Rosacea
Rosacea is a persistent skin disorder that produces redness, tiny pimples, and noticeable blood vessels, usually on the central area of the face.
The cause of rosacea is not known. The disorder usually appears during or after middle age and is most common in people of Celtic or Northern European descent who have fair complexions. Alcoholics tend to develop rosacea. Although usually easy for doctors to recognize, rosacea sometimes looks like acne and certain other skin disorders. It is often called "adult acne."
The skin over the cheeks and nose becomes red, often with small pimples. The skin may appear thin and frail, with small blood vessels visible just below the surface. The skin around the nose may thicken, making it look red and bulbous (rhinophyma), which is particularly common in alcoholics. Occasionally, rosacea appears on the torso, arms, and legs rather than on the face.
Treatment
People with rosacea should avoid foods that cause the blood vessels in the skin to dilate--for example, spicy foods, alcohol, coffee, and other caffeinated beverages.
Certain antibiotics taken by mouth relieve rosacea; tetracyclines are usually most effective and produce the fewest side effects. Antibiotics that are applied to the skin, such as metronidazole, clindamycin, and erythromycin, are also effective. In rare cases, antifungal creams, such as ketoconazole or terbinafine cream, are used.
Isotretinoin is effective when taken by mouth or when applied to the skin. Corticosteroids applied to the skin tend to make rosacea worse. Severe rhinophyma is unlikely to improve completely with drugs; a person with this disorder may need surgery or laser treatment (see Section 18, Chapter 215).
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