American Osteopathic Association

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An Unwanted Rosy Complexion: Rosacea

Woman with rosy cheeksFourteen million Americans between the ages of 30 and 60 struggle with a skin disease that resembles teenage acne. Although these men and women are not experiencing the hormone changes that cause acne during the adolescent years, they suffer from an inflammatory skin disease that causes small, red bumps—rosacea.

"Rosacea is more common in women, but men frequently display more severe signs of the disorder,” explains Coyle Connolly , DO, a board certified osteopathic dermatologist in Linwood, New Jersey. “While it isn’t life-threatening, it certainly affects patients’ appearance and self-esteem.” 

Further, Dr. Connolly explains that rosacea will recur and worsen over time without treatment. “Patients experience a break-out for weeks or months and then the symptoms subside for a while before they flare up again,” he explains.


Dr. Connolly says that symptoms of rosacea appear in three phases. The first stage is diagnosed in patients that flush or blush easily and eventually sustain redness in the center of the face. The second phase, vascular rosacea, occurs over time or with sun exposure. Tiny spider veins appear on the face. Finally, inflammatory rosacea is the stage of the disease that involves the spreading or break-out of red bumps or lesions across the face. 

While most people know that rosacea is a skin condition, few know that the disease can spread to their eyes. Ocular rosacea affects more than 50% of the people suffering from rosacea. This type of rosacea can result in a burning or gritty sensation in the eyes. Ocular rosacea can also cause the skin on the inside of the eyelids to appear inflamed or scaly. “Patients frequently notice an increase in the flaky, eye product that most refer to as ‘sleepy eyes’, with ocular rosacea,” explains Dr. Connolly. 

Treatment Options

While treatment exists for the different symptoms of rosacea, the cause is still unknown. “Treatment varies depending upon the stage and severity of the condition,” explains Dr. Connolly. “But most treatment plans include taking prescription medications and using products designed for sensitive skin.” Antibiotic gel or lotion is prescribed to reduce inflammation. Oral antibiotics may also be prescribed at the beginning of treatment to jump-start recovery, as they absorb into the bloodstream faster than gels or lotions. In select cases, electrosurgery, the use of a high-frequency electric needle with heat, might be used to treat the affected area. However, Dr. Connolly says that it is much more common to diminish the appearance of broken blood vessels and redness with a laser. 

Dr. Connolly explains that most rosacea patients tend to have sensitive skin. So, he recommends speaking with your family physician or dermatologist about non-soap cleansers and makeup that works best for your skin. Another important issue to discuss is sun protection. Protection from the sun should include a broad-brimmed hat; broad-spectrum sunscreen that blocks both UVA and UVB light; and sunglasses with 100% UV protection even during the winter months.

Rosacea Triggers

In addition to sunlight, Dr. Connolly explains that patients should minimize exposure to any item or activity that might aggravate the disease. While sunlight is a trigger for all patients, other triggers can vary depending upon the individual. Some common triggers include:

  • Extreme hot or cold temperatures;

  • Stress;

  • Exercise and other activities that induce stress, anger or embarrassment;

  • Steam from hot baths or saunas;

  • Hot or spicy foods and beverages;

  • Any medications that dilate blood vessels, including some blood pressure medications; and

  • Alcohol.

“Remember, the symptoms of rosacea are treatable but without treatment the disease will only get worse,” explains Dr. Connolly. “So, if you or someone you know is experiencing the symptoms of rosacea, visit your family physician or dermatologist.

If you don't have a physician, consider finding a Doctor of Osteopathic Medicine. Using a whole-person approach to care, Doctors of Osteopathic Medicine, or DOs, look beyond your symptoms to assess the impact of environmental and lifestyle factors on your health. They are trained to listen and partner with their patients to address their health care needs.


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