Red spots, pimples and a swollen nose: treating rosacea in good time
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Red spots, pimples and a swollen nose: treating rosacea in good time

Rosacea itches, burns and looks nasty. Even if this skin condition can’t be cured, there are a few things you can do to treat it.

Small blood vessels break and become larger, spreading over the cheeks and nose and occasionally even affecting the eyes. Severe cases also include a red, swollen nose. What may appear a symptom of excessive alcohol consumption could in fact be rosacea.

The skin disease, usually diagnosed between the ages of 30 and 50, is quite common. It’s estimated that between 2 and 5 per cent of adults have rosacea. In Germany, however, a study recently revealed that it’s about 12 per cent of adults. At up to 20 per cent, the number of people affected by the skin disease, also known as the «curse of the Celts», is significantly higher in Scandinavia.

Causes unclear

There’s currently no broad scientific agreement on what exactly causes rosacea. «The pathology and physiology of the disease is still unclear. It’s likely a stress-related and hormonally induced disease,» says Dr Ikonija Koceva, dermatologist at the Swiss Academy Hautwerk.

According to Dr Koceva, the private sector regularly carries out extensive research, which also produces effective medicine. Nevertheless, the causes of rosacea are still a mystery to science. What we already know, however, is that diet and lifestyle play an important role. And there’s a genetic disposition for rosacea too.


The general symptoms of the disease include red, often itchy and burning patches of skin, which can even turn into pimples and bumps. Symptoms may occur in episodes or become chronic.

Only the face is affected because facial skin is particularly thin and therefore offers little protection against external factors such as heat, cold and UV radiation. These factors already have a negative impact on healthy facial skin. People with rosacea need to be even more careful, as the already irritated blood vessels are even more severely affected without suitable creams.

Incidentally, women are affected by rosacea up to three times more frequently than men, with severe forms, including a bulbous nose, occurring more frequently in men (link in German). In addition, Celtic, fair-skinned skin types are far more frequently affected compared to Mediterranean skin types with darker tones. More than 50 per cent of patients also have affected eyes involving dryness, redness, increased sensitivity to light, corneal clouding and even impaired vision (link in German).

Treatment methods for rosacea

There are currently various ways to counteract rosacea. However, the skin disease can’t be fully cured, says Dr Koceva from Hautwerk: «As soon as the treatment interrupted or discontinued, symptoms return».

At the Hautwerk practice, doctors treat rosacea primarily with skin care and light or laser therapy. Local application of medication, known as topical medication, involves the use of either anti-inflammatory drugs or antibiotics. In some cases, swallowed antibiotics or vitamin A acids are also prescribed.

Unfortunately, none of these skin care products are covered by health insurance companies. Nonetheless, Dr Koceva advises against using medication or lotions covered by insurance. They’re often too greasy and tend to make symptoms worse rather than improve them.

Take individual needs into account

«The anti-inflammatory properties of topical medication help reduce redness, swelling and inflammation associated with rosacea,» says the dermatologist. «Frequently used active ingredients are azelaic acid and ivermectin. Other topical medication for rosacea, however, contains antibiotic agents such as metronidazole or clindamycin to combat the pimples and papules that may occur in some cases.»

Treatment depends on the individual needs of the person affected and the type of rosacea. «The most common method is to apply local treatment over six to eight weeks. Prolonged use of topical antibiotics can lead to a loss of effectiveness, as the skin reacts less sensitively to the medication over time.»

Light and laser

Rosacea is usually initially treated conservatively with medication. Depending on the degree of the disease, however, it may also be treated with vascular lasers and light therapy. These treatments are generally not covered by health insurance either, you have to pay for these services yourself.

«Laser treatment varies depending on the type and severity of rosacea,» says Dr Koceva. «It aims to close visible blood vessels and reduce redness typically associated with rosacea. However, laser treatment doesn’t cure rosacea, but temporarily improves the symptoms. In some cases, regular refresher treatments may be required to maintain the results.»

Laser therapy causes a slight burning or stinging sensation on the skin but, according to the expert, is generally well tolerated and should be carried out by specialist doctors. According to Hautwerk founder Dr Bettina Rümmelein in her article in the specialist journal «ästhetische Dermatologie und Kosmetologie» (English: aesthetic dermatology and cosmetology) (link in German): «Vascular laser treatments carry an increased risk of side effects, which is why good training is essential.»

Dos and don’ts if you have rosacea

Another way to influence the condition is with lifestyle choices. As with so many (skin) diseases, alcohol and smoking are counterproductive. Warming drinks in particular, such as red wine, should be avoided. «When it comes to food, there are a few types that make rosacea worse. I’d avoid spicy food, such as Thai or Indian cuisine,» says Dr Koceva.

  • use gentle facial care products specially developed for sensitive skin. Brushes, microfibre cloths, scrubs and alcohol-based tonics are off limits.
  • avoid waterproof make-up products and don’t use aggressive make-up removers
  • practice active stress management through yoga and meditation
  • avoid hot water when showering or use it only briefly
  • avoid hot spices, alcohol, hot drinks and smoking
  • take particular care in extreme temperatures (winter and summer)
  • avoid radical changes in eating and drinking habits. Instead, go for long-term change with the help of nutritional counselling
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Diagnosed with rosacea – what now?

The rule of thumb for rosacea: the earlier you take action, the better. Dr Koceva says that some of her patients come for a checkup even before the skin shows any real problems. If you notice a permanent reddening of the skin vessels on your face, it’s recommended that you first visit a dermatologist and then continue to observe the areas. A preliminary stage of rosacea can be so-called facial erythrosis, slightly reddened skin, but this can also occur as an independent skin disease.

It’s also worth taking a critical look at your life situation and habits. Are you under a lot of stress? What about your diet? Which guilty pleasures do you have? Do you regularly drink or smoke? Even if the pathophysiological process behind the disease isn’t yet clear, one thing’s for sure: you can do a lot to curb acute flare-ups. «Changing your lifestyle plus appropriate skin care and avoiding triggers can have a significant impact on symptoms and help keep the condition under control,» says Dr Koceva.

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Moritz Weinstock
Autor von customize mediahouse

Notebook, camera, laptop or smartphone. For me, life's about taking notes – both analogue and digital. What's always on me? My iPod Shuffle. It's all in the mix, after all. This is also reflected in the topics I write about.

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