?

Kindest regards,

Sarah

[Belinda27]

Dear Belinda,

thank you for posting your question - I wonder if I could begin by clarifying your diagnosis.

The rosea you detail is a temporary skin rash or raised, red scaly patches on the body. The face is not usually affected and although it can be itchy, the condition usually clears within 2-12 weeks.

Rosea occurs in 3 stages:
1) initial symptoms - e.g. fever, indigestion, loss of apetite, upset stomach, headache or joint pain
2) herald patch - the appearance of a pink/red oval patch of scaly skin which grows over a period of days. This usually presents on the tummy, chest, back or neck
3) rash - this rash develops after the appearance of the herald patch and may spread over the next 2-6 weeks. The rash usually occurs across the chest, back, tummy, neck and upper arms but the face is usually unaffected.

Another common skin condition is Rosacea - this is a long term skin condition which mainly affects the face.
Rosacea symptoms often begin with episodes of flushing, where the skin turns red usually for a few minutes. Rosacea is a relapsing condition which means that sometimes the symptoms will be particularly bad and other times they will be less severe.
Symptoms of Rosacea include; flushing, persistant facial redness, visible blood vessels, papules (red bumps on the skin), pistules (pus-filled bumps on the skin) and may also affect the eyes causing dryness and irritation.

Belinda could I ask that you confrim which of these conditions you have before I proceed with advice for the correct follow up?

Kindest regards,

Sarah

Hi Sarah, Sorry its been a while getting back to you but have been very busy at work. Its Rosacea I have.

[Sarah Buchan]

Hi Belinda,

it's great to hear from you again, thank you for confirming these details.

The overall cause of rosacea remains unknown however there are several commonly known trigger factors which I have detailed below:
- sunlight - hot drinks - spicy foods
- stress - humidity - menopause
- hot / cold weather - caffeine - dairy products
- strong winds - alcohol - other medical conditions
- strenuous exercise - hot baths - certain medicines (e.g. amiodarone, corticosteroids, high dose vit B)

Most patients require a combination of self-help measures and medication to control their symptoms.

Some self-help measures which may be useful for you are:

1) avoid trigger factors - e.g. wear sun screen
2) take good care of your skin - e.g. use products suitable for sensitive skin
3) use a camouflage make-up
4) keep eye-lids clean if causing inflammation of the eye-lids

Treatment for papules and pistules usually begins with a topical antibacterial such as metronidazole or azelaic acid. These may be applied for several weeks before you notice a significant improvement. If the symptoms are more severe, your GP or dermatologist may wish to prescribe an oral antibiotic for 4-6 weeks use.

Treatment for facial redness again may be administered topically using brimonidine gel once daily. An oral medication may be given in more severe symptoms to reduce the dilation of blood vessels.

I would recommend that you make an appointment to discuss your treatment options with your GP or dermatologist. Together you may be able to agree an appropriate regime which will aid your symptoms. Please do also consider the trigger factors and which ones may apply to you and therefore should be avoided.

All the best,

Sarah