What do Bill Clinton, Renee Zellweger and William Shatner all have in common? They each have rosacea, a skin disease which causes reddening on the face, according to a rosacea Web site.
One famous individual, W.C. Fields, is the poster person for one of the more severe forms of rosacea known as rhinophyma. Estimates are that 14 million of us experience rosacea in the U.S. each year. The majority don't recognize it as a treatable condition.
As with many diseases, rosacea has a spectrum of severity. The mildest cases are manifested by blushing and redness of the face triggered by sun, stress, alcohol and other influences.
In those with rosacea, this may progress to more permanent red markings, either acne-like spots on the face and nose, or prominent blood vessels (spider veins). In some cases, this leads to thickening of the skin, forming a prominent bulbous nose like actors W.C. Fields and Karl Malden.
Rosacea may also be present with symptoms related to the eyelids or the eyes themselves. Redness, irritation and symptoms like conjunctivitis may herald the onset of rosacea. Of course, this usually is persistent or recurrent, in contrast with a single episode of viral conjunctivitis.
Fortunately there is treatment available for this disease. The foundation of treatment is identification and avoidance of triggers. Avoiding excessive sun, spicy food and or hot environments may reduce symptoms and slow progression of the disease. Often skin products that are harsh or drying can trigger symptoms, so avoid alcohol-based or abrasive products.
Medical treatment usually includes oral or topical antibiotics. While oral treatment is generally more effective, side effects such as yeast infections or GI upset may limit its usefulness. As soon as rosacea is under control, it is important to taper to the lowest effective dose or switch to a topical antibiotic. This serves to minimize the risk of side effects.
In severe cases of rosacea or rhinophyma, surgery or laser therapy may be performed to reduce evidence of the disease. Cosmetics that mask the redness often provide adequate coverage.
It's important to note that rosacea is not caused by a hygiene issue or alcohol abuse. Indeed, overzealous washing of the skin may actually trigger the rosacea flare. And while drinking alcohol may cause a flare of rosacea, the vast majority of people with visible rosacea do not have an alcohol problem.
Potential triggers fall into several general categories: heat and cold, foods and alcohol, and things that stress the skin directly. Examples of the latter category include sun exposure, skin products, scrubbing the skin and life stress.
Foods and alcohol include different items for different people. For some, it's spicy foods, yet for others certain fruits or vegetables may trigger the redness. Avoiding heat and cold stress is harder than you may think - even hot beverages, hot weather, a hot shower or heat from exercise may trigger a reaction. Cold weather and wind can cause it as well.
Because there is such variability in what triggers the symptoms in any individual, it is wise to record a "rosacea diary," available from the National Rosacea Society. This helpful tool lists the most common triggers and allows you to evaluate your symptoms after exposure to a trigger.
If you find your rosacea is improving the more you avoid an item or activity, it's a safe bet that it is a trigger for you.
Bottom line with rosacea is that it is important to recognize the disease early. Avoidance of triggers and early medical treatment can reduce the impact of symptoms in the future.
