Rosacea

by | May 10, 2013 | Comorbidity

What is Rosacea?

Rosacea is a skin disorder causing redness, irritation, and sometimes, bumpy skin and acne-like breakouts.

Rosacea usually shows up between the ages of 30 and 50 or so. It occurs more commonly in women than in men, although affected men are more likely to experience more severe rosacea. Rosacea is also more common in the fair-skinned, especially those with Celtic or Scandinavian heritage.

The cause of rosacea is not known, but it is suspected to be due to a combination of genetics and environmental factors. In one study, 52% of rosacea sufferers had a family history of at least one family member with rosacea. People with rosacea are more likely to be infected with H. pylori (the bacteria causing ulcers). Those with the acne rosacea form of the disorder have been found to be more likely to react to Bacillus oleronius, which in turn causes overreaction of the immune system.

The Migraine-Rosacea Connection

A connection between migraine and rosacea was noted in 1976 by Tan and Cunliffe. In their study of 137 patients and 161 controls, 44% of the rosacea patients had suffered from migraine, as compared to 13% of the control group. Another Swedish study in 1996 with 809 subjects with rosacea found an overall rate of migraine of 14% as compared to 13% in the control group. However, they found a 27% rate of migraine in rosacea patients between the ages of 50 and 60, and proposed the possibility that hormonal changes were affecting both conditions.

Types of Rosacea

According to the American Academy of Dermatology, there are four types of rosacea:

  1. Erythematotelangiectatic rosacea – with symptoms of redness, flushing, and visible blood vessels
  2. Papulopustular rosacea, or rosacea acne – with symptoms of redness, swelling, and acne-like breakouts.
  3. Phymatous – with symptoms of skin thickness and a bumpy skin tecture.
  4. Ocular rosacea – with symptoms of red and irritated eyes, swollen eyelids, redness at base of eyelashes.

About half of rosacea sufferers indicate that their symptoms come and go.

Rosacea Triggers

Like migraine, rosacea has a variety of triggers. Some of the triggers between the two conditions overlap, although they are not identical. And also like migraine, not everyone has the same triggers.

The following are typical rosacea triggers:

  • Hot beverages
  • Alcohol
  • Spicy foods
  • A hot bath
  • Stress
  • Sun exposure – especially UVA
  • Exposure to cold or humid weather
  • Exposure to heat
  • Exercise
  • Topical creams or make-up

Treatment of Rosacea

The first step in the treatment of rosacea is trigger identification and lifestyle modification. In many cases, this is not sufficient, although it can be helpful. Skincare should include sunscreen, moisturizer, especially in cold weather, and avoidance of sunlight during midday. Many skin products or treatments can aggravate rosacea.

Medical treatment of rosacea can involve topical medications, short courses of antibiotics, and laser treatment.

It is important to see a dermatologist if you think you have rosacea, as the treatment will vary based on the rosacea type.

If you think you might have rosacea, here is a helpful rosacea quiz:

References:

1. Berg M, Liden S: Postmenopausal female rosacea patients are more disposed to react with migraine. Dermatology. 1996;193:73-74.

2. Tan SG, Cunliffe WJ. Rosacea and migraine. Br Med J. 1976;1(6000):21-21.
3. Wilkin JK. Flushing reactions: consequences and mechanisms. Ann. Intern. Med. 1981;95(4):468-476.
4. Spoendlin, Julia, Johannes J. Voegel, Susan S. Jick, and Christoph R. Meier.
Migraine, Triptans, and the Risk of Developing Rosacea: A Population-based Study Within the United Kingdom. Journal of the American Academy of Dermatology. http://www.jaad.org/article/S0190-9622(13)00308-3/abstract, accessed May 10, 2013.

 

Updated 5/10/2013