Frequently Asked Questions about ZENMED®'s Answer to Rosacea

Rosacea is a chronic disease which afflicts over 16 million North Americans. Rosacea is most commonly found in adults between the ages of 30 and 65 but Rosacea has been known to afflict even children.

The people who are the most prone to acquiring Rosacea are fair skinned adults, women especially.

Rosacea is a hereditary, chronic (meaning long term) skin disorder that most often affects the nose, forehead, cheekbones, and chin. In its beginning stages this common skin disease, which causes subtle redness in the center of the face, may come and go on its own. But, if left untreated, Rosacea may develop some inflammation, accompanied by skin eruptions, and may gradually become chronic and even permanent. Furthermore, the skin tissue can swell and thicken and may be tender and sensitive to the touch. About half of Rosacea sufferers also complain of symptoms with their eyes, also known as Ocular Rosacea.

The Medical Breakdown of Rosacea
Rosacea is caused by the dilation of tiny blood vessels close to the surface of the skin. This causes the skin to break out with blotchy red areas called papules. A papule is a red solid elevated inflammatory skin lesion without pus (unless the papule is severe). These papules have three classifications: minor, moderate and severe. A minor Rosacea papule is the size of a small measles lesion. A moderate Rosacea papule is the size of a pencil eraser. A severe papule is the size of a coin and also contains pustules (pus-filled inflammatory bumps).

Rosacea is a neurovascular disorder that affects the flushing zone. Yet it is common with Rosacea to present itself with blackheads and whiteheads that are not commonly seen with Acne Vulgaris. The age of onset, and the location of redness is a clue. Rosacea is commonly an adult disease, and is generally restricted to the nose, cheeks, chin and forehead. It can coexist with Acne Vulgaris. Some Rosacea sufferers have a significant Acne component in their symptoms so it can be easily confused with Acne Vulgaris. But the papules and pustules of Rosacea tend to be less follicular in origin. Rosacea will probably have an underlying redness that is related to flushing and thus looks different than Acne Vulgaris. Acne sufferers normally do not have the accompanying redness. Rosacea usually begins with flushing, leading to persistent redness. As both conditions are inflammatory, the treatment for Rosacea and Acne Vulgaris can be somewhat similar, but most of the Acne Vulgaris regimes are too harsh for Rosacea-affected skin and can severely aggravate the condition. Rosacea sufferers are cautioned against using common acne treatments such as alpha hydroxy acids (glycolic and lactic acids), topical retinoids (such as tretinoin, Retin-A Micro, Avita, Differin), benzoyl peroxide, topical azelaic acid, triclosan, acne peels, and chemical peels. Additionally the caution extends to topical exfoliants, toners, astringents and alcohol containing products.

Seborrheic Dermatitis and Rosacea are closely related, they both involve inflammation of the oil glands. Rosacea also involves a vascular component causing flushing and broken blood vessels. Seborrheic Dermatitis may involve the presence of somewhat greasy flaking involving the T zone such as crusts, scales, itching and occasionally burning. Dermatitis may also be found on the scalp, ears and torso. It does not usually involve red bumps as in Rosacea. The T zone is the area shaped like a `T' composed of your forehead, nose and around your mouth. Just to confuse things further, the two conditions are often seen together.

Rosacea is primarily a disorder of the facial blood vessels. Experts from across the world agree that vascular abnormalities are central to all stages and symptoms of Rosacea.

To paraphrase: Rosacea inflicted blood vessels undergo changes in function and become hyper-responsive to internal and external stimuli.These changes are ultimately responsible for the progression of all Rosacea symptoms. As with many conditions, there appears to be a genetic propensity to developing Rosacea.

Rosacea normally progresses in the same generalized fashion: frequent dilation of facial blood vessels leads to vascular hyper-responsiveness and structural damage. Rosacea experts talk about Rosacea symptoms appearing in 4 stages. Over time Rosacea can progress from one stage to the next.

Pre-Rosacea: The first cardinal sign of Rosacea: blood vessels dilate to more stimuli, open wider and stay open for longer periods of time compared to normal persons. No visible damage is normally seen.

Mild Rosacea: Begins when the facial redness induced by flushing persists for an abnormal length of time - usually 1/2 an hour or more after a trigger. Those who have frequent pre-Rosacea flushing are highly susceptible to progressing to mild Rosacea. Some of the common triggers for a facial flush are heat, cold, emotions, exercise, topical irritants and allergic reactions.

Moderate Rosacea: As facial flushing becomes more frequent and intense, vascular damage occurs. This can result in long lasting redness, swelling and inflammatory papules and pustules. Telangiectasia (damaged micro blood vessels, often visible on the surface of the skin) may be noticed in the areas where flushing is worst.

Severe Rosacea: Characterised by intense bouts of facial flushing, severe inflammation, facial pain, swelling and burning sensations. Sufferers may develop intolerance to products they were able to use before. Also inflammatory papules, pustules and nodules may be present. Some experience a bulbous enlargement of the nose, known as rhinophyma. This is just a guide, you may of course experience symptoms outside these ranges.