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Rosacea (Acne Rosacea)

Definition


Disease: Rosacea (Acne Rosacea) Rosacea (Acne Rosacea)
Category: Dermatological diseases
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Disease Definition:

The chronic, inflammatory skin condition that affects adults and causes redness in the face and produces small, red, pus-filled bumps or pustules, is called rosacea.

Rosacea tends to be progressive, which means that if left untreated, it gets worse over time. Rosacea is cyclic in most people, which means that the rosacea signs and symptoms may flare up for a period of weeks to months and then lessen for a while before flaring up again. Besides acne, rosacea can be mistaken for other skin problems, such as eczema or skin allergy.

Treatments can control and reduce the signs and symptoms, but there’s no cure for rosacea. A person should see the doctor for a diagnosis and proper treatment if he/she experiences persistent redness of the face.

Work Group:


Prepared by: Scientific Section

Symptoms, Causes

Symptoms:

Rosacea may cause some of these signs and symptoms:

 

  • Burning or gritty sensation in the eyes (ocular rosacea)
  • Visible small blood vessels on the cheeks and nose (telangiectasia)
  • Small, red bumps or pustules on the chin, forehead, cheeks and nose (but not the same as whiteheads or blackheads)
  • Tendency to flush or blush easily  
  • Rhinophyma (Red, bulbous nose)
  • Red areas on the face


Phases of Rosacea:

Pre-rosacea:
A simple tendency to flush or blush easily is how rosacea may begin. It may then progress to a persistent redness in the central portion of the face, particularly the nose. The dilation of blood vessels close to the skin's surface is the cause of this redness. This phase may sometimes be referred to as pre-rosacea.

Vascular Rosacea:
Small blood vessels on the nose and cheeks may swell and become visible (telangiectasia) as the signs and symptoms worsen. This phase is called vascular rosacea. The skin may become overly sensitive. Oily skin and dandruff may also accompany vascular rosacea.

Inflammatory Rosacea:
Spreading across the chin, forehead, cheeks and nose, small, red bumps or pustules may appear and persist. This is sometimes known as inflammatory rosacea.

Ocular Rosacea:
A burning and gritty sensation in the eyes, is experienced by about one in two people with rosacea. In a condition known as conjunctivitis, rosacea may cause the inner skin of the eyelids to become inflamed or appear scaly.
Left untreated, rosacea tends to worsen over time, and unfortunately it rarely clears up on its own. A person should sees a doctor or a dermatologist for a diagnosis and proper treatment when experiencing persistent redness of the face.
Rosacea may actually become worse by many over-the-counter skin care products that contain ingredients such as acids, alcohol and other irritants. An early diagnosis is important because of the progressive nature of rosacea. When started earlier, treatments tend to be more effective.

Causes:

Researchers believe that rosacea is due to some combination of hereditary and environmental factors; however, its exact cause is still not known.  

A number of factors can aggravate rosacea or make it worse by increasing blood flow to the surface of the skin, though the exact causes of rosacea remain a mystery. Some of these factors are:

 

  • Using corticosteroids
  • Hot baths, saunas
  • Strenuous exercise
  • Stress, anger or embarrassment
  • Alcohol
  • Hot foods or beverages
  • Sunlight
  • Spicy foods
  • Drugs that dilate blood vessels, including some blood pressure medications
  • Temperature extremes

Alcohol doesn't cause rosacea. People who don't consume alcohol at all can still get rosacea, while the consumption of alcohol can lead to flushing of the skin and may worsen rosacea.
Despite the fact that anyone can develop rosacea, a person may be more likely to develop rosacea if he/she:

 

 

  • Has a family history of rosacea
  • Is between the ages of 30 and 60, especially if going through menopause
  • Has fair or light skin
  • Experiences frequent flushing or blushing

Complications

Complications:

Resulting in a buildup of tissue on and around the nose in a condition that's called rhinophyma, the oil glands (sebaceous glands) in the nose and sometimes cheeks become enlarged in severe and rare cases. This complication develops very slowly over a period of years and it's much more common in men.

Treatments:

Effective treatment can relieve the signs and symptoms of rosacea, though there's no way to eliminate it altogether. This requires a combination of prescription treatments and certain lifestyle changes.
To improve the health of the skin, the doctor may recommend certain soaps, sunscreens, moisturizers and other products. A person may ask the doctor what treatment options are available for the signs and symptoms of menopause in case hot flashes appear to trigger the rosacea.

MEDICATIONS:
To treat rosacea, a combination of prescription-strength topical medication (lotion, cream or gel) and oral medication (pill, capsule or tablet) may be needed.

Oral antibiotics:
Rosacea could be treated with oral antibiotics. More than to kill bacteria, antibiotics are prescribed for their anti-inflammatory properties. Erythromycin, tetracycline and minocycline are examples of common prescription oral antibiotics. Oral antibiotics work faster than topical antibiotics.

Topical medications:
Medications that are applied to the skin once or twice daily may help reduce inflammation and redness. Topical medications could also be used along with oral medications or as part of a maintenance program to control symptoms. Common topical medications include azelaic acid, antibiotics, benzoyl peroxide and tretinoin.

Isotretinoin:
If other treatment options fail to improve symptoms in the severe cases of inflammatory rosacea, sometimes Isotretinoin could be used, which is a powerful oral medication. Usually prescribed for cystic acne, isotretinoin works to inhibit the production of oil by sebaceous glands. Because of the possibility of serious side effects, people who take this medication need to be closely monitored by a dermatologist.
Steroid eyedrops or oral antibiotics may treat ocular rosacea. The patient will probably notice an improvement within one to two months, but the duration of the treatment will depend on the type and severity of the symptoms. Usually, long-term regular treatment is necessary because symptoms may recur if the patient stops taking medications.

SURGERY:
Some redness, enlarged blood vessels and changes due to rhinophyma often become permanent. Laser surgery and electrosurgery and such surgical methods may generally improve appearance, remove tissue buildup around the nose and reduce the visibility of blood vessels in these cases.

Prognosis:

Not Available

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