What is rosacea?
Rosacea is an inflammatory skin disease associated with the sebaceous follicle, occurs more often in women and
usually manifests after the third decade of life.
How does it appear?
The disease is characterized by 4 stages:
- In the stage of transient erythema, patients complain that either suddenly or after the effect of some triggering factor such as increased ambient temperature, consumption of alcohol or spices and especially mental stress, they present transient erythema (redness) mainly on the face, neck or sternum. This lasts a few minutes but over time becomes more frequent and prolonged.
- In the permanent erythema stage, the redness is permanent on the face, while small vessels on the surface of the skin begin to disappear, especially on the sides of the nose and cheeks. The redness becomes even more intense under the influence of the triggering factors.
- In the stage of papules where, in addition to erythema, red pimples (papules), some of which also have pus (papules), appear on the skin. The picture is similar to the common pubertal acne, but the key feature of the latter is missing, the freckles (the small black spots (open freckles) or whitish papules (closed freckles).
- In the last stage, which is fortunately rare, in addition to all the previous characteristics, there is also a marked hyperplasia of the sebaceous glands together with an overgrowth of connective tissue, resulting in thickening of the skin and facial deformity. Depending on the location of the lesion, it is distinguished into rhinophyma (in the nose), frontophyma, otophyma and pogonophyma.
Patients generally complain of a burning sensation, itching, while of course in the papule stage they are also concerned with the aesthetic problem.
The condition can be combined with inflammation in the area of the eyelids (blepharitis, conjunctivitis) which precedes, follows or more commonly coexists with the exacerbation of skin manifestations.
Where is it due to?
The etiology is actually unknown but several possible factors have been blamed. Thus the negative effect of one is hypothesized
skin parasite, demodex, association with Helicobacter pylori, skin vasomotor changes, hormonal effects
endogenous sex hormones, etc.
Treatment
The treatment options depend on the stage and intensity of the disease.
In the initial stages, we recommend avoiding triggering factors and local application of blood-clotting cosmetic preparations. In more
advanced stages, the use of topical medicinal preparations containing mainly metronidazole or azelaic acid is required.
Their use is usually twice a day and they offer relief from the symptoms and an improvement in the aesthetic effect, but when they are stopped the disease recurs.
In advanced stages (paptosis) it is necessary to administer drugs by mouth, either antibiotics (tetracyclines) or vitamin A derivatives (isotretinoin) in low doses. Generally the response is very good but not permanent.
In the last stage of rhinophyma, dermatosurgical intervention is needed with cauterization of the lesions with diathermy or laser.