RosaceaNet Article
How to Calm the Itch of Rosacea

There is no denying that rosacea can itch. While not everyone with rosacea develops itchy skin, some who do say it feels as if the skin affected by rosacea constantly itches. The skin also may tingle, burn, and feel hot. Touching the affected skin often makes the itch worse.

This does not mean that you have to live with an incessant itch. A dermatologist can identify the cause and prescribe appropriate treatment.

Causes
If rosacea itches, it is most likely caused by:

Overly dry skin. Some people notice that rosacea causes their facial skin to become increasingly dry. Dry skin itches. It also may burn and sting.

If you have overly dry skin, dermatologists recommend that you:

  • Tell your dermatologist. In some cases, a topical medication prescribed for the rosacea may be causing your dry skin. Switching medications can bring relief. A skin condition other than rosacea also may be the culprit. A prescription salve can alleviate this problem. If a moisturizer is needed, your dermatologist can recommend one that does not clog pores.
     

  • Avoid standing or sitting next to a lit fireplace or stove. The flames can quickly dry the skin.
     

  • Turn down the thermostat. Heat dries the air considerably.
     

  • Use a humidifier. Regular use of a humidifier can help alleviate cracked, irritated skin when the air is dry.
     

  • Wash with lukewarm, not hot, water. Hot water tends to dry the skin. After washing the face, allow the skin to air dry.

Skin care products. Harsh or overly drying skin care products can cause the skin affected by rosacea to itch. People with subtype 1 rosacea — which is characterized by redness, swelling, and visible blood vessels — seem most susceptible to this irritation. It is important for people with rosacea to select skin care products that do not cause irritation. If any skin care product — including a medication meant to alleviate the redness of rosacea, a cosmetic, or a sunscreen — seems to irritate your skin, let your dermatologist know.

When shopping for over-the-counter skin care products, be sure to read the list of ingredients before buying. According to a survey conducted by the National Rosacea Society, products that contain alcohol, eucalyptus, fragrance, menthol, peppermint, or witch hazel are most likely to aggravate rosacea. Any product that causes your skin to burn, itch, or sting should not be used.

Folliculitis. Inflammation of the hair follicles, a condition that dermatologists call “folliculitis,” is another cause of itchy skin in people living with rosacea. When a hair follicle becomes inflamed, a tender red pustule usually appears. In some people with rosacea, infection develops in these inflamed hair follicles. If you have any of these signs, be sure to see a dermatologist for treatment. Treating the infection often eliminates the itch.

Avoid Rubbing, Scratching, and Using Topical Corticosteroids
If your skin itches, you may be tempted to rub, scratch, or apply a topical corticosteroid. While these can bring immediate relief, the fact is that all of these can make matters worse. Rubbing and scratching can increase the inflammation of folliculitis. If an infection exists, rubbing and scratching can spread the infection to hair follicles not yet affected. Therefore, it is important to stop the itch as soon as it begins.

To control the itch, your first thought may be to reach for a topical corticosteroid, such as over-the-counter hydrocortisone anti-itch cream. While applying a topical corticosteroid (also known as steroid, cortisone, glucocorticoid, and glucocorticosteriod) can bring immediate relief, it is generally not lasting relief. As soon as the topical corticosteroid is stopped, inflammation usually returns, and the inflammation can be worse. A flare-up causes many people to continue using the topical corticosteroid. Each time the medication is used, the redness lessens, the itching subsides, and the overall appearance of the skin generally improves. As soon as the medication is stopped, the skin tends to flare.

This is a common reaction in people who have rosacea and can lead to dependence on topical corticosteroids. Overuse of topical corticosteroids can worsen the very condition that you are trying to resolve — inflammation of the hair follicles. Additionally, long-term use of topical corticosteroids can cause side effects, such as thinning skin, stretch marks, and visible capillaries. Long-term use of corticosteroids also has been known to worsen rosacea.

Treatment
To control the itch of rosacea, dermatologists generally recommend moisturizing topical antibiotics and/or pramoxine lotion. While getting the itch under control, cool — not cold — compresses can help as itching tends to be more severe when the skin is warm.

Moisturizing topical antibiotics. These are especially helpful when the itch is caused by a topical product that has irritated the skin, such as a sunscreen or a cosmetic. The antibiotic can help prevent infections caused by bacteria. Topical moisturizing antibiotics should only be used on the skin and only as directed.

Pramoxine lotion. This prescription medication is used to relieve pain and itching as well as moisturize. Pramoxine lotion is generally applied three (3) or four (4) times a day. Unlike corticosteroids, pramoxine lotion does not worsen infection in the hair follicles, and flare-ups have not been reported when pramoxine lotion is stopped. This lotion should not be applied to an open wound or blistered skin.

Whether you have been bothered by the itch of rosacea for years or just recently noticed that your rosacea is beginning to itch, be sure to see your dermatologist. Appropriate treatment can calm the itch of rosacea.

Reference:
National Rosacea Society, “Ingredients May Aggravate Rosacea.” Rosacea Review, spring 2005. Available at: http://www.rosacea.org/rr/2005/spring/article_5.html. Last accessed: August 23, 2005.

 


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