Treatments available for rosacea

DEAR DOCTOR K: I read your column on adult acne with great interest. For years, I thought I had adult acne, but when I finally saw a doctor, she diagnosed me with rosacea. I’d like to learn more about this condition.

DEAR READER: Rosacea is a long-lasting skin condition that causes inflammation and redness of the face.

Rosacea tends to begin in adults over the age of 30, although it can affect younger adults and kids.

Rosacea usually affects fair-skinned people. It is progressive. Most often it affects the cheeks and nose. It starts with redness that looks like sunburn or blush. At first, the redness is intermittent. Gradually, it becomes more noticeable and doesn’t go away. It spreads to other areas of the face.

Doctors are not sure what causes rosacea, but one theory is supported by scientific studies. Certain bacteria that live on the skin seem to trigger an unusual immune response in some people. Immune system cells release chemicals to help attack the bacteria. Unfortunately, the chemical attack also causes collateral damage that causes the skin to redden and get bumpy.

Eventually, thin red lines appear on the face, especially on the cheeks. Left untreated, rosacea can create small, knobby bumps on the nose.

Fortunately, once rosacea is correctly diagnosed, it is very treatable. Depending on your symptoms, your doctor may prescribe:

• Antibiotics. Metronidazole cream or gel (MetroCream, MetroGel) is the most frequently prescribed therapy. Prescription antibiotics, taken by mouth, are also an option.

• Azelaic Acid (Finacea). This drug, which you apply to your skin, is used for the inflammatory pimples of mild to moderate rosacea.

• Estrogen. This female hormone is used when rosacea is aggravated by the hot flashes of menopause.

You can’t prevent rosacea, but you can control symptoms, which are often triggered by things that make your face flush. Once you identify your particular triggers, you can modify or avoid them. Common triggers include hot drinks, alcohol, spicy foods, stress, sunlight and extreme heat or cold.

Also, use sunscreens and sun blockers regularly and liberally to protect your face.