ROSACEA

ROSACEA

A common skin disorder affecting facial skin.
Initially carries both a vascular and an inflammatory component
– Inflammatory: Papules, pustules
– Vascular: Erythema, flushing

Distribution
Symmetrical localization on the face; may be asymmetrical
Nose, cheeks, forehead, chin
May involve a variety of ocular lesions

Causes
Unknown
Age – thirty to fifty years at onset (most common); may occur from adolescence to late adult life 
Females predominate, but severity is greater in males
Greater incidence in fair skinned people

Clinical Picture
Flushing – periodic reddening of the face (erythema)
Inflammatory lesions – papules, pustules
Edema may be present
Telangiectosia may be added with time
Ocular rosacea – accompanies vascular cutaneous rosacea
Comedones are characteristically absent
Diagnosis is made on a clinical basis
Rhinophyma is a late finding

Early Signs of Rosacea
Recurrent flushing, blushing; may last several minutes – several hours
Stinging in the malar areas, forehead, ears
Facial edema may be present

Facial Flushing – Pre-rosasea
Is a prominent feature of rosacea
Is usually the initial manifestation of the disease
Worsens during inflammatory outbreaks
Patients should avoid activities and aggravating factors which induce flushing

Rhinophyma – Late Rosacea
Enlargement of the nose
More common in males
Skin thickens
Enlarged follicles
Hyperplasia of sebaceous glands, connective tissue

Aggravating Factors of Rosacea –
Hot liquids
Sun exposure, wind exposure
Spicy foods
Extreme temperatures
Alcoholic beverages
Stress and other psychological factors
Prolonged use of topical fluorinated corticosteriods

Differential Diagnosis
Acne vulgaris
Seborrheic dermatitis
Perioral dermatitis
Lupus erythematosus
Carcinoid syndrome
Some may exist

Things to Remember :-
Only very mild soaps or cleansers should be used on the face. Avoid products containing alcohol or witch hazel.

You can use cosmetics , but use of high quality mosturizers and oil-free cosmetic products are recommended. Sunscreens of SPF 15 or higher should be used when prolonged sun exposure is expected. To reduce the redness or a rosacea flare, a green-based concealer may be used.

Certain things are known to aggravate rosacea. These include hot liquids, alcohol, spicy foods, extremes of temperature and stress.