Acne Rosacea is a common skin disorder. Typically I would see 4 or 5 new patients with this condition each day. It typically begins with a person who flushes and blushes. This flushing and blushing becomes progressive and they develop central facial redness and acne. Therefore the term acne rosacea; acne occurring in a person with a pink face.
There are 4 different forms of rosacea. The first is the classic flushing and blushing and central facial redness. The second is in folks who have much more active acne. This may range from single pimples to multiple markings and a progressive severe disease. We say acne occurring in people over 30 is due to acne rosacea. Two other forms of rosacea are worth discussing because they are not what you would normally associate with rosacea. One is the development of progressive thickening, particularly of the nose but also central face. This is also associated with large thick pores. This may go on and progress to a very disfiguring lumpy bumpy nose. The 4th form is described by the term 'ocular', meaning focus with symptoms around the eyes. Beginning as dry, gritty, watery, or burning eyes, the symptoms can progress and become debilitating. The acne component consists of inflammatory lumps which show us as pimples or sties, typically in an around the eyes. There also can be visible blood vessels. When you examine the eyes, they typically look red and irritated.
What happens with treatment? In general the treatment of rosacea with topical niacinamide is highly satisfactory to the patient. For the most highly sensitive skin patients who are adverse to using topical creams, oral niacinamide is effective. They note within a day or two of treatment that their skin becomes to feel much more normal. The stinging and burning is markedly reduced. Significant improvement in the overall redness, flushing and blushing, and the frequency of acne are all reduced after six weeks of treatment. The thickening of the nose takes longer to respond to treatment. Eye symptoms again markedly improve typically by six weeks.
The treatment plan is usually six months duration. After that time, treatment is withdrawn. It is repeated when there is a repeat of the symptoms. Some people are on continuous niacinamide, with NO harmful side effects.