Rosacea is a chronic, inflammatory disease of the skin that is episodic. It is also known as rosacea or acne rosacea. Read more about the symptoms, causes, diagnosis and treatment of rosacea.
The skin disease rosacea is particularly evident on the face. Due to the visible changes, it is often a great burden for those affected. Rosacea can be dangerous if it spreads to the eye and causes inflammation of the eyelids, conjunctiva, cornea or iris. Almost only in men, it is not uncommon for a bulbous nose (rhinophyma) to develop due to growths of the sebum glands on the nose.
Rosacea and acne
Because of the symptoms, the condition is sometimes referred to as “age acne”. In contrast to real acne , the characteristic blackheads (comedones) are missing. Occasionally there are mixed forms of the two diseases.
Rosacea affects women and men equally often, especially between the ages of 40 and 50. It also rarely occurs on the chest, back or (in men) the bald patch. Experts estimate that 5 to 7% of adults suffer from it; very fair-skinned people are more at risk.
Reddening and widening of the superficial veins (telangiectasia) are typical of rosacea. They can be found in the area of the nose, cheeks, chin and forehead, and more rarely on the neck and décolleté. The redness is followed by pus vesicles (pustules), nodules and thickened skin. The mouth and eyes are usually spared. Skin damaged by rosacea is extremely sensitive and easily irritated. Those affected are often very sensitive to skin care products, cosmetics and medication.
Rosacea proceeds in stages
Stage I (rosacea erythemato-telangiectatica; also copper fin, couperose)
- cheeks and nose are particularly affected
- reddened skin with visibly dilated vessels
- the skin burns, stings, or itches
- At first, the reddening disappears spontaneously, later it remains permanently.
Stage II (papulopustular rosacea)
- In addition to the redness and vasodilatation, there are nodules and pus pimples.
Stage III (Rosacea hypertrophica)
- Connective tissue and sebum glands proliferate.
- In men, the nose thickens nodularly (rhinophyma).
- Skin growths on the ear (otophyma), chin (gnatophyma), root of the nose (metophyma) or eyelids (blepharophyma) are rarely observed.
Rosacea on the eye
Rosacea rarely affects the eyes (ophthalmic rosacea). Typical signs of this are dry eyes and eye inflammation, for example inflammation of the conjunctiva (conjunctivitis), the edge of the eyelid (blepharitis) and the iris (iritis, iridocyclitis). The cornea of the eye is rarely inflamed (keratitis). As a result of this inflammation, those affected can go blind.
Rosacea in a pronounced form
Lupoid or granulomatous rosacea runs with painful nodules and brownish-red nodules that leave an apple jelly-like infiltrate after a glass spatula. If severe facial swelling and reddening persist, it is also referred to as Morbihan’s disease.
The exact causes of rosacea are unclear. A weakness of the vessels and nerves, which leads to circulatory disorders in the face, is suspected. What is certain is that rosacea is caused by inflammation. This inflammation may be triggered by a mite that sits in the hair follicles (Demodex Folliculorum). Recent research by the top dermatologist in delhi suggests that the inflammation of the skin is the result of an excessive immune response. Changed and greatly increased antimicrobial proteins, which are part of the body’s own defense system, are held responsible for this.
There may also be a connection to liver, stomach and intestinal diseases.
Contributing factors to rosacea
Intense sun exposure, strong temperature fluctuations and the consumption of coffee, tea, alcohol or spicy foods can favor the outbreak. The same goes for mental stress. There also appears to be some genetic predisposition to the disease. Family members of those affected are often also ill.
The doctor usually recognizes rosacea by the typical changes in the face. Only in unclear cases (e.g. very young patients) or very severe infestation may it be necessary to take a tissue sample from the skin and examine it more closely.
Applied topically, ointments with the antibiotics metronidazole or erythromycin help. The substance azelaic acid, which is used in acne treatment, can also reduce redness, pustules and nodules. Be careful with ointments containing cortisone: they can make rosacea worse!
If the symptoms are very pronounced or if there are complications in the eye, an antibiotic (usually Tetraycycline) must be taken in tablet form for four to eight weeks. In addition, the way to the ophthalmologist should lead.
Reserve drug with side effects
If these measures do not improve, there is still the option of taking isotretinoin, a relative of vitamin A. It inhibits inflammation, reduces the skin’s sebum production and normalizes the development of skin and mucous membrane cells.
This treatment for rosacea is also successful in the long term, but it can be burdened by numerous side effects. These include itching, muscle and joint pain, dry skin , possibly with flaking, gastrointestinal problems, hair loss, changes in the blood count, increases in fat and liver values, and depression.
In addition, women of childbearing potential who become pregnant during treatment are likely to cause harm to the unborn child. After discontinuing isotretinoin, contraception should therefore continue for another six months.
Treatment of redness and growths
The vasodilatation and redness associated with rosacea are not reduced by medication. To get rid of them, they have to be desolated or treated with a laser. Even the overgrown sebum glands in the rhinophyma do not react to local measures, but they can also be removed or reduced by laser or surgically.
Self-help with rosacea
There are a few steps you can take to help relieve rosacea or prevent it from flaring up again.
- Cleanse the skin consistently but gently every day. Do not use any alcoholic or aggressive detergent additives. We recommend lukewarm water and mild, soap-free, pH-neutral washing lotions or syndets.
- Avoid fatty creams or ointments, especially those with the ingredients menthol and camphor glycerine or silicone oil are well tolerated.
- Do not go too long in the sun and use a cream with high UV-A and UV-B protection all year round. Physical sun protection filters (e.g. zinc oxide or titanium dioxide) are more recommended than chemical sun protection products.
- Avoid stress and learn relaxation exercises such as autogenic training, yoga or progressive muscle relaxation according to Jacobsen.
- Keep your face as cool as possible, ie no hot showers in this area, avoid going to the sauna.
- Regular facial massages can prevent swelling.
- With a special make-up (camouflage) disturbing skin changes can be covered.
- Cold drinks or sucking pieces of ice are simple but effective in relieving sudden reddening of the face.
- Do not eat too spicy or too hot or drink alcohol.