Rosacea

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What is it about ?

Rosacea is a very common chronic skin condition that progresses in flare-ups. It is mainly characterized by a rapid appearance of red spots on the face. This redness lasts longer than a simple blush. They usually affect the central part of the face.

The cause of rosacea is unknown, but hereditary predispositions seem to play a role.

Certain factors can trigger and / or worsen the condition (this varies from person to person):

  • Hot drinks, spicy food, sunlight and sauna,
  • Cortisone-based creams,
  • Alcohol consumption.

Responses to these factors vary greatly from person to person.

What is its frequency?

Rosacea is usually seen in people who have fair skin. It is estimated to affect between 1 and 10 people aged 30 to 50 in 100. Women are more often affected than men.

How to recognize it?

The 4 main characteristics are

  • Redness (the term rosacea comes from the Latin “rosacea”, which means “red like a rose”);
  • Small dilated vessels (rosacea);
  • Small papules
  • Small pimples (pustules) that look like acne, but without comedones (blackheads).

The area usually affected is the central part of the face: the nose, cheeks, forehead and chin.

At first, only a fleeting blush is observed on the cheeks; the lesions then spread and become permanent.

About 1 in 2 people who suffer from rosacea also have abnormalities in the eyes and / or eyelids. The most common symptoms are dry eyes (dry eye), a burning or tingling sensation, runny eye (tearing) and a sensation of a foreign body in the eye (grain of sand).

The buildup of fluid and connective tissue in the skin can cause a “bulbous nose,” or rhinophyma, in older men.

How is the diagnosis made?

Most often, the doctor will recognize rosacea by simply looking at the skin.

Sometimes it can be a bit more difficult to diagnose because there are all kinds of facial skin conditions that can also be accompanied by redness, rosacea, and papules. In this case, the general practitioner will refer you to a skin specialist (dermatologist).

What can you do ?

Try to identify the triggers and avoid exposing yourself to sunlight, for example; if necessary, use sunscreen with a high protection factor (30 or more). Stay out of the wind, avoid saunas and (too) hot showers, and adapt your diet if certain foods cause the redness.

Do not use cosmetics that make symptoms worse. There are creams that camouflage redness without irritating the skin. Consult your pharmacist. Do not use cortisone cream. Keep in mind that symptoms may temporarily get worse when you stop using this type of cream.

What can your doctor do?

Rosacea is a stubborn condition that, unfortunately, recurs occasionally. There is no cure for it permanently. Treatment is primarily aimed at reducing papules and pustules. It may consist of applying a gel or ointment containing metronidazole or azelaic acid to the lesions. The effect of local treatment manifests itself slowly, it may not be visible until after 1 to 3 months. A basic treatment, for example twice a week, is important to prevent flare-ups. If this is not enough, the doctor will prescribe a low dose of the antibiotic for 6 to 12 weeks, always in combination with the local treatment. This antibiotic can reduce ‘pimples’, but has no effect on redness and rosacea.

Severe cases of rhinophyma or bulbous nose require laser treatment, cryotherapy or plastic surgery.

People suffering from serious eye problems resulting from rosacea are referred to an eye specialist (ophthalmologist).

Want to know more?

Source

Foreign clinical practice guide ‘Rosacea’ (2000), updated on 05/30/2017 and adapted to the Belgian context on 06/29/2017 – ebpracticenet

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