Welcome to WordPress. This is your first post. Edit or delete it, then start writing!
From early teenage years and onward, many people struggle with the blemishes and inflammations we call acne. Most annoying of all are those unsightly little dark bumps on your nose – blackheads!
But just what are blackheads? How can you get rid of them, or prevent them in the first place? To learn everything you need to know about blackheads, read on!
What Are Blackheads?
Blackheads are a mild kind of acne that can appear on any part of your body, though it is most commonly discovered on the face. Blackheads take the form of tiny dark bumps on your skin, and occur when pores become clogged with sebum and other kinds of debris. Blackheads are not a sign that your skin is too dirty, or that you are doing something “wrong” – they happen to almost everyone and can be treated at home!
Your skin is full of pores, known by doctors as “pilosebaceous units.” Each of these pores has a hair follicle and an oil gland, also called a sebaceous gland, inside. The sebaceous gland creates a substance called sebum, which is an oily liquid that your body uses to keep your skin soft and well hydrated. However, if the body produces too much sebum, the top of the pore may become plugged. As the sebum builds up in this plugged pore, it collects dead skin cells and bacteria, forming a comedone. When the comedone is open to the air, rather than covered up by the skin, it forms a blackhead. A covered-up comedone is what we know of as a pimple. Because the blackhead is open to the air, it causes less inflammation and usually less pain than pimples do.
Though sebum is white, the blackhead comedone can appear in a variety of colors, such as yellow, brown, gray, and – as you would expect from the name “blackhead” – black. Though some believe that the colors appear because dirt is present in the pore, the colorization is actually because of oxidation. Sebum contains melanin pigment – the substance that determines the color of your skin. When melanin makes contact with the air, such as in this open comedone, it oxidizes, turning a dark color. Less-oxidized melanin pigment can appear closer to yellow than black in color.
Blackheads tend to vary in size, location, and number. How many comedones are present on your skin can indicate the level of severity in your acne. Though scales vary, most dermatologists agree that mild acne is a case of less than twenty visible comedones at once; moderate acne involves between twenty and one hundred comedones at once; and people with severe acne have more than one hundred comedones at once.
Should You Squeeze Blackheads?
It can be incredibly tempting to squeeze and pop the blackheads on your skin with your fingers. However, most dermatologists do not recommend that you squeeze your blackheads, because squeezing can cause a variety of additional skin issues. Because blackheads are difficult to remove, for all your squeezing and prodding, you might not actually be able to get it out – and instead end up irritating the skin. Bacteria on your fingers can then get inside the blackhead, creating cysts or nodules that only make the blackhead worse. When you squeeze a blackhead, you also run the risk of stretching out your pores, leaving them permanently enlarged. You may also accidentally force the infected material deeper into your skin, creating more blackheads and causing scarring. Though the blackhead is temporary, the scars and marks left from squeezing it might not be!
Blackheads vs. Sebaceous Filaments
One dark spot on your skin can look very similar to another, and so it is very easy to mistake a sebaceous filament for a blackhead. It’s important to note the differences between the two, because how you treat a blackhead is different from how you treat a sebaceous filament!
Sebaceous filaments, also sometimes simply referred to as “clogged pores” by dermatologists, may look like blackheads and may also appear on the nose, but they are not a kind of acne. Sebaceous filaments appear when the oil that lines the hair follicle in a pore causes the pore to appear larger. Nothing has actually “plugged up” this pore like a blackhead is plugged by oil and bacteria; if you were to use a pore strip on a sebaceous filament, it would not pull out any gunk like it would for a blackhead.
The size of your pores is primarily determined by your genetics, so sebaceous filaments just plain are the way they are. They will neither shrink with time nor pop if squeezed, but you also do not have to worry about them becoming infected, as long as you do not scratch at them. However, if you do want to get rid of your clogged pores, you can lessen their appearance by controlling the buildup of oil in your skin. Over-the-counter salicylic acid and glycolic acid products, found in gel, pad, or scrub form, can help you reduce your oil buildup. The pore will fill up again as your body creates necessary oils, but its appearance can be managed!
Methods for Removing Blackheads
Blackheads occur when your body produces an excess of body oils, collecting bacteria and dead skin cells – and they only get worse during hormonal changes, such as during menstruation and the teenage years, which cause an increase in sebum production. Cures for blackheads tackle these factors, keeping away oils, bacteria, and dead skin cells.
Home Remedies for Blackheads
Several methods for removing and keeping away blackheads can be easily and cost-effectively applied at home!
Apple Cider Vinegar
Apple cider vinegar is a kind of vinegar made by fermenting the juice from pressed apples. This vinegar is known for its ability to fight a wide variety of bacteria and viruses, including the bacteria commonly found in blackheads. Apple cider vinegar is also known to suppress inflammation, consequently preventing the appearance of acne scars! Mix one part apple cider vinegar with three parts water – too much vinegar can cause burns on your skin, so the water is a necessary diluting factor. Once or twice per day, apply this mixture to your clean skin with a cotton ball. Let it sit for between five and twenty seconds, and then rinse your face with water and pat your skin dry.
Several vitamins and nutrients that can be easily bought over-the-counter at a pharmacy are also natural treatments for acne. Zinc is one such nutrient, which has vital functions in hormone production, cell growth, and immune system processes. Studies have shown that people with acne tend to have lower zinc levels in their blood than people with clearer skin do. Taking a daily zinc supplement can decrease the appearance of blackheads! Be sure to take no more than 40 mg. of zinc per day; too much zinc may cause stomach pain.
Honey and Cinnamon Mask
Honey and cinnamon both contain antioxidants, which are known to reduce blackheads because of their antibacterial qualities. Mix two tablespoons of honey and one teaspoon of cinnamon together to form a paste for a mask. Clean your skin, and then apply the mask to your face. Leave the honey and cinnamon mask on your skin for ten to fifteen minutes before rinsing it off and patting your face dry.
Exfoliate with a Sugar Scrub
Because blackheads involve dead skin cells getting caught in excess sebum, removing extra dead skin cells can both remove blackheads and keep them from appearing as often in the future. Exfoliation is a method of removing the layer of dead skin cells on top of your skin. One way to exfoliate is by applying a sugar scrub. Mix equal parts of sugar and coconut oil to create the scrub. Then rub your skin with the mixture, and, afterwards, rinse your skin well with water. Exfoliate once per day for the best results!
Other Useful Treatments
If the home remedies aren’t working for you, there are other ways to tackle blackheads, with the help of a dermatologist.
Though it isn’t a good idea to try to remove a blackhead with your fingers, dermatologists have a special tool called a round loop extractor, which they can use to remove blackheads. The dermatologist can safely push out the contents of the comedone without damaging the surrounding skin cells.
Another option is to use laser therapy, which includes a light that reaches deep into the surface of the skin and kill blackhead-causing bacteria. Laser therapy requires multiple sessions and can be expensive, but it may be a good idea for severe cases of acne.
For a deeper level of exfoliation, you can use chemical peels – either a mild, over-the-counter kind, or a stronger kind provided by dermatologists. These peels involve powerful chemical solutions that strip the top layers of skin from your body, revealing the smoother skin cells underneath and removing blackheads in the process.
Now you not only know what blackheads are and why they occur, but you also have a variety of options for taking charge of your skincare!
We all know by now that CBD oils can be used to treat many conditions. They have been helping people combat anxiety, depression, and different neurological conditions for years now. However, can we use CBD oil to treat skin conditions?
New studies suggest that it can not only cure acne, but it can also prevent them from appearing in the first place. As someone who has been struggling with acne for a long time, I wanted to see for myself. So, let’s see if using CBD oil for acne can actually make a difference.
What Is CBD Oil?
Cannabidiol (CBD) comes from the cannabis sativa plant. It doesn’t have any psychoactive properties and it is a non-addictive substance. CBD comes in many forms — we can buy oils, tinctures, food supplements, capsules, edibles, and pomades. Doctors have been prescribing CBD to treat:
- Depression and anxiety
- Chronic pain
The most common side effect of CBD is drowsiness. Also, in some rare cases, if it’s not used properly, it can cause nausea. Now, let’s see how CBD can help with acne.
What Causes Acne?
If you’ve been dealing with acne for a long time, you probably know the answer to this question already; however, let’s do a quick recap one more time. Our bodies create sebum, which is a waxy or oily substance that helps protect our body and face from harsh environmental factors. In some cases, when sebum gets mixed in with dirt or oils, it can get trapped under the pores. These clogged pores then turn into acne.
Furthermore, there are many genetic, environmental, and hormonal factors which cause acne to flare up. The severity of our acne condition can also depend on our diet, different medication, and stress levels.
How Can CBD Oils Help with Acne?
A study from 2014 shows that CBD oils can help reduce the production of sebocytes, which are the cells that create sebum. By decreasing the sebocyte production, CBD can help keep our sebum levels in check.
Also, CBD oils have anti-inflammatory properties. These properties can help reduce the production of cytokines. These proteins can sometimes cause inflammation. Finally, the oils can help fight off bacteria and fungi. If we’re able to prevent dirt from mixing in with the sebum — we might be able to prevent our pores from clogging.
While all of these studies sound promising, there still haven’t been enough human trials to make a proper decision. While doctors might not start prescribing CBD oil for acne just yet, we have faith they will start in the near future. If you decide that you want to try CBD to keep you acne at bay, while we aren’t doctors – just dermatologists – the only piece of advice we can give is to use a reputable CBD oil source, like Royal CBD.
How to Use CBD Oil for Acne
First, we’re going to need some sort of carrier oil to dilute the CBD. Since CBD oil is so concentrated, it might do more harm than good if we apply it directly to the skin. Carrier oils include:
- Olive oil
- Coconut oil
- Argan oil
- Jojoba oil
- Shea butter
There are some benefits to taking CBD orally; however, research shows that it is much more effective if we apply it topically. Nowadays, there are numerous companies online which sell CBD oil.
However, we recommend checking with your doctor first and doing proper research before buying anything online. Only by doing thorough research can we be sure that what we’re buying is actually skin-safe.
Some people have been blessed with a flawless complexion, others experience occasional breakouts, and some fight a never-ending battle with their skin. Still, all of us, whether we like to admit it or not, are a bit self-conscious when it comes to our skin.
And that isn’t surprising at all!
Truth be told, our skin is the first thing someone notices about us. Plus, not only is it our biggest organ, but it is also a very important one — both health- and appearance-wise. Therefore, it is no wonder that many of us pay so much attention to it.
What’s more, those who have suffered from acne know how persistent, tiring, and challenging the problem can be. Also, when our skin doesn’t look good and we realize that we have no control over it, we will start to feel frustrated sooner or later.
Luckily, there are countless acne treatments available on the market nowadays. Some include over-the-counter medication, others are prescribed by doctors, etc. Moreover, procedures such as microdermabrasion for acne have become increasingly popular in recent years.
If you want to learn why microdermabrasion is the right treatment for acne, keep reading. We will explain everything in detail.
What Is Microdermabrasion?
Microdermabrasion is a non-invasive, non-chemical procedure that combines suction with exfoliation from tiny crystals to remove impurities and dead cells from the skin. By removing the outermost layer of dead and dry skin cells, it reveals a brighter, younger, healthier-looking, and clearer complexion.
Microdermabrasion for acne can be an effective treatment depending on how serious the condition is. When it comes to mild acne, acne scars, as well as non-active acne areas, the treatment can be very beneficial. However, it isn’t recommended for active acne because it could help spread the infection.
Also, this procedure is suitable for all skin types and colors. Plus, since it takes little time and we needn’t prepare for it, many people refer to microdermabrasion as a “lunch break procedure”.
The treatment itself isn’t painful — we can expect minimal discomfort. Finally, it’s important to note that there is no downtime whatsoever; we can return to normal activities right after the procedure.
Microdermabrasion for Acne — Benefits
There are many different types of acne, as well as many different treatment options. When it comes to microdermabrasion for acne, we are glad to say that various types of acne patients can benefit from the procedure.
It doesn’t matter if we are prone to blackheads, whiteheads, inflamed pimples, or deep cystic acne. Since it provides multiple benefits, microdermabrasion can help different types of acne.
Also, the treatment is safe for most acne-prone areas, which is incredible news. That means that, apart from the face, we can also treat our back, neck, and chest areas.
If you are suffering from acne, there is no need to feel desperate; in fact, we have encouraging news for you. Microdermabrasion can help unclog your pores and thus clear your acne. Dermatologists often combine the procedure with medical acne extractions and gentle glycolic peels, which speeds up the acne clearing process.
However, note that microdermabrasion shouldn’t be used on areas with active acne. That could result in bursting of inflamed acne and spreading the infection across your entire face.
When it comes to blackheads, microdermabrasion is a particularly effective treatment. By exfoliating the skin, it removes the top of the blackhead. At the same time, the suction eliminates the hardened oily contents, thus clearing the skin and leaving the pores clean.
Also, once we get rid of blackheads, we should continue to occasionally use microdermabrasion. That will prevent blackheads from developing all over again.
Mild Acne Discoloration and Pick Marks
Those who have had acne know how hard it is not to touch them. All of us have picked at our skin at least a few times. When a big blackhead or an inflamed pimple appear in the middle of our face, that is sometimes impossible to ignore. In fact, even when we know that we will end up with nasty marks and scars, we often can’t help ourselves.
Luckily, microdermabrasion can help us get rid of mild acne discoloration and pick marks. By gently exfoliating the top layer of our skin, getting rid of dry and dead skin cells in the process, it will reveal a brighter, younger, and healthier skin layer. That will result in a more even, mark-free complexion.
Superficial Acne Scars
When it comes to acne scars, microdermabrasion can also be beneficial. However, those with deep scars should know that this procedure is best suited for very superficial acne scars. So if you have deep scars, you will need a much longer series of treatments to notice an improvement.
However, if your acne scars are superficial or raised, you can expect microdermabrasion to solve the issue by gently exfoliating your skin, leaving it bright and healthy-looking.
Better Product Results
Apart from unclogging the pores and exfoliating the skin, microdermabrasion also increases skin circulation. By doing that, the procedure can improve the results of topical products that we apply to our skin. Once the circulation starts to increase, cell metabolism is on the rise as well; that means that our acne products can penetrate deeper into our skin, achieving better results.
Is Microdermabrasion for Acne Safe?
We are happy to say that microdermabrasion for acne is, in fact, much safer than many other acne procedures. For example, laser skin procedures and chemical peels carry more risks.
Also, as we already mentioned, microdermabrasion requires no downtime whatsoever. You can expect slight redness or some tightness right after the treatment, but nothing more serious. Plus, those side effects will most likely subside a couple of hours after the procedure.
We do have to note that, since your skin will be more sensitive to the sun right after the procedure, sun exposure is to be avoided. By staying away from the sun, you will protect your skin from potential burns.
How Many Treatments Do You Need?
One of the most common questions we get is how often do I need microdermabrasion? Anyone who has ever suffered from acne knows that the condition differs from one person to another. In fact, there are no two same acne patients. Therefore, it is hard to say how many treatments one is going to need. That can depend on the type of acne, as well as on the area you want to treat.
Those who want to get rid of blackheads can notice the results right after the first treatment. However, if you want to clear existing acne or focus on acne scars/marks, you should be patient; a few sessions will be needed until you start to notice an improvement.
Audio Version of this Document | Time: 08:14 | Size: 7.7 MB
What Is Acne?
Fast Facts: An Easy-to-Read Series of Publications for the Public
Acne is a disease that affects the skin’s oil glands. The small holes in your skin (pores) connect to oil glands under the skin. These glands make an oily substance called sebum. The pores connect to the glands by a canal called a follicle. Inside the follicles, oil carries dead skin cells to the surface of the skin. A thin hair also grows through the follicle and out to the skin. When the follicle of a skin gland clogs up, a pimple grows.
Most pimples are found on the face, neck, back, chest, and shoulders. Acne is not a serious health threat but, it can cause scars.
How Does Acne Develop?
Who Gets Acne?
What Causes Acne?
How Is Acne Treated?
How Should People With Acne Care for Their Skin?
What Things Can Make Acne Worse?
What Are Some Myths About the Causes of Acne?
What Research Is Being Done on Acne?
- Whiteheads. These are pimples that stay under the surface of the skin.
- Blackheads. These pimples rise to the skin’s surface and look black. The black color is not from dirt.
- Papules. These are small pink bumps that can be tender.
- Pustules. These pimples are red at the bottom and have pus on top.
- Nodules. These are large, painful, solid pimples that are deep in the skin.
- Cysts. These deep, painful, pus-filled pimples can cause scars.
Acne is the most common skin disease. People of all races and ages get acne. But it is most common in teenagers and young adults. An estimated 80 percent of all people between the ages of 11 and 30 have acne outbreaks at some point. Some people in their forties and fifties still get acne.
- The hormone increase in teenage years (this can cause the oil glands to plug up more often)
- Hormone changes during pregnancy
- Starting or stopping birth control pills
- Heredity (if your parents had acne, you might get it, too)
- Some types of medicine
- Greasy makeup.
- Heal pimples
- Stop new pimples from forming
- Prevent scarring
- Help reduce the embarrassment of having acne.
Early treatment is the best way to prevent scars. Your doctor may suggest over-the-counter (OTC) or prescription drugs. Some acne medicines are put right on the skin. Other medicines are pills that you swallow. The doctor may tell you to use more than one medicine.
- Clean skin gently. Use a mild cleanser in the morning, evening, and after heavy workouts. Scrubbing the skin does not stop acne. It can even make the problem worse.
- Try not to touch your skin. People who squeeze, pinch, or pick their pimples can get scars or dark spots on their skin.
- Shave carefully. If you shave, you can try both electric and safety razors to see which works best. With safety razors, use a sharp blade. Also, it helps to soften your beard with soap and water before putting on shaving cream. Shave lightly and only when you have to.
- Stay out of the sun. Many acne medicines can make people more likely to sunburn. Being in the sun a lot can also make skin wrinkle and raise the risk of skin cancer.
- Choose makeup carefully. All makeup should be oil free. Look for the word “noncomedogenic” on the label. This means that the makeup will not clog up your pores. But some people still get acne even if they use these products.
- Changing hormone levels in teenage girls and adult women 2 to 7 days before their period starts
- Pressure from bike helmets, backpacks, or tight collars
- Pollution and high humidity
- Squeezing or picking at pimples
- Hard scrubbing of the skin.
- Working on new drugs to treat acne
- Looking at ways to prevent plugs
- Looking at ways to stop the hormone testosterone from causing acne.
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
National Institutes of Health
1 AMS Circle
Bethesda, MD 20892-3675
Toll Free: 877-22-NIAMS (226-4267)
Email: [email protected]
|1||Completed||Safety and Efficacy of MBI 226 1.25% and 2.5% Topical Acne Solutions in the Treatment of Acne
|2||Completed||Safety and Efficacy of MBI 226 2.5% and 5.0% Topical Acne Solutions in the Treatment of Acne
|3||Active, not recruiting||Comparative Antimicrobial Efficacy of Two Topical Acne Therapies for the Treatment of Facial Acne
|4||Completed||A Study of Acne Treatment in Children Ages 9 to 11
|5||Completed||Comparison Study of Topical Acne Regimens
|6||Terminated||Pilot Study of a Dietary Intervention to Prevent Acne Recurrence
|7||Active, not recruiting||Plant-based Dietary Intervention for Treatment of Acne
|8||Terminated||Photodynamic Therapy in the Treatment of Acne
|9||Recruiting||Safety and Efficacy of Skin Cleanser Contained Roselle Extract in Acne
|10||Recruiting||Efficacy of Lappa Arctium (Homoeopathic Medicine) in Treatment of Acne Vulgaris
|11||Active, not recruiting||Adherence to Study Medication Compared to Generic Topical Clindamycin Plus Generic Topical Tretinoin in Subjects With Mild to Moderate Acne Vulgaris
|12||Completed||A Study of Different Use Regimens Using Two Acne Treatments
|13||Completed||Comparative Efficacy and Safety of Benzoyl Peroxide Used in Combination With Clindamycin vs. Benzoyl Peroxide Used in Combination With Clindamycin and Doxycycline in the Treatment of Moderate Acne
|14||Active, not recruiting||A Study to Compare the Tolerability and Efficacy of Tazorac Cream Used With Duac Gel or Acanya Gel for Treatment of Acne
|Efficacy And Safety Of Azithromycin SR Compared With Minocycline In Acne
|16||Active, not recruiting||NdYag Laser for Acne Keloidalis Nuchae
|17||Recruiting||A Study to Examine the Safety and Efficacy Of Drospirenone and Ethinyl Estradiol (YAZ) Compared With Placebo In The Treatment Of Moderate Truncal Acne Vulgaris
|18||Completed||Microdermabrasion for Acne
|19||Enrolling by invitation||Proof of Concept Study to Investigate the Recurrence of Acne Post Isotretinoin
|20||Completed||Infrared Non-Cutting Laser Therapy for Acne
|21||Active, not recruiting||Non-Cutting Laser Therapy in the Treatment of Acne
|22||Completed||Study of Two Different 10.0% Benzoyl Peroxide Creams for Mild to Moderate Acne Vulgaris
|23||Active, not recruiting||Trial of Clindamycin / Benzoyl Peroxide Gel in Subjects With Acne
|24||Completed||Safety and Efficacy Study of Topical Methyaminlevulinate (MAL) in Subjects With Facial Acne
|25||Completed||A Split-Face, Paired-Comparison, Pilot Study to Evaluate Safety and Efficacy of Two Topical Salicylic Acid 1.0% Creams for Mild to Moderate Acne Vulgaris
|26||Completed||Comparison of Efficacy and Safety of Azelaic Acid 15% Gel With Its Vehicle in Subjects With Mild to Moderate Acne
|27||Completed||Evaluation of the Effectiveness, Safety, and Tolerability of Duac Akne Gel and Epiduo Gel in the Treatment of Facial Acne Vulgaris
|28||Completed||A Study to Evaluate Tolerability of Two Topical Drug Products in the Treatment of Facial Acne
|29||Recruiting||the Comparison Efficacy of Azithromycin With Doxycycline in the Treatment of Acne Vulgaris
|30||Completed||Comparison of Stacked-Pulses Vs. Double-Pass Treatments of Facial Acne With a 1450 Nm Laser
|31||Completed||Phase IV Study to Gather More Information About the Safety of ACZONE Gel, 5% in Treating Subjects With Acne Who Have G6PD Deficiency
|32||Recruiting||Safety and Efficacy of the Use of Botox on Acne
|33||Completed||Study to Demonstrate the Efficacy and Safety of Adapalene/Benzoyl Peroxide Topical Gel in Subjects With Acne Vulgaris
|34||Recruiting||A Study to Evaluate the Safety and Efficacy of Tazarotene Foam, 0.1%, in Subjects With Common Facial Acne
|35||Completed||Fractional Resurfacing Device for Treatment of Acne Scarring
|36||Active, not recruiting||Efficacy & Safety of Clindamycin and Tretinoin in Acne
|37||Completed||A Phase 2 Study of ASC-J9 Cream in Acne Vulgaris
|38||Completed||Study of Benzoyl Peroxide Cream for Mild to Moderate Acne Vulgaris
|39||Completed||Measuring Adherence in Subjects With Acne Vulgaris in a Clinic Population Subtitle: Topical Benzoyl Peroxide for Acne
|40||Active, not recruiting||Safety and Efficacy of 1550nm Fractional Laser Treatment for Acne Scars in Fitzpatrick Type IV-VI Skin
|41||Completed||Safety and Efficacy Study of Clindamycin/Benzoyl Peroxide/Tazarotene Cream in Subjects With Acne
|42||Recruiting||Apremilast in the Treatment of Moderate to Severe Acne
|Treatment of Acne Vulgaris With Doryx Tablets Compared to Doxycyline Hyclate
|44||Not yet recruiting||Safety and Efficacy Study of Acnase Creme in the Treatment of Acne Vulgaris I and II
|45||Recruiting||Study to Compare the Acne Relapse Rate of Oral Minocycline to Oral Minocycline in Combination With Topical Tretinoin, Followed by Topical Tretinoin Alone
|46||Active, not recruiting||Efficacy and Safety Study of Finacea to Treat Acne Vulgaris and Post-Inflammatory Hyperpigmentation
|47||Completed||The Development and Evaluation of an “E-Visit” Program for the Management of Acne
|48||Completed||Pulsed Dye Laser Treatment of Acne Vulgaris
|49||Withdrawn||The Treatment of Acne Vulgaris With Radiofrequency Device
|50||Completed||Efficacy and Tolerance of a Derivative of Salicylic Acid and 5% Benzoyl Peroxide in Facial Acne Vulgaris
|51||Terminated||Topical 5-ALA-PDT With Blu-U Therapy Versus Topical 5-ALA With Pulse Dye Laser In Treating Recalcitrant Acne Vulgaris
|52||Completed||A Comparative Study of the Tolerability of Two Combination Therapies for the Treatment of Acne
|53||Completed||Evaluate Safety & Efficacy of an OC Preparation vs Placebo for 6 Treatment Cycles in Women With Moderate Acne
|54||Completed||Evaluate Safety & Efficacy of an Oral Contraceptive (OC) Preparation Versus Placebo for 6 Treatment Cycles in Women With Moderate Acne
|55||Recruiting||A Study to Evaluate the Efficacy of Silk – Like Bedding Fabric, as Used in a Standard Pillow Case, in the Treatment of Acne Vulgaris
|56||Recruiting||“A Randomized, Controlled, Evaluator-blinded Pilot Study to Evaluate the Effect of Automated Text Message Reminders on Patient Compliance With Topical Medications and Its Efficacy on Skin Disease Control in Adolescents and Adults With Mild to Moderate Acne”
|57||Completed||Safety and Efficacy Study of Association Between Tretinoin and Clindamycin on the Treatment of Acne Mild and Moderate
|58||Recruiting||Exploratory Study to Evaluate the Efficacy and Safety of CD07223 Gel in Subjects With Acne
|A Study to Demonstrate the Efficacy and Safety of Adapalene/Benzoyl Peroxide Topical Gel in Subjects With Acne Vulgaris
|60||Not yet recruiting||Open and Comparative Study to Measure Tolerability and Efficacy of Taro Elixir
Address line 1
Address line 2
Address line 3
* First name (required):
* Last name (required):
* E-mail address (required):
* Message (required):
- What is rosacea?
- Is rosacea like acne?
- What causes rosacea?
- What are risk factors for rosacea?
- Is rosacea contagious?
- What are the signs and symptoms of rosacea?
- How is rosacea diagnosed?
- What else could it be?
- What happens to the nose?
- What happens to the eyes?
- How is rosacea cured?
- What about using acne medicine?
- What is used for treating rosacea?
- What should be avoided?
- What foods are good for rosacea?
- What natural or home remedies can help rosacea?
- Does rosacea get worse with age?
- How should I care for the skin of my face?
- How are the telangiectasias (the red lines) treated?
- How is a rhinophyma (the W.C. Fields nose) treated?
- What effect may rosacea have on my life?
- For more information
- Rosacea t A Glance
What is rosacea?
Rosacea (roz-ay-sha) is a very common red, acne-like benign skin condition that affects many people worldwide. As of 2010, rosacea is estimated to affect at least 16 million people in the United States alone and approximately 45 million worldwide. Most people with rosacea are Caucasian and have fair skin. The main symptoms of rosacea include red or pink patches, visible tinybroken blood vessels, small red bumps, red cysts, and pink or irritated eyes. Most people with the disease may not even know they have rosacea or that it is a diagnosable and treatable condition. Many people who have rosacea may just assume they blush or flush easily or are just very sun sensitive. .
Rosacea is considered a chronic (long-term), non-curable skin condition with periodic ups and downs. As opposed to traditional or teenage acne, most adult patients do not “outgrow” rosacea. Rosacea characteristically involves the central region of the face, causing persistent redness or transient flushing over the areas of the face and nose that normally blush — mainly the forehead, the chin and the lower half of the nose. It is most commonly seen in people with light skin, and particularly in those of English, Irish and Scottish backgrounds. Some famous people with rosacea have included former President Bill Clinton and W.C. Fields.
The redness in rosacea, often aggravated by flushing, may cause small blood vessels in the face to enlarge (dilate) and become more visible through the skin, appearing like tiny red lines (called telangiectasias). Continual or repeated episodes of flushing and blushing may promote inflammation, causing small red bumps that often resemble teenage acne. In fact, rosacea can frequently be mistaken for common acne. Rosacea is also referred to as acne rosacea.
Is rosacea like acne?
Rosacea is basically different than acne, although the two can coexist. It is also sometimes called “adult acne.” Unlike common acne, rosacea is not primarily a plague of teenagers but occurs most often in adults (ages 30 to 50), especially those with fair skin. Different than acne, there are usually no blackheads or whiteheads in rosacea. Furthermore, most teens eventually outgrow acne whereas patients with rosacea don’t generally outgrow it. Rosacea consists mostly of small red bumps that are not “squeezable” or extractable like blackheads. Squeezing a rosacea pimple usually causes a scant amount of clear liquid to expel. Unlike traditional acne where professional extractions can help remove whiteheads and blackheads, squeezing or extracting rosacea bumps does not help improve the rosacea. People with rosacea individuals tend to have a rosy or pink color to their skin as opposed to acne patients whose skin is usually less red.
Rosacea strikes both sexes and potentially all ages. Overall, it tends to be more frequent in women but more severe in men. It is very uncommon in children, and it is very infrequently seen in darker skin tones or black skin. Overall, it is seen in light-featured adults between 30-50 years of age.
Rosacea is sometimes called “adult acne.”
What causes rosacea?
The exact cause of rosacea is still unknown and remains a mystery. The basic process seems to involve dilation of the small blood vessels of the face. Suspected causes of rosacea include but are not limited to genetic factors, genetics plus sun exposure, a mite sometimes found in hair follicles (Demodex folliculorum), the bacteria Helicobacter pylori (that is associated with stomach ulcers), gastrointestinal disease, and medications that cause blood vessels to widen. There seems to be a hereditary component to rosacea in a large number of people. Often people have close family members with rosacea.
Rosacea tends to affect the “blush” areas of the face and is more common in people who flush easily. Additionally, a variety of triggers are known to cause rosacea to flare. Emotional factors (stress, fear, anxiety, embarrassment, etc.) may trigger blushing and aggravate rosacea. A flare-up can be caused by changes in the weather like strong winds or a change in the humidity. Sun exposure and sun-damaged skin is generally associated with rosacea. Exercise, alcohol consumption, emotional upsets, and spicy food are other well-known triggers that may aggravate rosacea. Many patients may also notice flares around the holidays, particularly Christmas and New Year’s holidays.
What are risk factors for rosacea?
Rosacea risk factors include fair skin, English, Irish or Scottish heredity, easy blushing, and having other family members with rosacea called “positive family history”. Additional risk factors include female gender, menopause, and adults in the age range 30-50years old.
Is rosacea contagious?
No. Rosacea is not considered contagious or infectious. There is no evidence that rosacea can be spread by contact with the skin, sharing towels, or through inhalation.
What are the signs and symptoms of rosacea?
Typical signs and symptoms of rosacea include facial flushing, blushing, redness, burning, red bumps, and small cysts. The symptoms tend to come and go. The skin may be clear for weeks, months, or years and then erupt again. Rosacea tends to evolve in stages and typically causes inflammation of the skin of the face, particularly the forehead, cheeks, nose, and chin.
When rosacea first develops, it may appear, then disappear, and then reappear. However, the skin may fail to return to its normal color and the enlarged blood vessels and pimples arrive in time. Rosacea may rarely reverse itself.
Rosacea generally lasts for years, and, if untreated, it tends to gradually worsen.
How is rosacea diagnosed?
Rosacea is usually diagnosed based on the typical red or blushed facial skin appearance and symptoms of easy facial blushing and flushing. Rosacea is largely under diagnosed and most people with rosacea often do not know they have the skin condition. Many people may not associate their intermittent flushing symptoms with a medical condition. The facial redness in rosacea may be transient and come and go very quickly.
Dermatologists are physicians who are specially trained in the diagnosis of rosacea. Generally no specific tests are required for the diagnosis of rosacea.
In unusual cases, a skin biopsy may be required to help confirm the diagnosis of rosacea. Occasionally, a non-invasive test called a skin scraping may be performed by the dermatologist in the office to help exclude a skin mite infestation by Demodex which can look just like rosacea. A skin culture can help exclude other causes of facial skin bumps like staph infections or herpes infections. Blood tests are not generally required but may be used to help exclude less common causes of facial blushing and flushing including lupus, other autoimmune conditions, and dermatomyositis.
What else could it be?
While most cases of rosacea are fairly straightforward, there are some atypical cases that are not as easy to diagnose. Other conditions and rosacea look-alikes include:
- Acne vulgaris
- Demodex folliculitis
- Staph infection
- Medication reaction (example: niacin)
- Seborrheic dermatitis
- Allergic or contact dermatitis
- Seasonal allergies
- Allergic conjunctivitis
- Perioral dermatitis
- Carcinoid Syndrome
- Herpes Simplex
What happens to the nose?
The nose is typically one of the first facial areas to be affected in rosacea. It can become red and bumpy and develop noticeable dilated small blood vessels. Left untreated, advanced stages of rosacea can cause a disfiguring nose condition called rhinophyma (ryno-fy-ma), literally growth of the nose, characterized by a bulbous, enlarged red nose and puffy cheeks (like the old comedian W.C. Fields). There may also be thick bumps on the lower half of the nose and the nearby cheek areas. Rhinophyma occurs mainly in men. Severe rhinophyma can require surgical correction and repair.
Some people falsely attribute the prominent red nose to excessive alcohol intake, and this stigma can cause embarrassment to those with rosacea. Although a red nose may be seen in patients with heavy alcohol use, not every patient with rosacea abuses alcohol.
What happens to the eyes?
Rosacea may or may not affect the eyes. Not everyone with rosacea has eye issues. A complication of advanced rosacea, known as ocular rosacea, affects the eyes. About half of all people with rosacea report feeling burning, dryness, and grittiness of the eyes (conjunctivitis). These individuals may also experience redness of the eyelids and light sensitivity. Often the eye symptoms may go completely unnoticed and not be a major concern for the individual. Many times, the physician or ophthalmologist may be the first one to notice the eye symptoms. Untreated, ocular rosacea may cause a serious complication that can damage the cornea, called rosacea keratitis. An ophthalmologist can assist in a proper eye evaluation and prescribe rosacea eye drops. Oral antibiotics may be useful to treat skin and eye rosacea. Untreated eye rosacea may cause permanent damage, including impaired vision.
How is rosacea cured?
Rosacea is currently not considered a curable condition. While it cannot be cured, it can usually be controlled with proper, regular treatments.
There are some forms of rosacea that may be significantly cleared for long periods of time using laser, intense pulse light, photodynamic therapy, or isotretinoin (Accutane). Although still not considered a “cure,” some patients experience long-lasting results and may have remissions (disease-free period of time) for months to years.
What about using acne medicine?
Since there is some overlap between acne and rosacea, some of the medications may be similar. Acne and rosacea have in common several possible treatments including (but not limited to) oral antibiotics, topical antibiotics, sulfa-based face washes, isotretinoin, and many others. It is important to seek a physician’s advice before using random over-the-counter acne medications since they can actually irritate skin that is prone to rosacea. Overall, rosacea skin tends to be more sensitive and easily irritated than that of common acne.
What is used for treating rosacea?
There are many treatment choices for rosacea depending on the severity and extent of symptoms. Available medical treatments include antibacterial washes, topical creams, antibiotic pills, lasers, pulsed-light therapies, photodynamic therapy, and isotretinoin.
Mild rosacea may not necessarily require treatment if the individual is not bothered by the condition. More resistant cases may require a combination approach, using several of the treatments at the same time. A combination approach may include home care of washing with a prescription sulfa wash twice a day, applying an antibacterial cream morning and night, and taking an oral antibiotic for flares. A series of in-office laser, intense pulsed light or photodynamic therapies may also be used in combination with the home regimen. It is advisable to seek a physician’s care for the proper evaluation and treatment of rosacea.
With the proper treatment, rosacea symptoms can be fairly well controlled. Popular methods of treatment include topical (skin) medications applied by the patient once or twice a day. Topical antibiotic medication such as metronidazole applied one to two times a day after cleansing may significantly improve rosacea. Azelaic acid (Finacea gel 15%) is another effective treatment for patients with rosacea. Both metronidazole and azelaic acid work to control the redness and bumps in rosacea.
Some patients elect combination therapies and notice an improvement by alternating metronidazole and azelaic acid: using one in the morning and one at night. Sodium sulfacetamide (Klaron lotion) is also known to help reduce inflammation. Other topical antibiotic creams include erythromycin and clindamycin (Cleocin).
Common topical medications used either 1-2 times a day:
- (Finacea gel 15%)
- (Klaron lotion)
- gel (Erygel)
- Clindamycin gel, solution, or lotion (Cleocin).
Oral antibiotics are also commonly prescribed to patients with moderate rosacea. Tetracycline, doxycycline, minocycline, and amoxicillin are among the many oral antibiotics commonly prescribed and they actually help reduce inflammation and pimples in rosacea. A newer low dose doxycycline preparation called Oracea 40mg once a day has been used in rosacea. The dose may be initially high and then be tapered to maintenance levels. Common side effects and potential risks should be considered before taking oral antibiotics.
Oral antibiotics include:
Short-term topical cortisone (steroid) preparations of minimal strength may in occasional cases also be used to reduce local inflammation. Some mild steroids include desonide lotion or hydrocortisone 0.5% or 1% cream applied sparingly once or twice a day just to the irritated areas. There is a risk of causing a rosacea flare by using topical steroids. Prolonged use of topical steroids on the face can also cause Perioral dermatitis.
Some doctors may also prescribe tretinoin (Retin-A), tazarotene (Tazorac), or adapalene (Differin) which are prescription medications also used for acne. Rarely, permethrin (Elimite) cream is prescribed for rosacea cases that are associated with skin mites. Permethrin is also used for the body mites that cause scabies.
Isotretinoin is infrequently prescribed in cases of severe and resistant rosacea. Often it is used after multiple other therapies have been tried for some time and have failed. It is used as a daily capsule for 4-6 months. Isotretinoin is not typically used in rosacea and it is most commonly used in the treatment of severe, common acne called acne vulgaris. Close physician monitoring and blood testing are necessary while on isotretinoin. Typically at least 2 forms of birth control are required for females on this medication and pregnancy is absolutely contraindicated while on isotretinoin.
In addition, prescription or over-the-counter sensitive skin cleansers may also provide symptom relief and control. Harsh soaps and lotions should be avoided, whereas simple and pure products such as Cetaphil or Purpose gentle skin cleanser may be less irritating. Patients should avoid excessive rubbing or scrubbing the face.
- Cetaphil Cleanser
- Purpose Soap
- Sulfa based washes ( example: Rosanil)
- Benzoyl Peroxide washes (example: Clearasil)
Laser and intense pulsed light
Many patients are now turning to laser and intense-light treatments to treat the continual redness and noticeable blood vessels on the face, neck, and chest. Often considered a safe alternative, laser and intense pulse-light therapy may help to visibly improve the skin and complexion.
Laser treatment may cause some discomfort. While most patients are able to endure the procedure, ice packs and topical anesthetic cream can help alleviate the discomfort. Multiple treatments are typically necessary and the procedure is not covered by most insurances. Treatments are recommended in three- to six-week intervals; during this time, sun avoidance is necessary. Risk, benefits, and alternatives should be reviewed with your physician prior to treatment. Laser treatments may be combined with photodynamic therapy (light-activated chemical using Levulan) for more noticeable results.
Photodynamic therapy (PDT) is one of the newly available treatments. PDT uses a topical photosensitizer liquid that is applied to the skin and a light to activate the sensitizer. Levulan (aminolevulonic acid) and blue light, commonly used to treat pre-cancers (actinic keratosis) and acne vulgaris, can also be used to treat some rosacea patients. The use of PDT in rosacea is considered off-label use to some extent, since it is primarily designed for regular acne. PDT is thought to work at reducing the inflammation, pimples, and also improving the skin texture. PDT is an in-office procedure performed in your physician’s office. The treatment takes anywhere from one to one and a half hours to complete. Strict sun avoidance for approximately one to three days is required after the treatment. Mild discomfort during the treatment and a mild to moderate sunburn appearance after the treatment is common. Some patients have experienced remissions (disease free periods) of several months to years from these types of treatments. Other patients may not notice significant improvement.
Glycolic-acid peels may additionally help improve and control rosacea in some people. The chemical peels can professionally be applied for approximately two to five minutes every two to four weeks. Mild stinging, itching, or burning may occur and some patients experience peeling for several days after the peel. Any peel can irritate very sensitive skin and cause flares for some people. Peels should be used with caution in rosacea as not everyone is bale to tolerate these treatments.
Sun exposure is a well known flare for many rosacea sufferers. Sun protection using a wide-brimmed hat (at least 6 inches) and physical sunscreens (like zinc or titanium) are generally encouraged. Because rosacea tends to occur in mostly fair-skinned adults, the use of an appropriate daily sunscreen lotion and overall sun avoidance is recommended. Zinc-based sunscreens (SPF 30 or higher) provide superior sun protection.
What should be avoided?
While not all rosacea people are exactly the same, there are some common rosacea triggers. Avoiding these potential triggers may also help relieve symptoms and disease flares. It may be helpful to keep a personal diary of foods and other triggers that flare rosacea symptoms.
Smoking, spicy foods, hot drinks, and alcohol may cause flushing and should be avoided. Exposure to sunlight and to extreme hot and cold temperatures should be limited as much as possible. Red wine and chocolate are two well known rosacea triggers. Some listed foods may have no effect on your rosacea but severely affect someone else. Individual reaction patterns vary greatly in rosacea and therefore a food diary may help to elucidate your special triggers.
Possible rosacea dietary triggers include:
- Dairy including yogurt ,sour cream, cheese (except cottage cheese)
- Alcohol including red wine, beer, vodka, gin, bourbon, and champagne
- Soy sauce
- Yeast extract
- Eggplants, Avocados, Spinach
- Some beans and pods, including lima, navy or peas
- Citrus fruits, including tomatoes, bananas, red plums, raisins or figs
- Spicy and temperature hot foods
Potent cortisone or steroid medications on the face should be avoided because they can promote widening of the tiny blood vessels of the face. Some patients experience severe rosacea flares after prolonged use of topical steroids.
Vasodilator pills can also flare rosacea. Vasodilators include several blood pressure medications like nitrates, calcium channel blockers, and thiazide diuretics.
These potential triggers are found in many skin cleansers and should be avoided in rosacea.
- Witch hazel
- Eucalyptus oil
- Clove oil
- Salicylic acid
What foods are good for rosacea?
Foods that help avoid rosacea flares include less spicy meals, non-alcoholic cool beverages, caffeine-free drinks, non-dairy cheese, and thermally cooler meals.
What natural remedies can help rosacea?
Rosacea skin tends to be fairly sensitive and may easily flare with self treatment or common acne therapies. Any home treatment or attempts for natural remedies should be approached with mild caution. As with any rosacea therapy, some people may experience sensitivity or irritation with treatment. Several possible natural remedies including dilute vinegar cleansing and green tea applications may be useful in rosacea.
Dilute white vinegar facial soaks or cleansing daily or weekly using approximately 1 part regular table vinegar to 6 parts water may be helpful. Vinegar is thought to help as a natural disinfectant and can help decrease the number of yeasts and bacteria on the skin. Since vinegar may flare rosacea in some people, a small test area should be tries before applying to the entire face.
Green tea soaks to the face may also help decrease the redness and inflammation seen in rosacea. Green tea is thought to have anti-inflammatory properties. A few commercially available products also use green tea as the active ingredient.
Does rosacea get worse with age?
Yes. Although rosacea has a variable course and is not predictable in everyone, overall it tends to gradually worsen with age, especially if untreated. In small studies, many rosacea sufferers have reported that without treatment their condition had advanced from early to middle stage within a year. With good therapy, it is possible to prevent progression of rosacea.
How should I care for the skin of my face?
Proper skin care involves using a gentle cleanser to wash the face twice a day. Over-washing may cause irritation. A sunscreen lotion is advisable each morning. Your physician may prescribe a topical antibiotic to use once or twice a day under your sunscreen.
Rubbing the face tends to irritate the reddened skin. Some cosmetics and hair sprays may also aggravate redness and swelling.
- Gentle skin cleanser twice a day
- Sunscreen in AM
- Sun avoidance
Facial products such as soap, moisturizers, and sunscreens should be free of alcohol or other irritating ingredients. Moisturizers should be applied very gently after any topical medication has dried. When going outdoors, sunscreens with an SPF of 15 or higher are needed.
How are the telangiectasias (the red lines) treated?
Telangiectasias are the small blood vessels that arise on the surface of the skin, commonly on around the nose, cheeks, and chin.
Simple cover-up makeup can be used for the telangiectasias. There are some green-based moisturizers or tinted foundations that may help conceal the redness.
Telangiectasias can also be medically treated in your physician’s office with a small electric needle, a laser, intense pulse light, or minor surgery to close off the dilated blood vessels. Usually, multiple treatments are required for best results and only a portion of the blood vessels may be improved with each treatment. Not everyone responds the same to these types of treatments, and your physician can help you decide which treatment is best for your skin type, condition, and size of blood vessels.
- Intense Pulse Light Therapy
How is a rhinophyma (the W.C. Fields nose) treated?
Rhinophyma of the nose is frequently treated by surgery. The excess tissue may be removed with a scalpel, laser, or electro surgery. Dermabrasion can help improve the look of the scar tissue. Follow-up treatments with laser or intense pulsed light may help lessen the redness. Medical maintenance therapy with oral and or topical antibiotics may be useful to decrease the chance of recurrence.
What effect may rosacea have on my life?
Rosacea may affect your life minimally, moderately, or severely depending on how active the condition is and your overall tolerance of the skin symptoms.
Some people have absolutely no symptoms and are not bothered at all by their rosacea. They may enjoy perfectly healthy normal lives without any effect from this benign skin condition. Some patients really like the pink glow to their cheeks and find it gives them a pleasant color without having to use blush. They may not even know they have rosacea. They usually do not want to use any treatment.
People with moderate rosacea may have periodic flares that require treatment with oral antibiotics, lasers, and other therapies. They may continuously take an antibiotic daily for years and years to keep their symptoms under control. Many of these people may complain of embarrassment from the flushing and blushing of rosacea. They may have ups and downs and times that their disease is quiet and other times when it feels like it is on fire. With the help of their physician, these patients can learn the pattern of their rosacea and develop a treatment plan to keep it from interfering in their daily lives.
Other patients have very bothersome rosacea that causes them issues on a daily basis. There are subsets of severe rosacea sufferers who have extreme psychological, social, and emotional symptoms. Some have developed social phobias causing them to cancel or leave situations when their rosacea is flaring or active. Some patients complain of looking like they have been drinking alcohol when in fact they don’t drink at all. Although rosacea is not a grave medical situation, severe cases may wreak havoc in some patient’s lives. It is important for these patients to discuss their physical and emotional concerns with their physicians and to get professional help in treating their rosacea.
Overall, promptly diagnosed and properly treated, rosacea should not prevent people with the condition from enjoying long and productive lives.
Additional information is available from the American Academy of Dermatology at www.aad.org. Names of U.S. board certified dermatologists are available on this website.
Rosacea at a Glance
- Rosacea is a common, chronic, incurable, adult, acne-like skin condition.
- It has periodic ups and downs (flares and remissions).
- Rosacea symptoms tend to come and go.
- It is easily controllable and medically manageable.
- Rosacea may begin with easy facial blushing or flushing.
- Rosacea commonly affects the central third of the face, especially the nose.
- Rosacea causes tiny red pimples and fine red lines on the facial skin.
- Rosacea may be mistaken for rosy cheeks, sunburn, or quite often, acne.
- Rosacea triggers include alcohol, hot or spicy foods, emotional stress, and heat.
- Rosacea can be a very bothersome and embarrassing condition.
- Untreated rosacea tends to worsen over the time and be a progressive disease.
- Rosacea untreated can cause a bulbous red nose (like W.C. Fields).
- Prompt recognition and proper treatment permit people with rosacea to enjoy life.
Information in this publication and site is not intended to serve as medical advice. Individuals may use the information as a guide to discuss their treatments with their own physicians. This site does not promote nor endorse the unauthorized practice of medicine by non-physicians or state licensed health care providers.
Medicine is a constantly changing science and not all therapies are clearly established. New research changes drug and treatment therapies daily. The authors, editors, and publisher of these artciles have used their best efforts to provide information that is up-to-date and accurate and is generally accepted within medical standards at the time of publication. However, as medical science is constantly changing and human error is always possible, the authors, editors, and publisher or any other party involved with the publication of this article do not warrant the information in this article is accurate or complete, nor are they responsible for omissions or errors in the article or for the results of using this information. The reader should confirm the information in this article from other sources prior to use. In particular, all drug doses, indications, and contraindications should be confirmed in the package insert.
Questions and Answers about Rosacea
This booklet contains general information about rosacea (ro-ZAY-she-ah). It defines rosacea and describes its symptoms, possible causes, and treatments. If you have further questions after reading this booklet, you may wish to discuss them with your doctor.
- What Is Rosacea?
- Who Gets Rosacea?
- What Does Rosacea Look Like?
- How Is the Eye Affected?
- What Causes Rosacea?
- Can Rosacea Be Cured?
- What Research Is Being Conducted to Help People With Rosacea?
- Where Can People Find More Information About Rosacea?
What Is Rosacea?
Rosacea is a chronic (long-term) disease that affects the skin and sometimes the eyes. The disorder is characterized by redness, pimples, and, in advanced stages, thickened skin. Rosacea usually affects the face. Skin on other parts of the upper body is only rarely involved.
Who Gets Rosacea?
Approximately 14 million people in the United States have rosacea. It most often affects adults between the ages of 30 and 60. Rosacea is more common in women (particularly during menopause) than men. Although rosacea can develop in people of any skin color, it tends to occur most frequently and is most apparent in people with fair skin.
What Does Rosacea Look Like?
There are several symptoms and conditions associated with rosacea. These include frequent flushing, vascular rosacea, inflammatory rosacea, and several other conditions involving the skin, eyes, and nose.
Frequent flushing of the center of the face, which may include the forehead, nose, cheeks, and chin, occurs in the earliest stage of rosacea. The flushing often is accompanied by a burning sensation, particularly when creams or cosmetics are applied to the face. Sometimes the face is swollen slightly.
A condition called vascular rosacea causes persistent flushing and redness. Blood vessels under the skin of the face may dilate (enlarge), showing through the skin as small red lines. This is called telangiectasia (tel-AN-je-ek-tay-ze-ah). The affected skin may be swollen slightly and feel warm.
A condition called inflammatory rosacea causes persistent redness and papules (pink bumps) and pustules (bumps containing pus) on the skin. Eye inflammation and sensitivity as well as telangiectasia also may occur.
In the most advanced stage of rosacea, the skin becomes a deep shade of red and inflammation of the eye is more apparent. Numerous telangiectases are often present, and nodules in the skin may become painful. A condition called rhinophyma also may develop in some men; it is rare in women. Rhinophyma is characterized by an enlarged, bulbous, and red nose resulting from enlargement of the sebaceous (oil-producing) glands beneath the surface of the skin on the nose. People who have rosacea also may develop a thickening of the skin on the forehead, chin, cheeks, or other areas.
How Is the Eye Affected?
In addition to skin problems, up to 50 percent of people who have rosacea have eye problems caused by the condition. Typical symptoms include redness, dryness, itching, burning, tearing, and the sensation of having sand in the eye. The eyelids may become inflamed and swollen. Some people say their eyes are sensitive to light and their vision is blurred or otherwise impaired.
What Causes Rosacea?
Doctors do not know the exact cause of rosacea but believe that some people may inherit a tendency to develop the disorder. People who blush frequently may be more likely to develop rosacea. Some researchers believe that rosacea is a disorder where blood vessels dilate too easily, resulting in flushing and redness.
Factors that cause rosacea to flare up in one person may have no effect on another person. Although the following factors have not been well-researched, some people claim that one or more of them have aggravated their rosacea: heat (including hot baths), strenuous exercise, sunlight, wind, very cold temperatures, hot or spicy foods and drinks, alcohol consumption, menopause, emotional stress, and long-term use of topical steroids on the face. Patients affected by pustules may assume they are caused by bacteria, but researchers have not established a link between rosacea and bacteria or other organisms on the skin, in the hair follicles, or elsewhere in the body.
Can Rosacea Be Cured?
Although there is no cure for rosacea, it can be treated and controlled. A dermatologist (a medical doctor who specializes in diseases of the skin) usually treats rosacea. The goals of treatment are to control the condition and improve the appearance of the patient’s skin. It may take several weeks or months of treatment before a person notices an improvement of the skin.
Some doctors will prescribe a topical antibiotic, such as metronidazole, which is applied directly to the affected skin. For people with more severe cases, doctors often prescribe an oral (taken by mouth) antibiotic. Tetracycline, minocycline, erythromycin, and doxycycline are the most common antibiotics used to treat rosacea. The papules and pustules symptomatic of rosacea may respond quickly to treatment, but the redness and flushing are less likely to improve.
ome people who have rosacea become depressed by the changes in the appearance of their skin. People who have rosacea may experience low self-esteem, feel embarrassed by their appearance, and claim their social and professional interactions with others are adversely affected. A doctor should be consulted if a person feels unusually sad or has other symptoms of depression, such as loss of appetite or trouble concentrating.
Doctors usually treat the eye problems of rosacea with oral antibiotics, particularly tetracycline or doxycycline. People who develop infections of the eyelids must practice frequent eyelid hygiene. The doctor may recommend scrubbing the eyelids gently with diluted baby shampoo or an over-the-counter eyelid cleaner and applying warm (but not hot) compresses several times a day. When eyes are severely affected, doctors may prescribe steroid eye drops.
Electrosurgery and laser surgery are treatment options if red lines caused by dilated blood vessels appear in the skin or if rhinophyma develops. For some patients, laser surgery may improve the skin’s appearance with little scarring or damage. For patients with rhinophyma, surgical removal of the excess tissue to reduce the size of the nose usually will improve the patient’s appearance.
Working With Your Doctor to Manage Rosacea
The role you play in managing your rosacea is important. You can take several steps to keep rosacea under control:
- Keeping a written record of when flares occur may provide clues about what is irritating the skin.
- Most people should use a sunscreen every day that protects against UVA and UVB rays (ultraviolet rays) and has a sun-protecting factor (SPF) of 15 or higher, but sunscreen is particularly important for people whose skin is irritated by exposure to the sun.
- Using a mild lubricant may be helpful, but avoid applying any irritating products to the face. Some people find that a green-tinted makeup effectively conceals skin redness.
- If your eyes are affected, faithfully follow your doctor’s treatment plan and clean your eyelids as instructed.
What Research Is Being Conducted to Help People With Rosacea?
Researchers are studying the eyes of people who have rosacea to find ways to prevent dry eyes and other eye problems related to rosacea. Scientists also are evaluating the most effective ways to use medications to treat rosacea and the best methods to minimize scarring of the sebaceous glands when removing excess nasal tissue in rhinophyma.
Additionally, researchers are looking at the immunological aspects of rosacea. In one study, researchers found that people with rosacea had high levels of cathelicidins, peptides with antimicrobial and proinflammatory properties that protect the skin against infection. (Cathelicidins are secreted in an inactive form and undergo a cleaving process to take on their active form.) Investigators also discovered that levels of stratum corneum tryptic enzyme or SCTE—the enzyme responsible for cleaving the inactive cathelicidins into their active form—were also elevated in people with rosacea.
Where Can People Find More Information About Rosacea?
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Toll free: 877-22-NIAMS (226-4267)
Email: [email protected]
- American Academy of Dermatology (AAD)
Toll free: 866-503-SKIN (7546)
- National Rosacea Society
Toll free: 888-NO-BLUSH (662-5874)
For additional contact information, visit the NIAMS Web site, or call the NIAMS Information Clearinghouse.
NIAMS gratefully acknowledges the assistance of Mark Dahl, M.D., Mayo Clinic, Scottsdale, AZ; Sam Huff, National Rosacea Society, Barrington, IL; Robert Katz, M.D., Rockville, MD; M. Carol McNeely, M.D., University Dermatology Associates, Washington, DC; Larry Miller, M.D., Chevy Chase, MD; Alan Moshell, M.D., NIAMS, NIH; and Gary Peck, M.D., Washington Hospital Center, Washington, DC, in the review of this booklet.
The mission of the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), a part of the U.S. Department of Health and Human Services’ National Institutes of Health (NIH), is to support research into the causes, treatment, and prevention of arthritis and musculoskeletal and skin diseases; the training of basic and clinical scientists to carry out this research; and the dissemination of information on research progress in these diseases. The National Institute of Arthritis and Musculoskeletal and Skin Diseases Information Clearinghouse is a public service sponsored by the NIAMS that provides health information and information sources. Additional information can be found on the NIAMS Web site at www.niams.nih.gov.
For Your Information
This booklet contains information about medications used to treat the health condition discussed here. When this booklet was printed, we included the most up-to-date (accurate) information available. Occasionally, new information on medication is released.
Clinical Trials for Rosacea
|1||Recruiting||Atralin Gel for the Treatment of Rosacea
|2||Not yet recruiting||Open Label Pilot Study of Apremilast in Treatment of Rosacea
|3||Active, not recruiting||Zinc Sulfate in the Treatment of Rosacea: A Randomized, Controlled Trial
|4||Not yet recruiting||Study to Evaluate the Safety and Efficacy of Topical Minocycline FXFM244 in Rosacea Patients
|5||Completed||A Study to Determine the Safety and Efficacy of Atralin (Tretinoin 0.05%) Gel for the Treatment of Rosacea
|6||Recruiting||Combination Therapy for the Treatment of Rosacea
|7||Completed||A Phase II, Randomized Study of ACZONE™ (Dapsone) Gel, 5% for Papulopustular Rosacea.
|8||Completed||Effects of PRK 124 Lotion in Acne Rosacea
|9||Completed||Determine the Effect of Administering Periostat(R) Twice Daily on Patients With Acne Rosacea
|10||Completed||Exploratory Study of Azelaic Acid 15% Foam Compared to Vehicle in Patients With Papulopustular Rosacea
|11||Recruiting||Safety and Efficacy Study of Clindamycin Phosphate 1.2% and Tretinoin 0.025% Gel to Treat Rosacea
|12||Completed||Dose-Finding Study of CD07805/47 Topical Gel in Subjects With Erythematotelangiectatic Rosacea
|13||Active, not recruiting||Efficacy of Topical Azelaic Acid 15% Gel Plus Anti-inflammatory Dose Doxycycline or Metronidazole Gel 1% Plus Anti-inflammatory Dose Doxycycline in Moderate Papulopustular Rosacea
|14||Completed||Isotretinoin in Papular-Pustular Rosacea
|15||Completed||Systemic Bioavailability Study Of Col-118 Administered Topically as a 0.18 % Facial Gel And Brimonidine Ophthalmic Solution 0.2%
|16||Recruiting||Efficacy of Topical Cyclosporin for Ocular Rosacea
|17||Completed||Safety and Efficacy Study to Compare Two Rosacea Treatment Regimens
|18||Completed||Laser-Mediated Photodynamic Therapy of Acne Vulgaris and Rosacea
|19||Not yet recruiting||A Study of DER 45-EV Gel to Treat Rosacea
|20||Active, not recruiting||Safety and Efficacy of Azelaic Acid Foam 15% in Papulopustular Rosacea