Rosacea is a chronic inflammatory condition involving the central face. It may be persistent and is characterised by its red colour. Flushing and skin hypersensitivity are common complaints. Pimples may appear and can then be confused with acne.
This condition most often affects adults aged 30 to 60 and is common in those with fair skin and blue eyes. All types of rosacea requires treatment.
Cause of Rosacea
It is still uncertain, but involves a combination of genetic, environmental, vascular and inflammatory factors.
Blood vessels dilate causing an increase in bloodflow and fluid to leak into the dermis, increasing the inflammation. An increase in certain enzymes increase production of blood vessels, that contribute to inflammation and thickened, hardened skin.
Chronic exposure to ultraviolet radiation plays a part. Hair follicle mites are sometimes observed and the stomach bacterium, Helicobacter pylori, is also associated.
Rosacea may be aggravated by facial creams and topical steroids.
Types of Rosacea
- Persistent facial redness (erythematotelangiectatic)
- Acne-like lesions (papulopustular rosacea)
- Thickened skin and prominent pores (phymatous rosacea)
- Rosacea affecting the eyelids (ocular rosacea)
Characteristics of rosacea
- Frequent blushing or flushing
- Persistent red face and/or prominent blood vessels
- Red papules and pustules on the face
- Dry and flaky facial skin
- Aggravated by sun, hot and spicy food and alcohol
- Sensitive skin
- Red or gritty eyelid margins
- Enlarged nose with prominent pores
Conditions that may mimic Rosacea
Other conditions may look similar but require different treatment and special investigations
- Acne
- Flushing due to other causes
- Ageing and sun-damaged skin
- Dermatitis
- Auto-immune disease
Treatment
- General measures
- Minimise hot or spicy foods and alcohol
- Daily oil-free sunscreen
- Water-based facial creams and make-up
- Topical treatment of rosacea
- Longterm treatment
- Avoid topical steroids
- Oral treatment of rosacea
- Vascular laser
