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acne rosacea

Introduction

chronic inflammatory red rash mainly involves the central face in 30-80 yr olds but can arise in younger patients
10% of population develop rosacea and of these, 60% develop ocular rosacea
characterised by erythema, flushing, +/- papules but no blackheads
may be transient, recurrent or persistent
4 main sub types:
- Erythematotelangiectatic Rosacea (facial flushing)
- Papulopustular Rosacea (papules and pustules)
- Phymatous Rosacea (enlarged nose leading to rhinophyma)
- Ocular Rosacea (inflamed eyes) - see blepharitis / dry eyes

in women, it seems that drinking white wine or liquor may trigger onset of it while drinking red wine can trigger flare ups but not trigger onset ¹⁾:
- 1-3 glasses white wine / month = 14% risk of developing rosacea
- >5 glasses white wine / wk = 49% risk of developing rosacea
- liquor = 8-28% risk of developing rosacea

avoid all UV light
avoid heat and other causes of vasodilatation such as exercise, alcohol, spicy foods, etc
avoid oil-based creams
avoid topical steroids
inflammatory lesions may be Rx with low dose tetracycline antibiotics, or long term low dose isotretinoin (Roaccutane)
troublesome flushing may be helped by clonidine (Catapres) or beta adrenergic blockers
ocular rosacea is generally treated with oral antibiotics to prevent serious ocular complications:
- eg. oral azithromycin 1 g each week for 3 weeks every 3-4 months

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