Rhinophyma

mainly the forehead, the chin and the lower half of the nose. The tiny blood vessels in these areas enlarge (dilate) and become more visible through the skin, appearing like tiny red lines (called telangiectasias). Pimples can occur that look like teenage acne.

Unlike acne, rosacea is not primarily a plague of teenagers. It occurs most often in adults (ages 30 to 50), especially those with fair skin, and affects both sexes but tends to be more common in women but worse in men. Unlike acne, there are no blackheads or whiteheads in rosacea.

When rosacea first develops, it may appear, then disappear, and then reappear. However, in time the skin fails to return to its normal color and the enlarged blood vessels and pimples arrive. Rosacea rarely reverses itself. It lasts for years and, untreated, it worsens.

About half of all people with rosacea feel burning and grittiness of the eyes (conjunctivitis). If this is not treated, the complications of what is called rosacea keratitis may impair vision.

Rosacea can be treated but not cured. Over-the-counter medications for acne can be a hazard; they can irritate the skin in rosacea. Topical antibiotics (such as metronidazole) and oral antibiotics (such as tetracycline) are often used. Short-term topical cortisone (steroid) preparations of the right strength may also be used to reduce local inflammation.

Avoiding smoking and food and drink (such as spicy food, hot beverages and alcoholic drinks) that cause flushing helps minimize the blood vessel enlargement. Limiting exposure to sunlight and to extreme hot and cold temperatures also helps relieve rosacea.

Rubbing the face tends to irritate the reddened skin. Some cosmetics and hair sprays may aggravate redness and swelling. 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.

Cover-up make up is used for the telangiectasias. Telangiectasias can be treated with a small electric needle, a laser or surgery to close off the dilated blood vessels.