Q. What causes rosacea?
A. Although the exact cause of rosacea is unknown, various theories about the disorder's origin have evolved over the years. Facial blood vessels may dilate too easily, and the increased blood near the skin surface makes the skin appear red and flushed. Various lifestyle and environmental factors -- called triggers -- can increase this redness response. Acne-like bumps may appear, often in the redder area of the central face. This may be due to factors related to blood flow, skin bacteria, microscopic skin mites (Demodex), irritation of follicles, sun damage of the connective tissue under the skin, an abnormal immune or inflammatory response, or psychological factors.
None of these possibilities has been proven, although potential inflammatory pathways have been identified in recent ongoing research -- including an immune response triggered by a type of antimicrobial protein known as cathelicidin. A recent study also found that certain bacteria present on otherwise harmless Demodex mites could prompt an inflammatory response in rosacea patients.
Q. Is rosacea contagious?
A. No. Rosacea is not considered an infectious disease, and there is no evidence that it can be spread by contact with the skin or through inhaling airborne bacteria. The effectiveness of antibiotics against rosacea symptoms is widely believed to be due to their anti-inflammatory effect, rather than their ability to destroy bacteria.
Q. Is rosacea hereditary?
A. Although no scientific research has been performed on rosacea and heredity, there is evidence that suggests rosacea may be inherited. Nearly 40 percent of rosacea patients surveyed by the National Rosacea Society said they could name a relative who had similar symptoms.
In addition, there are strong signs that ethnicity is a factor in one's potential to develop rosacea. In a separate survey by the Society, 33 percent of respondents reported having at least one parent of Irish heritage, and 26 percent had a parent of English descent. Other ethnic groups with elevated rates of rosacea, compared with the U.S. population as a whole, included individuals of Scandinavian, Scottish, Welsh or eastern European descent.
Q. Can rosacea be diagnosed before you have a major flare-up
A. It is sometimes possible to identify "prerosacea" in teenagers and persons in their early 20s. These individuals generally come to the dermatologist for acne treatment and exhibit flushing and blushing episodes that last longer than normal. The prolonged redness usually appears over the cheeks, chin, nose or forehead. These patients also may find topical acne medications or certain skin-care products irritating.
Once identified, these rosacea-prone individuals can be counseled to avoid aggravating lifestyle and environmental factors known to cause repeated flushing reactions that may lead to full-blown rosacea. If you recognize the symptoms of prerosacea in a younger family member or others, they might be advised to consult a dermatologist.
Q. Is there any kind of test that will tell you if you have rosacea?
A. There are no histological, serological or other diagnostic tests for rosacea. A diagnosis of rosacea must come from your physician after a thorough examination of your signs and symptoms and a medical history. During your exam you should explain any problems you are having with your face, such as redness; flushing; the appearance of bumps or pimples; swelling; burning, itching or stinging; or other information.
Q. Will my rosacea get worse with age?
A. There is no way to predict for certain how an individual's rosacea will progress, although physicians have observed that the signs and symptoms tend to become increasingly severe without treatment. Moreover, in a National Rosacea Society survey, about half of rosacea sufferers said without treatment their condition had advanced from early to middle stage within a year. Fortunately, compliance with medical therapy and lifestyle modifications to avoid rosacea triggers has been shown to effectively control its signs and symptoms on a long-term basis.
Q. How long does rosacea last?
A. Rosacea is a chronic disorder, rather than a short-term condition, and is often characterized by relapses and remissions. A retrospective study of 48 previously diagnosed rosacea patients found that 52 percent still had active rosacea, with an average ongoing duration of 13 years. The remaining 48 percent had cleared, and the average duration of their rosacea had been nine years. While at present there is no cure for rosacea, its symptoms can usually be controlled with medical therapy and lifestyle modifications. Moreover, studies have shown that rosacea patients who continue therapy for the long term are less likely to experience a recurrence of symptoms.
Q. How can I find a rosacea specialist?
A. As with most disorders, there is no formal medical specialty devoted to rosacea alone. The appropriate specialist for rosacea is a dermatologist, who specializes in diseases of the skin, or for those with eye symptoms, an ophthalmologist.
Q. Can rosacea occur in children?
A. Although the incidence of rosacea in adolescents and children is infrequent, such cases have been documented in the medical literature. Eyelid styes may be one form. Rosacea often runs in families, and rosacea sufferers would be wise to be on the lookout for early signs in children in order to seek diagnosis and treatment before the condition worsens.
Q. Are there support groups for rosacea sufferers?
A. The National Rosacea Society is the world's largest support organization for rosacea, offering information and educational services to hundreds of thousands of rosacea patients and health professionals each year.
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