Rosacea is one of the most common skin pathologies and is accompanied by noticeable cosmetic defects on the face. Less often, the disease is accompanied by painful sensations, rashes, and physical discomfort.
There is an opinion that rosacea, like acne, passes with age after the hormonal storms subside in the body. But in reality, it is not so. Such a disease can be associated with an imbalance of hormones, but more often it is genetically determined. According to research results, it was established that in 40% of cases, patients with rosacea have a history of the disease in their relatives.
Also, the pathology is related to the peculiarities of the structure of blood vessels. Less often, the disease manifests itself as a result of the incorrect functioning of various systems and organs in the body.
Usually, vascular rosacea manifests itself at the age of 28–35 years. In children and adolescents, this disease is rarely diagnosed and may be caused by hormonal changes. At a more mature age, around 45–48 years, the appearance of symptoms is associated with menopause in women. It is interesting that after the age of 50, the primary signs of rosacea are diagnosed extremely rarely.
Let’s analyze in more detail what such a disease is, what the reasons are for its appearance, and how to improve the condition of the skin if it has already appeared.
Rosacea—what is it?
Rosacea is a chronic, non-infectious skin disease. This pathology has not yet been definitively studied, so the question of how exactly such a condition occurs remains open. It is also worth noting that there is still no single strategy for the treatment of rosacea that would suit all patients without exception. In each case, treatment methods are selected individually.
Rosacea is manifested by reddening of the skin (erythema), expansion of small blood vessels called “vascular stars” (telangiectasia), and the appearance of papules and pustules that visually resemble acne. The skin can take on a swollen appearance, become uneven, or become bumpy. Such a dermatological problem is characterized by periodic exacerbations and periods of remission. Rosacea is often called “pink acne.”
Redness and other signs are usually localized on the face.
- on the forehead;
- on the nose;
- on the cheeks;
- on the chin
Less often, rosacea is observed on the neck, chest, and scalp.
Often, patients do not even suspect that they have this disease because its symptoms are similar to ordinary rashes. At the same time, there may be a situation where the patient has both acne and rosacea at the same time.
At the same time, pathology occurs twice as often in men, but it is more severe. Such a disease is extremely rare in children. The average age at which rosacea begins to manifest itself, if there is a predisposition to this disease, is 30 years.
Do not think that rosacea is a purely aesthetic problem. In the absence of timely treatment, skin pathology can lead to serious complications.
- keratosis (tightening of the skin);
- the formation of purulent tissue inflammations;
- eye diseases (ophthalmosacea);
- deformities of the nose (rhinophyma).
Therefore, at the first signs of rosacea, it is necessary to consult a dermatologist, get a diagnosis, and start treatment.
This skin problem is widespread in various regions of the world, but the largest number of cases of the disease is registered among light-skinned representatives of European ethnic groups, such as Danes, Estonians, Finns, and Swedes. For this reason, rosacea is sometimes called “celtic tides.”.
People with the first and second skin phototypes according to the Fitzpatrick classification have a higher risk of developing rosacea. But dark-skinned representatives, for example, Asians and Africans, are less prone to such diseases.
So, we can summarize:
- According to medical statistics, rosacea is most often diagnosed in people with fair skin.
- Patients who complain of redness on the skin are middle-aged people.
- Due to similar symptoms, rosacea is often confused with acne and couperosis. Despite the external similarity, these are different pathologies. For example, with rosacea, there are no black spots or blackheads, which are characteristic of acne.
- In most cases, rosacea on the face develops gradually. Periods of remission, when the disease does not manifest itself, are rare.
- Among people who are faced with this pathology, the most are women aged 40 to 55 years.
Causes of the disease
The exact mechanisms of the development of rosacea have not yet been thoroughly studied. One of the main versions is a genetic predisposition, which causes changes in the tone of superficially located small vessels (arterioles). At the same time, there are factors that can also provoke the appearance of dermatological problems:
Angioneurotic disorders
A change in vascular tone in response to external and internal factors provokes the appearance of rosacea.
Hormonal failures
If the balance of such hormones as cortisol, estrogen, testosterone, progesterone, and melatonin is disturbed, the skin begins to react with external manifestations. An increased level of cortisol leads to the destruction of collagen; elasticity and firmness are lost. Melatonin is responsible for cell regeneration and renewal processes.
In cases of surges of estrogen and progesterone, rashes and peeling of the epidermis are possible. Many women who have already been diagnosed with rosacea note that the disease worsens during the period of hormonal changes (pregnancy, postpartum period, menstruation, menopause). Often, patients with rosacea have endocrine disorders.
Imbalance in the composition of the skin microbiome
Reactivity and excessive sensitivity of the skin, uneven tone, and rashes may be the result of disturbances in the balance of the microflora of the skin. Harmful habits (alcohol, smoking), nervousness, and improperly selected cosmetic care are harmful to the microbiome.
There are studies, the results of which indicate a connection between the complications of rosacea and the increased activity of Demodex folliculorum mites. These microorganisms are often found in biomaterials in their papulo-pustular form.
Unbalanced nutrition
Consumption of alcohol, hot drinks, and spicy food can affect the mucous membrane of the stomach, which, in turn, provokes the reflex expansion of blood vessels on the face. At the same time, each person may have a trigger in the form of a certain product.
Some rosacea patients report reactions to foods such as coffee, tea, avocados, citrus fruits, soy, spinach, nuts, spices, chocolate, vanilla, tomatoes, bananas, yogurt, and dried fruit. Try to refrain from such products during the exacerbation of rosacea.
Disturbances in the work of the gastrointestinal tract
Scientists do not consider gastrointestinal disease to be the main cause of rosacea. At the same time, 50–90% of patients have histological and clinical signs of gastritis, and 33% have pathological changes in the mucous membrane of the small intestine, such as a duodenal ulcer.
Stages of rosacea
Rosacea is a chronic dermatological disease characterized by periods of exacerbation and remission. At the same time, five main stages are distinguished:
- Transient erythema of the central part of the face. This stage is characterized by short-term episodes of redness, which are most often located in the central part of the face. Such manifestations appear suddenly and disappear without a trace on their own.
- Persistent (background) erythema and telangiectasia. At this stage, persistent manifestations of redness are present on the skin, vascular stars are already visible, and traces of the previous stage appear repeatedly, alternating between more pronounced redness and fading.
- Papular stage. At this stage, papules begin to appear. These are small areas that rise above healthy areas of the epidermis.
- Pustular stage. At this stage, pustules are added to the above signs. These are small formations that are filled with purulent contents.
- Infiltrative and productive stage. This is the last stage of rosacea. Swelling occurs on the affected areas of the skin, and fibrotic-hypertrophic changes are formed.
Dermatologists also distinguish four subtypes of rosacea:
- Erythematous-telangiectatic rosacea. This subtype is characterized by the appearance of sudden redness, which gradually turns into persistent redness with the formation of stars and swelling.
- Papulopustular rosacea is manifested by the formation of hollow elements on the skin, which can be filled with purulent contents.
- Phymatous rosacea. In this case, the dermatological problem is accompanied by the thickening of the skin, the appearance of characteristic bumpiness, and the formation of cone-like growths on the nose, forehead, chin, auricles, and eyelids.
- Ophthalmorozacea. This variety can appear at any stage of the disease, even before the appearance of visual changes on the skin. Ophthalmorozacea manifests itself in the form of various eye pathologies. It can be blepharitis (inflammation of the eyelids), conjunctivitis (inflammation of the mucous membrane of the eye), meibomitis (inflammation of the meibomian glands on the edges of the eyelids), or chalazion (benign formations in the thickness of the eyelids). In complex cases, serious pathologies may develop keratitis (inflammation of the cornea), scleritis (inflammation of the sclera), and iridocyclitis (inflammation of the iris and ciliary body).
How to determine the first stage of rosacea
In most cases, rosacea begins with short-term episodes of intense facial redness. A strong burning sensation is felt in the central part of the face, and pronounced redness occurs. Such episodes occur suddenly in response to certain external stimuli. At the same time, such manifestations quickly disappear; in just a few minutes, the condition of the skin returns to normal.
The situation will worsen over time. Redness will occur more often and will be accompanied by an unpleasant sensation of tingling and burning. The skin will react much more sensitively to all external factors.
If you continue to ignore the symptoms of rosacea and postpone a visit to a dermatologist, other problems may join the listed symptoms. Papules, pustules, and pink acne will appear. Later, external manifestations of destroyed vessels will appear. Capillary ruptures “draw” vascular stars, and couperosis may form.
The symptoms and methods of manifestation of rosacea
Rosacea is a complex dermatological pathology caused by many factors. There are several theories about the causes of this skin disease, but dermatologists cannot give an unequivocal answer as to how rosacea will manifest itself in one or another case.
Angioneurosis with a predominant lesion of facial vessels, which is considered as a manifestation of vegetative-vascular dystonia, plays a key role in the pathogenesis of the disease. Rosacea is largely a genetically determined disease. Psychoemotional factors also play an important role in the manifestation of rosacea symptoms. Prolonged stay in a state of chronic stress creates prerequisites for reducing the production of endorphins. At the same time, the work of the kinin-kallikrein system, which regulates the tone of blood vessels, is disrupted. This is the explanation for the fact that the first symptoms of the disease are often triggered by emotional or physical overstrain.
As already mentioned above, at the initial stage, the symptoms of rosacea can easily be confused with excessive sensitivity of the skin. They appear suddenly and disappear quickly. At the same time, without proper treatment, the pathology develops: the expansion of blood vessels becomes more pronounced. A characteristic sign that should alert you to redness is an increase in the temperature of the skin.
Dilated blood vessels due to insufficient care and thickening of the stratum corneum are an excellent environment for the development of staphylococcus and Demodex. As a result, a bacterial infection joins, and papules and small pustules are formed. In case of dryness and increased sensitivity of the skin, nodules, papules, and pustules with serous fluid may appear.
Dilated and damaged vessels, which are located close to the surface of the skin, are subject to various effects. Because of this, the skin acquires a bright red, pink,, or bluish shade.
It is very difficult to determine on your own that you have rosacea. If you observe persistent redness after consuming certain products or in response to weather conditions, this is a reason to consult a dermatologist. This way, you will prevent the appearance of complications and be able to choose appropriate care promptly.
Diagnosis of rosacea
At a consultation with a dermatologist, you can get answers to your questions about the condition of the skin. The specialist will study the anamnesis, specify when the first manifestations began, assess the situation in general, and listen to complaints. After a visual examination, the doctor can prescribe a number of additional studies: blood tests, scraping from the affected areas, and analysis of the content of papules or granulomas.
In some cases, a full understanding of the “picture” may require the consultation of other specialists:
- an ophthalmologist;
- otolaryngologist;
- an allergist;
- immunologist
A comprehensive approach to diagnostics helps to better understand the causes of the disease and choose the most effective treatment plan.
How to treat rosacea
First of all, you need to adjust to the fact that neither a “magic” pill nor a “magic” cream for rosacea has been invented yet. To achieve a sustainable result, you need to be ready for long-term treatment. You should also not rely on “grandmother’s” recipes: self-medication can worsen the situation.
Rosacea treatment should be comprehensive. It should be aimed primarily at restoring vascular tone and optimizing vascular innervation. Effective therapy is impossible without correction of risk factors, in particular concomitant diseases.
In each case, the doctor selects the treatment taking into account the individual characteristics of the patient.
Conservative therapy
To eliminate symptoms and restore blood circulation at the initial stage of rosacea, use:
- antibacterial drugs;
- nonsteroidal anti-inflammatory drugs;
- glucocorticosteroids.
These medications have a strong effect on the body, so you can take them only after consultation with a specialist and under his supervision. Local treatment involves the use of creams and ointments with anti-inflammatory and healing effects. Also, a dermatologist can prescribe compresses made of medicinal herbs, washing with decoctions. It helps to relieve inflammation, reduce swelling, and restore normal blood circulation in the tissues.
The use of antibacterial therapy is recommended in cases of the detection of infectious manifestations in the rash. In cases of severe forms of rosacea, broad-spectrum antibiotics are usually prescribed for effective treatment.
Hardware treatment
The following methods provide good results:
- Laser therapy (phototherapy). The principle of such treatment consists of the effect of a laser beam on dilated blood vessels. This leads to their coagulation and elimination of symptoms. Several sessions are required to achieve a permanent result. Laser therapy is part of a comprehensive treatment plan for rosacea, provides an antiseptic and antibacterial effect, especially in cases of papulopustular forms of the disease, and promotes longer remission.
- Cryotherapy. This is another effective method of treating rosacea, which helps to eliminate inflammation, provides comfort, and restores microcirculation and metabolic processes in the dermis.
- IPL therapy (Intense Pulsed Light). In this case, high-intensity flashes of light are used. The essence of the method is that light pulses penetrate the skin and are absorbed by hemoglobin in dilated blood vessels. As a result, their narrowing occurs. IPL therapy also stimulates collagen fibers, improves skin texture, and relieves redness.
- Microcurrent therapy. In this case, weak electrical impulses are used to stimulate muscles and improve microcirculation in the epidermis. This method of treatment helps reduce inflammation and improves the tone of the skin and blood vessels, which has a positive effect on the appearance of the skin.
Prevention of rosacea
It is much easier to prevent rosacea than to treat it. To minimize the risk of unpleasant symptoms, it is necessary to focus on care that will help strengthen the vessel walls.
You can follow these rules:
- Avoid being outdoors for long periods in hot and cold weather. Temperature changes hurt the condition of the skin. It is important to use cosmetic products for protection that meet the needs of the skin and seasonality. In the heat, cosmetic products with an SPF factor are needed, in the cold, fatty creams and protective balms should be used to avoid weathering and peeling.
- Refuse to visit the solarium, bath, and sauna. High temperatures in combination with high air humidity have a detrimental effect on the condition of blood vessels.
- Monitor microclimatic parameters in residential premises. It is necessary to control the temperature and humidity.
- Review your usual diet. Exclude products that hurt capillaries, and can provoke dermatological problems.
- Avoid bad habits. Nicotine, alcohol, overeating, sedentary lifestyle – all these are the first enemies of beauty and health.
- Avoid aggressive cosmetology procedures (microdermabrasion, laser polishing, peels with a high percentage of acids), preferring careful skin care. Use mild cosmetic products to clean the skin and exfoliate, making sure that the skin is sufficiently moisturized.
- Before taking drugs for the treatment of other diseases, consult a dermatologist about how they can affect the state of the vessels.
- Avoid creams that contain hormonal components.
- When choosing cosmetics, carefully study the composition. Make sure that the beauty product does not contain vasodilators and alcohol.
Today, rosacea is successfully treated. In most cases, its course can be effectively controlled. With the right approach and strict adherence to the dermatologist’s recommendations for treatment and prevention, long-term stable remission can be achieved.
Acne and rosacea – how to tell the difference? What is the difference?
The difference is that acne is more likely to appear at a younger age, while rosacea occurs in people between the ages of 30 and 50. It is important to note that acne usually disappears with age. But rosacea remains for a long time and at the same time progresses.
Lupus and rosacea – how to distinguish? What is the difference?
Lupus and rosacea are two different diseases. Lupus, or systemic lupus erythematosus, is associated with autoimmune processes and can affect internal organs. Rosacea, in turn, is characterized by chronic inflammation of the skin of the face, manifested by redness, telangiectasias, and inflammatory elements such as papules and pustules.
Can rosacea be cured permanently?
Rosacea is well amenable to symptomatic treatment, while it is not completely curable. With the right treatment and care, you can quickly relieve the acute course and prevent exacerbations in the future. The scheme of treatment measures is selected taking into account the form of the disease: the doctor can prescribe medication, diet, hardware procedures, and special cosmetics.