Rosacea is a skin condition that is often chronic and mainly causes redness and flushing of the face. In addition to redness there may be burning or stinging over the affected area, reddish spots that persist and visible tiny blood vessels under the skin. Over time the skin may become thick and enlarge usually over the nose causing significant deformity.
Rosacea commonly affects around 10% of all individuals and is particularly severe among fair skinned Caucasians. It can also, however, be seen in people of Asian and African origin. It affects persons of both genders and usually affects middle aged persons.
Diagnosis of Rosacea depends on clinical examination and some rarely used laboratory confirmatory tests.
Diagnosis more often than not is made based on clinical symptoms and appearance of the lesions.
History of trigger factors and symptoms
A detailed history of trigger factors and clinical symptoms of the condition are obtained. Some of the common triggers for Rosacea flare ups include exposure to sunlight, stress, cold weather exposure, heat, vigorous exercise, alcoholic and caffeine containing beverages, spicy foods, certain medicines and after menopause. These may be present in many individuals. There are usually periods when the symptoms disappear or are less severe than others. History of similar lesions in the family are also enquired.
Examination of the skin lesions
The skin lesions are examined in detail. Typically the lesions appear red and over time there may be enlargement of the skin over the nose leading to nose deformity. The blood vessels underlying the skin may be visible under the skin surface.
Ruling out other conditions
Other conditions that also manifest with similar facial lesions include systemic lupus erythematosus (SLE) which is an autoimmune condition where the immune system attacks healthy tissues of the body. Menopause may also give rise to similar symptoms.
These conditions need to be differentiated from Rosacea via blood tests that include immunological tests for ruling out SLE.
In rare cases a small scraping of the affected area of skin is taken and examined under the microscope. This is called a skin biopsy. This may reveal microscopic skin mites like Demodex folliculorum or skin infections.
Reviewed by April Cashin-Garbutt, BA Hons (Cantab)