National Organization for Rare Disorders, Inc.
It is possible that the main title of the report Acne Rosacea is not the name you expected.
Acne Rosacea is a skin disorder limited to the nose, cheeks, chin, and forehead, typically beginning during adulthood. The facial skin becomes oily, reddened and bumpy. Small red blood vessels are visible. In extreme cases, the nose may appear very red and bulbous.
Acne Rosacea affects the skin of the nose, surrounding cheeks, chin, and forehead areas. The skin becomes oily and progressively reddened (erythematous) with enlarged blood vessels apparent in the skin (telangiectasias). Typically, small elevated growths (papules), some containing dead skin cells and fluid (pustules) develop over the central area of the face. Scarring usually does not occur. In very severe cases, the skin of the nose becomes extremely red and bulbous (rhinophyma). Some affected individuals may experience gritty-like feeling in their eyes. In addition, their eyes may appear watery or bloodshot.
Adolescents and young adults who blush frequently or whose flushes produce a redness that lasts longer than would otherwise be expected, may be prone to this disorder. People who have relatives with Rosacea and whose skin becomes irritated from anti-acne creams may also be predisposed to Acne Rosacea.
The exact cause of Acne Rosacea is not known. Studies indicate that some people may have a genetic predisposition to this disorder. Approximately 40 percent of affected individuals report a family history of the disorder.
Episodes of redness may be brought on or intensified by the consumption of hot liquids, spicy foods, and/or alcohol. Vigorous exercise, heat, exposure to sun and strong winds, exposure to cold weather, certain vitamin deficiencies, endocrine disturbances and/or emotional stress may also trigger an episode of Acne Rosacea. Other studies indicate that Helicobacter pylori, a bacteria; commonly associated with peptic ulcers, may play a role in triggering Acne Rosacea in some people.
One study indicated that Acne Rosacea may be triggered by common skin-care products (e.g., soap, exfoliant agents, makeup, perfume or cologne, moisturizer, hairspray, shaving lotion, sunscreen, and shampoo).
Another study indicated that Acne Rosacea may also be triggered by allergic reactions, colds, fever, or migraines.
Acne Rosacea is believed to affect more than 13 million Americans. Acne Rosacea usually begins between the ages of thirty and fifty years of age, but can occur at any age. The disorder tends to affect females more than males, although cases among males tend to be more severe. Acne Rosacea is most common among people of Irish, English, and northern or eastern European descent.
Symptoms of the following disorders can be similar to those of Acne Rosacea. Comparisons may be useful for a differential diagnosis:
Acne Conglobata may occur alone, or may be part of a symptom complex in conjunction with Hidradenitis Suppurativa and connective tissue inflammation (cellulitis) of the scalp. Lesions usually occur on the neck and upper trunk, but may extend to the upper arms, lower back, buttocks, and thighs. The typical acne skin eruptions are present, but symptoms are chronic with abscesses and the development of connective formations between inflamed skin growths (nodules) and cysts. The cysts contain foul-smelling fluid, and severe scarring is common. Although this form of acne resists treatment with systemic antibiotics, symptoms may be controlled by the use of isotretinoin in some cases.
Acne Vulgaris is the most common form of acne which affects many adolescents during puberty. The skin eruptions primarily appear on the face, upper back, and/or chest due to overactive oil-secreting (sebaceous) glands related to changes in hormonal activity.
Acne Fulminans is a rare variant of acne seen predominately among adolescent males. Mild Acne Vulgaris initially develops but it is unexpectedly followed by markedly inflamed and painful lesions on the upper trunk and occasionally the face. Lesions may bleed and/or crust, and may be accompanied by fever and other systemic abnormalities. Treatment with isotretinoin, with or without systemic corticosteroid drugs and antibiotics, can be effective in most cases.
Excoriated Acne of Young Women (Acne Excorie Des Jeunes Filles) is a variant of acne produced by excessive manipulation of acne lesions resulting in increased scarring. Although it is often found among young women, it can be found in any age group and both sexes.
Chloracne may develop among workers exposed to chlorinated hydrocarbons. Treatment of the skin lesions should be accompanied by removal of the irritating substance from the environment.
Atypical Acneiform eruptions are seen in any age group and are not always limited to oil-secreting (sebaceous) glands. These eruptions may appear as a result of corticosteroid, androgen, or progesterone drug therapy. Occupational problems including ingestion of iodine or bromine salts, or skin contact with machine oils such as insoluble cutting oils, may also cause this type of acne. Additionally, drugs such as diphenylhydantoin and lithium can induce this skin condition.
Although there is no cure for Acne Rosacea, symptoms can be controlled. Antibiotics can control inflammation, but may cause adverse reactions in som. patients.
A specific type of laser therapy (pulse dye laser) may make the spider. veins (telangiectasia) disappear from the surface of the skin. The lase. does not cause surface damage and requires no anesthesia; this procedure ca. be performed on an outpatient basis. Laser therapy may eliminate some o. the facial redness that is experienced by many people with Rosacea.
Carbon Dioxide laser and conventional surgery are used to remove exces. skin growth (rhinophyma) as a temporary measure. Argon lasers have bee. effective in reducing redness in the nose area, but only in mild cases whic. have not progressed to rhinophyma.
The orphan drug metronidazole (Metrogel) was approved in 1988 by the FD. for treatment of Acne Rosacea. This drug is manufactured by Curate. Pharmaceuticals of Elk Village, IL.
People who are predisposed to Acne Rosacea should avoid anything tha. causes them to have episodes of flushing (e.g., sun, stress, extrem. temperatures, hot weather, spicy foods, and skin-care products). Individuals with Acne Rosacea can try to find a particular ingredient in these products that may be the most irritating (e.g., alcohol, witch hazel, fragrance, menthol, peppermint, and eucalyptus oil). Individuals should avoid any ingredient they find to be irritating. For some individuals, sunscreens ma. irritate the skin. If that is the case, sunscreens developed for childre. should be applied. Predisposed adolescents should use nonirritating facia. products. Other treatment is symptomatic and supportive.
Information on current clinical trials is posted on the Internet at www.clinicaltrials.gov. All studies receiving U.S. government funding, and some supported by private industry, are posted on this government web site.
For information about clinical trials being conducted at the NIH Clinical Center in Bethesda, MD, contact the NIH Patient Recruitment Office:
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For information about clinical trials sponsored by private sources, contact:
Stein JH, ed. Internal Medicine, 2nd Ed.: Little, Brown and Co.;1987:1379-1381.
Bleicher PA, Charles JH, Sober AJ. Topical metronidazole therapy for rosacea. Arch Dermatol. 1987;123(5): 609-614.
Wheeland RG, Bailin PL, Ratz JL. Combined carbon dioxide laser excision and vaporization in the treatment of rhinophyma. J Dermatol Surg Oncol. 1987;13(2):172-177.
Eisen RF, et al. Surgical treatment of rhinophyma with the shaw scalpel.Arch Dermatol. 1986;122(3):307-309.
Dicken CH. Treatment of the red nose with the argon laser. Mayo Clin Proc.1986;61(11):893-895.
Hoting E, Paul E, Plewig G. Treatment of rosacea with isotretinoin. Int J Dermatol. 1986;25(10):660-663.
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Last Updated: 4/8/2008
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