What are the other Names for this Condition? (Also known as/Synonyms)

• Steroid-Induced Rosacea

What is Steroid Rosacea? (Definition/Background Information)

• Steroid Rosacea describes a skin condition presenting rosacea-like eruptions due to the adverse effects of topical steroidal agents. Rosacea is a common chronic skin disorder that manifests as reddish skin with papules and pustules on the face. It occurs due to inflammation of the oil glands and hair follicles. Steroid Rosacea may develop both from the application of topical steroids and from their withdrawal (withdrawal symptoms)
• Topical steroids are prescription ointments and creams used for various skin conditions such as contact dermatitis and atopic eczema. They help lower body inflammation and decrease the immune system activity. Topical steroids are also known as topical corticosteroids. Skin side effects usually arise from long-term use of potent steroids
• Steroid-Induced Rosacea may be managed by gradually discontinuing the use of the causative steroid medications, along-with administration of other topical and/or oral therapeutic medications. The outcomes of the condition are good with adequate treatment of the same

Who gets Steroid Rosacea? (Age and Sex Distribution)

• Steroid Rosacea may be observed in both children and adults
• Both males and females are affected. However, a large number of cases are reported in adult women
• Worldwide, individuals of all racial and ethnic background may be affected

What are the Risk Factors for Steroid Rosacea? (Predisposing Factors)

• Long-term usage of potent topical steroid applications is the primary risk factor for Steroid Rosacea

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Steroid Rosacea? (Etiology)

• Steroid-Induced Rosacea develops from using potent topical steroid for long durations, possibly in the absence of appropriate medical supervision
• It is important to note that a variety of signs and symptoms may be observed as side effects of steroid medications

What are the Signs and Symptoms of Steroid Rosacea?

The signs and symptoms of Steroid Rosacea may vary from one individual to another. The presentations may resemble periorificial dermatitis, another skin condition that may develop from the usage of topical steroidal creams. The signs and symptoms may develop following weeks of application of the topical agents.

The signs and symptoms may include:

• The presence of small multiple red papules and pustules. The lesions may be observed in clusters
• The skin feels warm to touch, and may be dry and scaly
• The papules and pustules may sting, burn, and itch
• Appearance of telangiectasia (spider veins) when tiny blood vessels cause a mesh-like pattern on skin
• The skin around the face is usually affected - the region around the mouth, nose, and eyes are usually involved. The cheeks and forehead may also present the characteristic lesions
• Increased skin sensitivity is often noted

How is Steroid Rosacea Diagnosed?

A diagnosis of Steroid Rosacea may involve the following:

• Physical examination and a complete medical history, including history of topical corticosteroid use and/or related medical conditions
• Blood tests, analysis of pus, and culture of the fluid being drained, as needed
• Dermoscopy: Dermoscopy is a diagnostic tool where a dermatologist examines the skin using a special magnified lens
• Wood’s lamp examination: In this procedure, the healthcare provider examines the skin using ultraviolet light. It is performed to examine the change in skin pigmentation
• Skin biopsy: A skin tissue biopsy is performed and sent to a laboratory for a pathological examination. The pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Steroid Rosacea?

Steroid Rosacea can cause the following complications:

• Emotional and psychological stress
• Cosmetic issues
• Secondary bacterial and fungal skin infections
• Withdrawal symptoms (rebound flare): The condition may worsen when the topical steroids are suddenly discontinued
• Scarring of the affected region leading to permanent scarring
• Treatment complications

How is Steroid Rosacea Treated?

The treatment of Steroid Rosacea depends on the cause and its severity. The treatments may involve:

• Gradually discontinuing the medication responsible for the side effect may result in a cure, or in improvement of the condition. Usually less potent topical steroids are recommended before completely discontinuing the same
• Use of topical medications: The frequently used medications include azelaic acid, metronidazole, sodium sulfacetamide, with or without elemental sulfur
• Mild topical retinoids in selected cases
• Administration of oral medications, such as doxycycline, for severe cases
• Laser therapy to treat telangiectasia, if needed
• Antibiotic or antifungal therapy for secondary infections, if necessary

Self-care (home) remedies may include:

• Wash the lesions with mild soap (antibacterial)
• Apply warm compress
• Wash hands before applying topical applications
• Keep nails trimmed; do not pick at the lesions
• Use non-oily moisturizing creams for dry skin

How can Steroid Rosacea be Prevented?

The prevention of Steroid Rosacea may involve the following measures:

• Use topical steroids as prescribed, only under medical supervision
• Avoiding self-medication, or bringing about any changes to one’s medications, or continuing to take medications beyond the prescribed period without consulting the healthcare provider, may help lower the risk for Steroid Rosacea

What is the Prognosis of Steroid Rosacea? (Outcomes/Resolutions)

The prognosis of Steroid Rosacea depends on the severity of the condition but is generally good with early recognition of the condition followed by suitable treatment.

Additional and Relevant Useful Information for Steroid Rosacea:

Cleaning the skin too hard with strong chemicals or soaps may aggravate the skin condition. Care must be taken avoid strong soaps and chemicals that could potentially worsen the condition.