Rosacea (pronounced "roh-ZAY-sha") is a chronic and potentially life-disruptive disorder primarily of the facial skin, often characterized by flare-ups and remissions. Many have observed that it typically begins any time after age 30 as a redness on the cheeks, nose, chin or forehead that may come and go. In some cases, rosacea may also occur on the neck, chest, scalp or ears. Over time, the redness tends to become ruddier and more persistent, and visible blood vessels may appear. Left untreated, bumps and pimples often develop, and in severe cases the nose may grow swollen and bumpy from excess tissue. This is the condition, called rhinophyma (pronounced "rhi-no-FY-muh"), that gave the late comedian W.C. Fields his trademark bulbous nose. In many rosacea patients, the eyes are also affected, feeling irritated and appearing watery or bloodshot.
What Should I Look For?
Rosacea can vary substantially from one individual to another, and in most cases some rather than all of the potential signs and symptoms appear. According to a consensus committee and review panel of 17 medical experts worldwide (see Classification of Rosacea), rosacea always includes at least one of the following primary signs, and various secondary signs and symptoms may also develop.
Primary Signs of Rosacea
Many people with rosacea have a history of frequent blushing or flushing. This facial redness may come and go, and is often the earliest sign of the disorder.
Persistent facial redness is the most common individual sign of rosacea, and may resemble a blush or sunburn that does not go away.
Bumps and Pimples
Small red solid bumps or pus-filled pimples often develop. While these may resemble acne, blackheads are absent and burning or stinging may occur.
Visible Blood Vessels
In many people with rosacea, small blood vessels become visible on the skin.
Patient with Subtype 1 (erythematotelangiectatic) rosacea, before and after treatment with topical gel.
Bumps (papules) and Pimples (pustules)
Patient with Subtype 2 (papulopustular) rosacea, treated with topical therapy in a split-face study.
Visible Blood Vessels (telangiectasia)
Patient with Subtype 1 (erythematotelangiectatic) rosacea, before and after pulsed-dye laser treatment.
Patient with Subtype 1 (erythematotelangiectatic) rosacea, before and after treatment with a pulsed-dye laser
Vitiligo (vit-uh-lie-go) causes the skin to lose color. Patches of lighter skin appear. Some people develop a few patches. Others lose much more skin color.Vitiligo usually affects the skin, but it can develop anywhere we have pigment. Patches of hair can turn white. Some people lose color inside their mouths. Even an eye can lose some of its color. Vitiligo is not contagious. It is not life-threatening. But, vitiligo can be life-altering. Some people develop low self-esteem, no longer want to hang out with friends or develop serious depression. Vitiligo causes loss of color. Your dermatologist may call this “loss of pigment” or “depigmentation.” We can lose pigment anywhere on our bodies, including our:
Skin Hair (scalp, eyebrow, eyelash, beard) Inside the mouth Genitals
Most people who get vitiligo lose color on their skin. The affected skin can lighten or turn completely white. Many people do not have any other signs or symptoms; they feel healthy. A few people say that the skin affected by vitiligo itches or feels painful.
Eczema is a class term for a group of medical conditions causing the skin to be irritated or inflamed. The most common type of eczema is atopic dermatitis which is common among young children and runs in a triad with allergies and asthma. Eczema (dermatitis) is a common condition where the skin is inflamed or irritated causing skin to lose water or have "transepidermal water loss" TEWP. Loss of water means that skin is dry and itchy. This can be caused by genetics (having genes that cause a predisposition to being easily irritated) or by some physical environmental cause (dry weather, chemicals, or allergies).
What Are the Symptoms?
Eczema is almost always itchy. Sometimes the itchiness can come before the rash, and eczema is fondly coined "the itch that rashes".
When eczema has been present for an extended period of time, the skin affected can change and become thicker, scaly, dry and discolored. In light skinned individuals, the discoloration can be pink/red then turn brown. In darker skinned individuals, the rash may make the skin darker in color or lighter in color.
What Causes Eczema?
The exact cause of eczema is unknown, but it is thought to be a natural body reaction to an allergen or irritant. Sometimes stress, weather changes or illness can trigger eczema. Exposure to certain chemicals that cause irritation such as household cleaning products or acetone can cause an outbreak. Certain people are sensitive to pet dander and pollen, causing a flare.
Eczema is not contagious and can't be spread from person to person.
How Is Eczema Diagnosed?
Eczema is a clinical diagnosis made by a dermatologist. There are many other skin conditions that can look like eczema so it is best to be seen by your medical provider.
How Is Eczema Treated?
Improving the skin texture and removing allergens/triggers are the treatment of choice. Treatments normally entail relieving itchiness and removing causes of itchiness. Lotions, oils and creams can be used to keep the skin moist.
Over the counter produces for itchiness and skin relief can be used and in more severe cases, prescription creams and ointments can be used to reduce itchiness. Topical corticosteroids do not, however, repair the skin, they simply relieve the symptom of itch.
Oral medications such as antihistamines or antiinflammatories, tar treatments, or phototherapy can be used. There are also two FDA approved topical immunomodulators for mild to moderate eczema: Elidel and Protopic. Both should not be used in kids under age 2.
How Can Eczema Flares Be Prevented?
Moisturize often to avoid dry skin. Avoid stressful situations and coming into contact with irritating allergens. If you are itchy, do not scratch. This will make your rash worse.