Rosacea
Everything you need to know about the causes, symptoms, and treatments of the chronic disease that causes redness and inflammation of the facial skin.
Symptoms and Causes
Rosacea is a benign skin disorder that causes inflammation, redness, and itching. In some cases, it also presents with purulent papules and dilation of blood vessels. Despite its appearance, it is not a contagious disease.
It is a chronic condition with no cure; however, the prognosis is good when appropriate treatment is provided to control symptoms and reduce the frequency of flare-ups. The goal of therapy is to improve patients’ quality of life, as many tolerate the condition poorly because it negatively affects their social interactions.
Symptoms
The symptoms of rosacea mainly affect the central part of the face, namely the nose, cheeks, and the perioral area, which includes the lips, chin, and nasolabial folds. Although manifestations may vary from one patient to another, the most common symptoms are:
- Facial redness: begins with an increased tendency to flush and usually progresses to persistent facial erythema that does not resolve.
- Inflamed papules: pus-filled bumps that may be mistaken for acne.
- Telangiectasias: capillaries in the nose and cheeks become damaged, making blood vessels visible.
- Burning sensation.
- Itching.
- Occasionally, phymatous changes: skin thickening and nodule formation.
There are four types of rosacea, classified according to the symptoms they produce:
- Erythematous rosacea: the most difficult form to control. It is characterized by permanent facial redness that periodically worsens for limited periods of time. It has the greatest impact on quality of life, as society often associates it with excessive alcohol consumption, leading many patients to struggle with accepting their condition.
- Papulopustular rosacea: characterized by inflammatory lesions containing pus.
- Phymatous rosacea: more common in men and typically affects the nose, which enlarges due to skin thickening.
- Ocular rosacea: difficult to treat and often highly symptomatic. It commonly presents with red eyes, itching, ocular dryness, blurred vision, increased sensitivity to light, and eyelid inflammation.
Causes
The specific causes of rosacea remain unknown; however, studies indicate a correlation with the following factors:
- Immune system dysfunction, resulting in an exaggerated response to external triggers such as cold weather, sun exposure, wind, alcohol consumption, or certain cosmetics. Stress and anxiety may also trigger flare-ups.
- Vascular dysregulation: blood flow does not adequately adapt to the needs of the tissues.
Risk Factors
Factors that increase the risk of developing rosacea include:
- Age: it most commonly appears between 30 and 50 years of age.
- Sex: although it occurs in both sexes, it is slightly more common in women.
- Caucasian ethnicity: it is commonly seen in individuals with fair skin.
- Pregnancy: flare-ups may worsen because the skin becomes more sensitive and blood vessels dilate due to hormonal changes.
- Family history of the disease.
Complications
Rosacea may cause the following complications:
- Skin infections.
- Acne.
- Blepharitis: inflammation of the eyelids.
- Vision loss.
- Social isolation.
- Depression.
Prevention
Rosacea cannot be prevented because it has a genetic component. To reduce symptoms and delay the onset of flare-ups, the following measures are recommended:
- Apply high-SPF sunscreen daily.
- Keep the skin properly moisturized.
- Use cosmetics specifically designed for sensitive skin.
- Avoid triggering factors whenever possible.
Which specialist treats rosacea?
Rosacea is diagnosed and treated within the specialty of Medical-surgical dermatology and Venereology.
Diagnosis
The diagnosis of rosacea is clinical, meaning that it is based on the patient's medical history, symptoms, and physical examination. Currently, there is no specific test that can confirm the diagnosis.
When another condition, such as acne or dermatitis, is suspected, a differential diagnosis is performed to rule out disorders that do not fully match all of the patient's signs and symptoms.
Treatment
Treatment for rosacea focuses on relieving symptoms. The most effective options include:
- Topical medication: creams or ointments with anti-inflammatory properties and the ability to reduce redness are used.
- Oral medication: in more advanced cases, antibiotics are prescribed to reduce lesions and prevent infection.
- Laser treatment: applied in a controlled manner to areas of redness and telangiectasias to reduce their appearance.
- Intense Pulsed Light (IPL) therapy: intense light pulses are delivered to the skin to stimulate collagen and elastin production. As a result, skin texture improves, redness decreases, and blood vessels constrict.
