Rosacea is no fun. It is a stubborn skin disorder that is frustrating and extremely difficult to treat. Thought to afflict at least 30% to 50% of the Caucasian population, it is frequently misdiagnosed by dermatologists and physicians. Rosacea develops over a long period of time, starting with what at first seems like a tendency to blush easily, a ruddy complexion, or an extreme sensitivity to cosmetics. The distinctive redness or flushing, which appears in a characteristic butterfly pattern over the nose and cheeks, is likely to be the first indication that rosacea may be what your skin is struggling with. Though bothersome, the subtle initial redness is often ignored by women as being just a skin-tone or color problem and not a skin disorder.
Another challenge with identifying rosacea is that pustules (pimples) and papules (red raised bumps) that resemble acne are often present. That makes rosacea look like acne and that means it’s often misdiagnosed. But, unlike most acne conditions, rosacea is rarely, if ever, accompanied by blackheads. The distinctive flushing and extreme skin sensitivity also differentiate rosacea from acne. The final toll on the face is the presence of flaky patches that may or may not be accompanied by either dry or oily skin, or possibly by both at the same time.
Rosacea can be extremely confusing for a woman because the dry, flaky skin responds minimally or not at all to moisturizers and the acnelike bumps and whiteheads respond minimally, or not at all, to typical acne treatments. Adding to the elusive nature of this disorder the skin is its extreme reactivity to outside influences. Flare-ups can be caused by sun exposure, heat, stress, sweating, exercise, and friction.
For men it can create a bulbous nose, typified by redness, lumpy swollen areas, and noticeable veining, called rhinophyma, as well as puffy cheeks (rhinophyma rarely occurs in women). In the past, the occurrence of rhinophyma was wrongly thought to be caused by drinking too much alcohol, but no amount of alcohol can change the appearance of the nose in this manner. (Sources: Annals of Plastic Surgery, July 2008, pages 114-120; and Journal of Otolaryngology Head and Neck Surgery, April 2008, pages 269-272.)
Even more confounding, when rosacea first develops it may appear, disappear, and then reappear a short time later. This fluctuation also makes diagnosis difficult. Yet, despite its evasive beginnings, the condition rarely reverses itself (meaning there is no cure), and it almost always becomes worse without treatment.
As rosacea progresses and changes, what usually happens over time is that the affected areas of the face don’t return to their normal color and stay persistently red. Other symptoms, such as enlarged, surfaced blood vessels (called telangiectasia) start appearing; flaky patches, oily skin, increased skin sensitivity, and breakouts can become more visible, too.