ROSACEA

Rosacea is a chronic inflammatory skin condition predominantly affecting the central face, most often it starts between the age of 30–60 years. It is more common in women, although men tend to have more severe facial lesions and in higher incidence of associated complications of keratitis and rhinophyma.

The pathogenesis of rosacea is thought to be multifactorial and includes genetic susceptibility, altered microbiome of the skin and gut, neurocutaneous mechanisms and impaired skin barrier.

What are the symptoms of rosacea?

• Flushing, eyelid margin teleangiectasia, inflammatory papules and pustules, phymatous changes
• In women, rashes are common on the cheeks and chin, in men – on the nose.
• The typical locations of rosacea are the nose, cheeks, forehead and chin.
• Rarely – behind the ears, upper back, neck and scalp.
• Usually the disease progresses slowly and is characterized by certain stages.

What are the stages of rosacea?

• Transient erythema – lasts for several hours and is localized in the middle part of the face.
• Persistent erythema and telangiectasia (rosacea stage I) – lasts for several days or weeks, multiple telangiectasia appear, especially on the cheeks, which causes discomfort to the patient.
• Papules and pustules (rosacea stage II) – against the background of erythema, small, often grouped papules gradually develop on the nose, nasolabial folds, chin and forehead, some of them transform into pustules. Edema and skin infiltration are also characteristic of this stage.
• Phymatous changes (Rosacea Stage III) – Inflammatory rash increases in size and coalesces. Fibrosis and hyperplasia of the sebaceous glands sometimes cause diffuse enlargement of two regions of the skin – phymas.

What contributes to the development of the disease:

• genetic predisposition to the disease;
• relationship with diseases of internal organs, for example diseases of the gastrointestinal tract and hypertension;
• mite – Demodex folliculorum
• risk factors related to diet and lifestyle

Common risk factors for rosacea include:

Women develop rosacea somewhat more frequently than men, although men are more prone to developing severe rosacea.

Rosacea tends to develop in adults between the ages of 30 and 60 years of age. In women, some cases of rosacea occur around the onset of menopause.

A tendency to develop rosacea may be inherited. It can often be found in several members of the same family.

Although rosacea can develop in people of any skin color, it tends to occur most often in people with fair skin.

Exposure to the sun may cause skin and blood vessel damage, especially on the face. This may increase the risk of developing rosacea.

Diagnosis

Rosacea is diagnosed clinically according to diagnostic and major criteria recommended by the 2017 global Rosacea Consensus (ROSCO) panel. Patients should be asked about potential triggers. Ophthalmic evaluation is necessary for patients with ocular symptoms. Although there is no definitive cure for rosacea, symptoms can be very successfully managed through a variety of treatments tailored to each person’s particular signs and symptoms. A variety of treatments are available to reduce its appearance and prevent further progression, especially when started early. If allowed to worsen over a long period, however, rosacea may become more difficult to treat, and it could take longer to see positive results. Treatments for rosacea include oral and topical medications, lifestyle modifications, laser and light therapies, and surgical procedures for advanced cases.