Rosacea is a common chronic skin condition which affects an estimated 14 million Americans. People who are most affected by rosacea tend to be in their 30s or 40s and are generally of lighter complexion.

Signs and Symptoms: Rosacea refers to a range of symptoms that generally start with some blushing or modest redness on the cheeks, nose, forehead and chin.

As the condition progresses, symptoms typically worsen to include persistent redness on the nose and cheeks. Small blood vessels begin to grow, particularly on the nose, and become increasingly visible. Diffused generalized redness may become constant and often worsens after exercise, the drinking of coffee or alcohol, or exposure to some other kind of "trigger." Pimples may develop as well, a factor that has led to the misperception that rosacea is "adult acne."

Rosacea Will Worsen Without Treatment: Rosacea absolutely gets worse if you don't treat it. I tell my patients who have rosacea that it takes a long time for the telltale spider veins (a major symptom of rosacea) to first appear on the face. The sun has to hit the skin for a significant period of time to trigger the creation of a few blood vessels, but once those have formed, it becomes easier for the sun to stimulate the gene in those cells to produce even more. So you have this downward spiralling effect. I often hear such comments from my patients as, "I just started having these facial veins a year ago and now I'm covered." The process begins to snowball, creating more and more blood vessels — and redness.

Treatments Help Manage Symptoms: While there is currently no cure for rosacea, its symptoms often can be managed quite effectively. Inflammatory symptoms, such as acne, are usually treated with oral and topical antibiotics. The blood vessels associated with rosacea can be treated with lasers.

Long-lasting Results: Once you've undergone laser treatments to remove the blood vessels associated with rosacea, it takes a very long time for them to come back. If you then use sunscreen every day, you might not need to have any further laser treatment for another two to eight years, maybe longer. Reducing sun exposure is imperative for preventing further blood vessels from developing.

Consult an Experienced Doctor: It's important to visit with a physician who's highly experienced with using laser therapy for rosacea. You want someone knowledgeable about the very latest — and most effective —treatments available.

Laser Treatment: Relief from Flushing and Dilated Blood Vessels: Redness and flushing, which are probably the most prominent and common features of rosacea, are, in my opinion, best treated with lasers. This technology is also highly effective in treating the red lines (telangietasis) that appear when the tiny blood vessels under the skin become enlarged. In addition, some studies have demonstrated that laser treatments can improve the acne-like pimples associated with rosacea. Various lasers are used to treat rosacea, including the ND:YAG laser, the pulsed-dye laser, and the KTP laser. To help remove rosacea-associated thickening of the skin on the nose and cheeks (rhinophyma), lasers such as the erbium:YAG laser and the CO2 are sometimes used.Although most patients see a significant improvement in their symptoms following one laser session, several sessions are usually needed to complete the treatment. If you then make the effort to avoid rosacea-aggravating sun exposure (by wearing a strong sunscreen daily), visible blood vessels may not return for years.

Does It Hurt?: Laser treatments are slightly uncomfortable, but not painful. In fact, the discomfort is not even great enough to require that a topical numbing cream be applied to the skin before the procedure begins. Just how uncomfortable you'll feel during your treatment session will depend on your pain threshold. Interestingly, I find that men tend to have lower thresholds for pain than women. Let me emphasize, however, that rarely does anyone complain about pain during a laser treatment.

How Long Is Recovery?: You'll experience no downtime, and can return to your normal activities as soon as you feel comfortable doing so. Expect some redness, which usually lasts for an hour or two after treatment, and some swelling, which typically lasts for two to six hours, but sometimes lingers for up to four days. You may also experience purpura, or bruising; this side effect, when it occurs, may take four to seven days to go away.

Physician Experience Is Essential: You want to be in the hands of a physician who is experienced and skilled in using lasers to treat rosacea. The treatment of the diffused generalized redness of rosacea particularly requires considerable skill. If an area is overtreated, the "footprints" of the laser treatment will be visibile as white circular marks on the skin. Such marks look like scarring, although they are, in fact, the skin's normal color. The way to fix this, believe it or not, is to get additional laser treatments. But, of course, the best course of action is to prevent the overtreatment in the first place. That's why it's essential to seek care from a physician with extensive experience in using lasers to treat rosacea.

Oral Treatment: A First-line Treatment: Oral medications, particularly antibiotics, are usually a first-line treatment for rosacea once acne-like papules and pustules appear. These drugs are typically prescribed in conjunction with topical medications, lifestyle changes, and laser and/or light therapy.

Antibiotics Fight Inflammation: Antibiotics have anti-inflammatory effects that seem to suppress the inflammation associated with rosacea. It's thought that these drugs may also reduce the excess vascularity (formation of blood vessels) that plays such a central role in the development of the condition's symptoms. The most common oral antibiotics prescribed for rosacea include tetracycline, doxycycline, and minocycline. Because oral antibiotics can produce unwanted side effects, including an upset stomach and diarrhea, and because of the dangers of bacterial resistance, their long-term use is not recommended. You'll most likely be prescribed these drugs until your symptoms have been brought under control, at which point topical medications, lifestyle changes, and laser and/or light treatments will be used to keep further flare-ups at bay.

Isotretinoin for Severe Cases: For severe cases of rosacea—those, in particular, that involve cystic acne—doctors sometimes prescribe low doses of isotretinoin (Accutane or Roaccutane). This powerful drug, which is derived from vitamin A, appears to shrink the skin's sebaceous glands, thus keeping papules and pustules from forming. Isotretinoin cannot be taken by women who are pregnant or who may become pregnant while on the drug, for it has been linked to birth defects.

Short-term Oral Steroids: Short-term (a week or less) doses of oral steroids may be prescribed in severe cases of rosacea to reduce swelling and inflammation to the point where topical antibiotics can then be comfortably applied.

Anti-Hypertensives for Severe Flushing: Some people have found that taking anti-hypertensive medications—drugs used to lower blood pressure—help reduce their symptoms of severe flushing. Obviously, these drugs are not for everybody, and you'll need to discuss their pros and cons carefully with your physician.