Couperose? It does have a treatment...

Couperose is the appearance of fine reddish filaments, mainly in cheeks, nostrils and chin. These filaments are commonly known as "telangiectasias" of which we will talk later. Couperose is much more common in women than in men and is not a serious disorder, but for many people it is annoying and anti-aesthetic. This is the reason why they seek solutions to their problem.

This circulation disorder caused by a dilation of micro-capillaries in the framework of a skin inflammation is more common in people with sensitive, white, fine skin and/or who get red easily, because the epidermis of these skins is much more transparent.

Couperose is not a disease but an aesthetic problem. However, if those who suffer it do not take good care of their skin, as time goes by –between 35 and 40 years old– it can lead to a rosacea, a more serious condition.

Vascular Disorder

Couperose can be categorized as an arterioles and venules vascular disorder. As there is almost no elasticity in these peripheral vessels, when blood flow increases abruptly, stressful external factors weaken the vessel walls and this continuous dilation of venules and arterioles is the reason that they are visible in white and sensitive skin.

It usually has a genetic component –family– and it can be aggravated by certain toxics, such as alcohol, tobacco, drugs, etc.

Triggering factors

We must distinguish between internal and external factors.

External factors
Among the factors that may cause the appearance of telangiectasis we can distinguish different categories: chemical, physical and environmental.

Chemical factors are those that because of harmful actions of chemical or irritant agents cause a facial eczema easily like, for example, soaps.

Physical factors are the contact with cold water, heat exposure and small bruises and trauma to the skin.

Environmental factors are changes in temperature, rainfall, intense heat, wind and cold, among others. They favour dermal dehydration and produce alterations in vascularization. We can also mention the case of couperose produced by microorganisms such as Demodex folliculorum and Helicobacter pylori.

All these factors can cause a vasodilation and acute vasoconstriction and prompt the appearance of telangiectasia.

Internal factors
Digestive disorders caused by the excessive alcohol intake, spicy or irritating foods and/or poorly chewed food, nervousness combined with stress and diseases such as hypertension, diabetes and liver problems may favour the appearance of couperose.

Characteristics of a sensitive skin

Sensitive skin often presents a clear, delicate, white appearance and a very fine consistency. There may be burning sensations, tightness prone to dryness, tendency to spots, erythema, itching and heat, fragile-looking skin, faster aging and frequent appearance of couperose.


The first symptoms found in couperose are redness and congestion in the middle of the face. At first, it shows for short periods, but it can stay permanently. The next symptom is the appearance of red or red-violet telangiectasias.


There are two types of couperose:

Rosacea couperose: dilated veins around the nose and cheekbones, causing an accelerated reddening which, at the same time, is often confused with acne given that it may appear small pimples that do not produce comedo. It usually appears after the age of 25. It also differs from acne due to its source because it is not caused by hormonal changes, but is related to stress, consumption of hot products and even alcohol intake.

Acquired couperose: is related to external factors such as long exposures to the sun without the adequate protection or abuse of sunlamps. It is also attributable to the use of cortisone creams –used with the purpose of reducing skin inflammation– or certain cosmetics that are aggressive to the skin.


Rosacea –unlike couperose– is a disease that permanently presents telangiectasias in the skin. It shows up with spots and small red pimples that –besides lasting for days and creating pustules, papules and granulomas– it follows an evolutionary chronic course with alternating periods of remission and worsening. It also affects the visual system with minor (frequent) and higher (rare) manifestations. The first are: chalazion, conjunctivitis and marginal ulcers. The higher consist in nodular infiltrations of the conjunctiva, episcleral tissues and cornea. Corneal alterations are characteristic and severe keratitis can result into serious deterioration of sight.

Clinical manifestations vary a lot from one patient to another and in the same patient during the clinical course of the process, although they can be defined as flushing sensation, erythema, telangiectasia, and oedemas. Rosacea is especially developed in midfacial seborrheic areas, but in severe cases it covers the entire face including the eyelids and also spreading to the neck. The condition appears both on thick or seborrheic skin and on thin or dry skin. However, it is more common on sebaceous deposits. The development is slow and misleading because the whole condition takes years to manifest. The capillary dilations sometimes start in the teenage years and often coincide with spider angioma.


In a minority of cases, due to the hyperplasia of the venular and lymphatic system the nose grows adopting a mamillated form –a protuberance shaped like a nipple– with red-violet lobes.

This nasal elephantiasis –a real complication of rosacea– is known as vascular rhinophyma.

nother variety is the glandular rhinophyma that is developed by a remarkable sebaceous structures hyperplasia. The highly seborrheic skin shows the greatly enlarged pilosebaceous orifices.

Rhinophyma is seen almost exclusively in males. Severe keratitis may progress even if there’s a skin injuries improvement.