rosacea

Rosacea is a chronic dermatological disease that causes redness and sometimes acne-like nodules (but be careful, it’s not acne ).

Rosacea is primarily a true aesthetic damage. This disease mainly affects women between 30 and 60 years of age, Caucasians and descendants of northern Europe, but the entire population is subject to the disease. Men usually have more severe symptoms. It is estimated that over 45 million people suffer from rosacea worldwide.

The causes of rosacea are still uncertain, but it is known that some seasonal factors are related and can worsen symptoms, such as: exposure to the sun, alcohol consumption, stress, spicy foods, hot foods and drinks, very cold or hot weather and some medications.

Symptoms other than redness and erythema may be associated: blushing easily, the appearance of small blood vessels in the skin, sensitivity to skin products, a red and swollen nose.

Rosacea is a long-term condition that worsens over time if left untreated. They are usually located mainly on the nose, forehead, cheeks, eyelids and chin, but can also manifest in the ears, chest and ribs.

There is no test to diagnose this disease, this is done based on the experience of the doctor, usually a dermatologist, through clinical examination.

Treatment should include medication and lifestyle changes. There are different types of rosacea and there is an appropriate treatment for each one, as well as for each skin type, so the treatment is personalized and should be done under medical guidance.

There is usually an improvement in the condition after 2 months, but as with the treatment of acne, it is important to be patient.

Drug treatment can be done locally (metronidazole or vitamin A based ointments), orally (antibiotics) or combined. The use of sunscreen with a protection factor of at least 30 is essential. The change in lifestyle should basically be done by avoiding the triggering factors.

Other treatments such as laser, pulsed light, psychotherapy, thermal waters, cold water compresses can be used.

There are some tips that can help the treatment, such as moisturizing the skin frequently, avoiding products that irritate the skin, avoiding synthetic detergents, reducing alcohol consumption, avoiding very hot baths, among others.

If you want to get pregnant, talk to your doctor, as there are some medications that should not be used during pregnancy.

Here you will find all the information about rosacea.

Definition

Rosacea is a chronic and frequent inflammatory dermatological disease that causes redness and elevation of the skin on the cheeks, nose, chin, forehead and eyelids. This condition lasts for a long time and gets worse over time if left untreated.

Adults between 30 and 60 years suffer from this disease more often.

We sometimes also speak of acne rosacea or adult acne, but this is not correct, as acne and rosacea are different conditions. For example, in rosacea there are no black dots ( blackheads ).

There are different subtypes of rosacea: Erythematotelangiectatic rosacea, Papulopustular rosacea, Phymatous rosacea and Ocular rosacea. Generally, people with rosacea have more than one subtype at the same time.

Epidemiology

Rosacea affects more than 45 million people worldwide, 14 million of whom are Americans. In Brazil there is no precise estimate.

The prevalence of rosacea is very difficult to determine, due to the varied symptoms common to other diseases. It is estimated that the prevalence of rosacea in Caucasians is between 1 and 10%.

Adults between 30 and 60 years of age suffer from this disease more frequently, especially women, but men usually have the most severe cases.

In the US, the National Rosacea Society estimates that 16 million Americans suffer from rosacea.

According to the Mayo Clinic , women are more affected than men, especially fair-skinned women.

In general, when men develop rosacea, the symptoms are more pronounced than when women are affected.1.

Causes

The exact causes of rosacea are still unknown. However, there are some theories that talk about immune system failure, skin inflammation to microorganisms, ultraviolet damage and vascular problems.

We can observe that genetic factors of local circulation of the endocrine, digestive or nervous system, as well as environmental factors can intervene, and partially explain the origin of this dermatological disease.

We emphasize that certain triggering factors (triggers in English) can aggravate or favor rosacea. Are they:

– the sun (therefore, the use of sunscreen is more than mandatory for people who have rosacea)

– the alcohol

– stress , nervousness or other strong emotions

– seasonings, especially pepper

– hot drinks (tea, coffee). However, a study published in December 2018 in the Journal of the American Medical Association Dermatology (DOI: 10.1001/jamadermatol.2018.3301) showed that drinking coffee daily can significantly reduce the symptoms of rosacea. Caffeine, an important molecule in coffee, is known to reduce blood vessel dilation and have immunosuppressive effects, allowing to lower the risk of rosacea, as noted by the authors.

– very hot or cold weather

– some medications (vasodilators, photosensitizers,…)

– menopausal hot flashes

– hot baths or saunas

However, there may be personal triggering factors for each patient. In this case, we recommend that you keep a diary to report flushing episodes and potentially associated factors, to identify and avoid triggering factors.

Possible Cause
A possible cause or, at any rate, a trigger for rosacea could be dust mites, such as Demodex which seem capable of triggering inflammatory reactions in the skin. The active ingredient ivermectin (used as a cream, read under Treatments below) seems to work particularly against Demodex.

Groups of risk

Rosacea manifests itself particularly in women aged 30 to 60 years. But men and women of all ages can be affected by this disease.

Individuals with phototype I and II skin are more affected. People from northern Europe are at a higher risk of developing the disease.

We also note that the most severe cases of rosacea occur mainly in men.

According to a study published in August 2015 carried out by the University Hospitals Case Medical Center in Cleveland (Ohio) on 275 pairs of twins, genes (hereditary factors) were responsible for 46% of the risk of developing rosacea. In other words, in 54% of cases, the risk was related to the environment, such as sun exposure and alcohol consumption.

Symptoms

Rosacea is a disease that evolves progressively, tends to get worse over time when left untreated. We also observed that there are differences in intensity for each patient.

In general, rosacea starts with redness on the face, favored by triggering factors (triggers) such as stress, sun exposure, a very spicy meal,… read also “causes of rosacea”.

Then we can observe the permanent and visible dilation of small vessels on the skin of the face and the rosacea itself, with the eruption of small pustules on the face. These are mainly located on the nose, forehead, cheeks, eyelid and chin. In some cases, rosacea can also manifest in the ears, chest and ribs.

ocular rosacea

In about 50% of cases, rosacea patients may have eye problems (similar to conjunctivitis), these eye problems should be treated by a doctor to avoid complications.

Other related symptoms are:

– blush easily

– Red bumps (pustules) with or without pus, which can often look like acne but are not

– Appearance of small swollen blood vessels in the skin

– Burning or gritty sensation in the eyes

– Red and swollen nose.

– Sensitivity to cosmetics, skin products and topical medications

– Eyes may become dry.

Rarely, rosacea can lead to an enlarged nose. The nose may become misshapen and bulbous. This symptom is more common in men than in women.

Diagnosis

The diagnosis of rosacea can be made by a family doctor or a dermatologist. The doctor will easily identify rosacea, thanks to his experience and the clinical examination. There are no tests for diagnosing rosacea.

Not to be confused
Rosacea is a disease that can be confused with acne, allergy (allergic reaction) and other dermatological diseases.

Treatments

Rosacea occurs differently in each person, so the treatment will be personalized by the doctor. Currently (2020) available treatments do not cure the disease but improve symptoms. In other words, there is currently no cure for rosacea. A goal of treatment is to take care of acute flare-ups of the disease.

Treatment should include medication and lifestyle changes.

Among drug treatments, we highlight mainly local and oral treatments, which can also be combined. We also observed that, in general, there is an improvement in the condition after 2 months, but as with the treatment of acne, it is important to be patient.

If you want to get pregnant, talk to your doctor, as there are some medications that should not be used during pregnancy.

Local treatment (creams)

The first treatment consists of applying a sunscreen (with a high SPF against UVA and UVB rays), with a protection factor of at least 30, every time you are exposed to the sun, as this is a true trigger of rosacea, and the sunscreen solar acts preventively. It’s better to be safe!

Another means of prevention consists of cleaning the skin with mild soaps and avoiding the use of oily cosmetics. Give preference to water-based and oil-free creams or lotions.

From the point of view of healing, there are creams or ointments based on metronidazole (an imidazole) or ointments based on vitamin A. The use of topical retinoids, topical oxymetaxonin, topical brimonidine are still under study, but have been shown to be effective in some cases. cases.

Drug treatment depends on the type of rosacea that the patient has and only the doctor can determine the best treatment for each case.

oral treatment

In more serious cases, the doctor may prescribe antibiotics such as tetracyclines, metronidazole, among others.

Change in lifestyle

– Avoid the triggers listed under “causes of rosacea” or any other factor that you know makes your symptoms worse.

– Wash your face frequently.

– Use sunscreen every day.

= Avoid using products on your face that contain alcohol, acid or other ingredients that irritate the skin.

Other treatments

– To destroy the dilated vessels, the doctor may also resort to laser or pulsed light. This treatment is usually more expensive.

– Psychotherapy

– Thermal cures

– Cold compress in cases of flushing

– Anxiolytics or antihistamines

Tips

– As we mentioned in the “treatment of rosacea” section, in case of sun exposure, do not forget to apply a sunscreen (with high UVA and UVB protection), with a protection factor of at least 30 even if the sun is weak, as this is a strong trigger for rosacea.

– According to a dermatologist in an interview on a Swiss television program, in March 2010: Using green makeup creams to hide the red spots of rosacea makes sense, as green is a complementary color to red, which allows to soften the red patches of rosacea.

– Avoid eating very spicy foods and very hot drinks

– Moisturize your skin frequently. Emollients help repair and maintain skin barriers.

– Gently clean the skin: touch your face with your fingers and avoid using sponges and do not use soaps or products with synthetic detergents, alkaline soaps are preferable.

– Avoid products that irritate the skin, such as chemical exfoliants and astringents. Manual exfoliation should also be avoided.

– Skin care products in the form of powders or creams are generally better tolerated than gels or lotions.

– Reduce alcohol consumption

– Avoid the use of corticosteroids (in internal or external use)

– Avoid very hot showers

– Do not self-medicate. Consult a dermatologist.

– To clean the skin, use a delicate cleanser.

– In winter and when it’s cold, protect your face with a scarf, for example.

– Write a diary identifying irritants and triggers (eg UV radiation or spicy food). Then show it to your doctor if possible.

Jeanne Kenney
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I’m a stylist trainer, a content creator, and an entrepreneur passion. Virgo sign and Pisces ascendant, I move easily between my dreams, the crazy world I want, and my feet on the ground to carry out my projects.

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