Rosacea — Know It All!

All you need to know about Rosacea.

Know your ailment well, so you can manage it better!!

Here we come with Rosacea today!

What is Rosacea?

Rosacea (ro-zay-sha) is a normal, acne-like, and globally spread, benign inflammatory skin disease in adults. In the United States alone, Rosacea affects an estimated 16 million people and nearly 45 million globally. The majority of rosacea individuals are Caucasian and have fair skin. Red or pink facial skin, tiny dilated blood vessels, tiny red bumps that sometimes contain pus, cysts, and pink or irritated eyes are the principal symptoms and signs of rosacea. Many individuals with rosacea can only think they have very sensitive skin that easily blushes or flushes.

An incurable auto-inflammatory skin disease that waxes and wanes is known to be rosacea. Many adult patients should not “outgrow” rosacea, as opposed to conventional or adolescent acne. The central area of the face, primarily the forehead, cheeks, chin, and the lower half of the nose, is characteristically involved in Rosacea. It usually occurs in people with light skin, particularly in people with English, Irish, and Scottish backgrounds. The former U.S. contains some prominent people with rosacea. Bill Clinton, president, and W.C. Oh. Fields. The consumption of alcohol does not induce rosacea directly, but can be exacerbated by it. Rosacea is not viral or contagious.

Rosacea redness, frequently exacerbated by flushing, can permanently widen (dilate) small blood vessels in the face and become more apparent through the skin, looking like tiny red lines (called telangiectasias). Continuous or frequent flushing and blushing episodes may cause inflammation, causing tiny red bumps or papules that are sometimes identical to adolescent acne. Other names for rosacea include Acne rosacea and adult acne. The overgrowth of dermal tissues causing a ‘phymatous’ shift in the skin is one of the most painful aspects of rosacea. This manifests as a thickening of the facial tissues and irreversible swelling of them. An example of this transition is a bulbous nose called rhinophyma.

Symptoms: Pimple; Erythema; Rhinophyma

Who Gets The disease?

Rosacea affects middle-aged and older adults more frequently. In women (particularly during menopause), it is more common than in men. While in people of any skin colour, rosacea may grow, it appears to occur more frequently and is most noticeable in people with fair skin.

What are the Causes and Risk Factors of Rosacea?

It is still unclear the exact cause of rosacea. The basic mechanism seems to include dilation of the face’s tiny blood vessels. Health experts generally agree that patients with rosacea have a genetically mediated reduction in the ability to dampen facial inflammation that is induced by environmental factors such as sunburn, demodicosis, flushing, and some drugs. Rosacea appears to influence the areas of the face of the “blush” and is more common in individuals that quickly flush. In addition, a range of causes are known to cause rosacea to flare up. Emotional factors can cause blushing and aggravate rosacea (stress, fear , anxiety, embarrassment, etc.). A flare-up can be caused by changes in the weather, including strong winds, or a change in humidity. Rosacea is associated with sun exposure and sun-damaged skin. Other well-known causes that can exacerbate rosacea are exercise, alcohol intake, smoking, emotional upsets, and spicy food. Flares around the holidays, particularly Christmas and New Year holidays, may also be noticed by many patients.

• Fair skin, English, Irish, or Scottish inheritance, fast blushing, and having other rosacea family members (called’ good family history’) are risk factors for rosacea. Female gender, menopause, and being 30–50 years of age provide additional risk factors.

What are the types of Rosacea?

There are four main types of rosacea, according to the American Academy of Dermatology (AAD):

• Erythematotelangiectatic rosacea: Symptoms include skin discoloration, flushing, and visible blood vessels.
• Papulopustular rosacea: Symptoms include flushing, swelling, and breakouts that resemble acne.
• Phymatous rosacea: Symptoms include thickened, bumpy skin.
• Ocular rosacea: Symptoms include eye redness and irritation and swollen eyelids.

A condition known as steroid rosacea can result from long-term use of corticosteroids, specifically when a person uses them to treat dermatitis and vitiligo.

What are the symptoms of Rosacea?

Facial redness. In the central part of your face, rosacea typically causes constant redness. Small blood vessels frequently swell and become noticeable on your nose and cheeks.

• Swollen, red bumps. Many people with rosacea often grow pimples that mimic acne on their faces. Sometimes these bumps contain pus. It can feel hot and tender on your skin.
• Eye problems. Dry, irritated, swollen eyes and red, swollen eyelids are often encountered by many individuals with rosacea. This is known as rosacea ocular. In certain persons, skin symptoms are accompanied by eye symptoms.
• Enlarged nose. Rosacea can thicken the skin of the nose over time , causing the nose to look bulbous (rhinophyma). This happens in men more frequently than in women.

How is Rosacea diagnosed?

For rosacea, there is no clinical examination. After inspecting the skin of the person and asking about their symptoms and causes, a doctor may make a diagnosis. It will allow the doctor to differentiate it from other skin disorders by the existence of swollen blood vessels.

A distinct or coexisting diagnosis is generally indicated by the presence of a rash on the scalp or ears. The signs and symptoms of rosacea occur predominantly in the face.

Early diagnosis and timely care will reduce the risk of progression dramatically. The doctor may order blood tests or refer the individual to a dermatologist if the doctor suspects that there may be an underlying medical condition, such as lupus.

What is the treatment for Rosacea?

Depending on the severity and duration of symptoms, there are several treatment options for rosacea. Antibacterial washes, topical creams, antibiotic tablets, lasers, pulsed-light therapies, photodynamic therapy and isotretinoin are also available medical treatments.

Mild rosacea, if the person is not troubled by the disorder, does not actually need medication. More resistant conditions which involve a mixed-method, using many of the treatments at the same time. Twice a day, prescription sulfa facial wash, morning and night application of an antibacterial cream, and oral antibiotic for flares can be a combination method. Combined with the home routine, a series of in-office lasers, powerful pulsed light, or photodynamic therapies can also be used. It is best to seek the diagnosis of a physician for the correct assessment and treatment of rosacea.

• Topical Medications. Patients can monitor the symptoms and signs of rosacea with appropriate therapy. Topical (skin) medicines applied by the patient once or twice a day are common methods of treatment. Rosacea may be substantially improved by topical antibiotic treatment such as metronidazole (Metrogel) administered once or twice a day after cleaning. Another effective treatment for patients with rosacea is Azelaic acid (Azelex cream, Finacea gel 15 percent). To regulate redness and bumps in rosacea, both metronidazole and azelaic acid function.
• Some patients prefer combination therapy and note an increase when metronidazole and azelaic acid alternate: one in the morning and one in the evening. Inflammation reduction is assisted by sodium sulfacetamide (Klaron lotion). Erythromycin and clindamycin (Cleocin) are used in other topical antibiotic creams. Ivermectin topical cream (Soolantra Cream, 1%) is also available.
• A new topical prescription gel intended to alleviate the redness that is so typical of rosacea has recently become available. In patients with rosacea, brimonidine gel (Mirvaso) and oxymetazoline hydrochloride cream (RHOFADE) applied once a day may result in a prolonged period of blanching of previously red skin.
• Oral Antibiotics: Patients with mild rosacea are usually administered oral antibiotics by physicians. The oral antibiotics widely prescribed are tetracycline (Sumycin), doxycycline (Vibramycin, Oracea, Adoxa, Atridox), and minocycline (Dynacin, Minocin), which are believed to work by reducing inflammation. Rosacea is treated by a newer low-dose doxycycline preparation called Oracea (40 mg once a day). Initially, the dosage will be high and then be tapered to maintenance levels. Before taking oral antibiotics, patients should consider common side-effects and possible risks.
• Miscellaneous Medicines: In occasional cases, patients may use short-term topical cortisone (steroid) preparations of minimal strength to reduce local inflammation. Some mild steroids include desonide lotion or hydrocortisone 1% cream applied sparingly once or twice a day just to the irritated areas. There is a risk of causing a rosacea flare by using topical steroids. Prolonged use of topical steroids on the face can also cause irritated skin around the mouth (perioral dermatitis).
• Some medical professionals may also prescribe tretinoin (Retin-A), tazarotene (Tazorac) or adapalene (Differin), which are also acne drugs. In rosacea cases associated with skin mites, physicians seldom recommend permithrin(Elimite) cream. Even, if warranted, allow ethrin treats follicular demodex mites.
• Isotretentoin: Doctors seldom recommend rosacea for serious and resistant isotretinoin. Many doctors prescribe it after several other treatments have been tried and failed for some time. Patients take isotretinoin for four to six months in a regular capsule. Isotretinoin is usually most widely used for the treatment of acne vulgaris. Near physician supervision and blood tests on isotretinoin are required. Generally, for females who use this drug, at least two types of birth control are required as pregnancy is completely contraindicated with isotretinoin.
• Cleansers: In addition, prescription or over-the-counter sensitive skin cleansers may also provide symptom relief and control. Avoid harsh soaps and lotions. Simple and pure products such as Cetaphil or Purpose gentle skin cleanser may be less irritating. Patients should avoid excessive rubbing or scrubbing the face.

Other recommended cleansers include

• sulfa-based washes (for example, Rosanil) and
• benzoyl peroxide washes (for example, Clearasil).

You and your doctor can recommend surgery to fix damaged joints if medications fail to prevent or delay joint damage. Surgery will help to regain the ability to use the joint. It can also decrease pain and enhance function.

How to cope up:

Professionals in health can recommend or offer medications to help you control rosacea, but there are also measures you can do to reduce the symptoms. Here are a few things which will support you:

• Keep a written record of when flares, or periods of worse symptoms, occur. This may help you and your doctors figure out what irritates your skin.
• Use sunscreen with a sun protection factor (SPF) of 15 or higher every day, especially if sun irritates your skin. Use a sunscreen that protects against UVA and UVB rays, two types of ultraviolet rays that can harm your skin.
• Use a mild lubricant on your face if it helps, but avoid any products that irritate your skin.
• Green-tinted makeup may help conceal skin redness.
• Talk to a doctor if you feel sad or have other signs of depression. Some people with rosacea feel bad because of the way their skin looks and may need treatment for depression.

Some things can make your rosacea become worse, or flare, but what seems to trigger a flare varies from person to person. Although these factors have not been well-researched, some people say these things make their rosacea worse:

• Heat, including hot baths.
• Exercise.
• Sunlight.
• Wind.
• Very cold temperatures.
• Hot or spicy foods and drinks.
• Alcohol.
• Menopause.
• Emotional stress.
• Long-term use of steroids on the skin.
• Bacteria.

References:

https://www.medicinenet.com/rosacea/article.htm

https://www.niams.nih.gov/health-topics/rosacea/

https://www.mayoclinic.org/diseases-conditions/rosacea/diagnosis-treatment/drc-20353820

https://www.medicalnewstoday.com/articles/160281

By,

Gopala Krishna Varshith,

Content Developer & Editor,

Clipo.