- More common in fair skinned, 30-60 age group.
- Aggravating factors include topical steroids and other creams, spicy foods, hot drinks, alcohol, UV light and wind.
- Possible but, as yet, unproven connections with demodex species (mites) or Helicobacter pylori.
- Long-standing history of facial flushing, often with burning or stinging.
- Papulopustular rosacea - redness of central part of face with small erythematous papules and pustules.
- Phymatous rosacea - skin thickening and irregular nodularities of the nose, chin, forehead and eyelids.
- Ocular rosacea - may precede skin changes. Gritty feeling in the eye, blepharitis, conjunctivitis and conjunctival telangiectasis.
- Avoid trigger factors. Regular use of sunscreen. Green tinted cosmetic helps mask erythema.
- Papulopustular rosacea - antibiotics (tetracycline or erythromycin) for six to 12 weeks. Topical metronidazole gel. Isotretinoin in severe, persistent cases. Anti-inflammatory drugs such as diclofenac. Antiflushing medication such as clonidine.
- Phymatous rosacea - topical isotretinoin. Surgical correction.
- Ocular rosacea - lid hygiene, artificial tears, tetracycline or erythromycin, metronidazole.
- Inflammatory reaction related to excess proliferation of the normally present yeast, Malassazia.
- Develops after puberty - may be very persistent.
- The immunosupressed and those with Parkinson's or stroke are particularly prone.
- Ill-defined pink rash with yellowish scaling.
- Commonly affects the naso-labial folds, eyebrows, eyelids and behind the ears.
- Often spreads to the scalp (dandruff).
- Patch of similar rash often seen over sternum or upper back.
- Sometimes affects axilla and inguinal region.
- Sometimes itchy.
- Antifungal agents, such as topical ketoconazole. Systemic if severe or poor response.
- Mild topical steroids helpful in acute flares but recurrences likely on discontinuing. Rebound effect leads to dependence.
- Antifungal shampoos.
- Shampoos containing salicylic acid and coal tar help to soften thick plaques.
- Topical metronidazole gel useful on the face.
- Blepharitis - use baby shampoo.