Acne and Rosacea

Rosacea is a disorder of unknown origin that especially affects young adults with light skin. It can have an important aesthetic and psychological impact on the sufferer because it is usually located on the face. In fact, those affected by it often suffer from anxiety and sometimes even behavioural disorders because they feel embarrassed.

It is a chronic skin disease of high incidence in the population. It occurs between the third and fifth decade of life and reaches its maximum intensity when the person is 40 to 50 years old –being a little more common in light-skinned women.

Its aetiology is uncertain, but it is known multiple factors are involved, such as vascular disorders, genetic predisposition, the presence of an infection of the pilosebaceous follicle by the parasite Demodex folliculorum, the use of topical or oral corticosteroids, psychological factors, sun exposure and –according to some authors– the Helicobacter Pylori.

It is located mainly on the face, primarily affecting cheeks, chin and forehead. There are four consecutive clinical stages: flushing, persistent erythema, papulopustules and rhinophyma, with flare-ups and remission or improvement periods.

The flushing phase usually begins between the ages of 25 and 30 and is characterized by sudden facial flush crisis because of vasodilatation, which is triggered by ambient heat, alcoholic drinks, hot drinks and foods, spices, coffee, tea and stress.

In the second phase, the erythema becomes permanent and it appears telangiectasia on cheeks and chin as a result of repeated vasodilation.

The third phase usually begins at the age of 40, when inflammatory papules and pustules appear –indistinguishable from those related to acne– on a base with erythema and telangiectasia. The fourth phase occurs almost exclusively in males and is characterized by the development of fibrosis and hyperplasia of the sebaceous glands of the nose that clinically translates as a red and dimpled nose with what is called rhinophyma or dilatation of the follicular orifices.

It differs from late acne because comedones don’t show up and injuries do not leave scars.

The disease manifests a chronic course with acute outbreaks. It is important to highlight the possibility of suffering an ophthalmic disorder, as it may complications as blepharitis, conjunctivitis and keratitis can occur. Another complication –exclusively in males– is the development of a rhinophyma, more likely if the person does not follow a treatment.

Although women are usually more affected, rosacea tends to be more severe in men.

Rosacea appears between the ages of 30 and 40, albeit the peak of the disease is between 40 and 50 years old.

Among the symptoms of rosacea there are erythema, persistent redness, dilated blood vessels or the appearance of papules and pustules in the central area of ​​the face. Moreover, in advanced stages of the disease, swelling in the nose or in other areas of the face can occur due to the hyperplasia of the sebaceous glands (i).

Rosacea is a chronic skin disease, but it is possible to control it thanks to medical treatments and some changes in lifestyle.

Depending on the severity of clinical symptoms, dermatologists recommend a personalized treatment. Another important element to control the rosacea is to identify and avoid triggering factors that cause erythema or outbreaks of skin injuries. Some of the most known factors are exposure to UV radiation, extreme weather conditions, alcohol, spicy food or hot drinks.

Suggestions to minimize the harmful impacts of common rosacea triggers include a consequent protection against UV radiation –for example with the regular application of sunscreen products with highly effective UV– filters staying in cool rooms when it is hot outside, wearing protective clothing like wide-brimmed hats or scarves when exposed to extreme weather conditions, reducing the consumption of hot drinks and spicy foods.

The skin is very sensitive to irritations. Therefore, only mild products for skin care should be used. Establishing a proper daily regime for skin care can help control redness. The facial treatment should start with cleansing the face with a soft cleanser product without soap in order to reduce possible irritant effects. Water shall be warm. It is also important to keep the face moisturized with a non-comedogenic moisturizer with a 15-SPF or higher to protect it against diseases caused by UV rays. Plus, some products contain green pigments that immediately reduce the reddish appearance of the face.