What is Rosacea ?

Rosacea is a long-term skin condition in which a person can experience periodic episodes of visible blushing or flushing of the face. Usually, this is seen predominantly on the nose, cheeks, forehead and sometimes, the ears. Although Rosacea can be common in those with paler skin,  smokers and those who have a family history of rosacea , it is not uncommon for darker skin types to experience this as well. Usually , darker skin types experience skin sensitivity, in the form of burning sensation after stepping out in the sun or when drinking hot beverages. In severe cases, the redness can remain on certain areas of the face and can appear unsightly on the skin.

What are the Causes of Rosacea ?

There is no definitive cause for Rosacea but it can be triggered by certain conditions that worsen the symptoms They could be environmental, hormonal, immune-mediated , hereditary or a combination of causes. Some of the most commonly encountered triggers are-

  • Environmental Factors like exposure to extreme hot or cold weather conditions.
  • Medication: Certain drugs like blood pressure medication can cause rosacea because of their vasodilating properties
  • Food habits like intake of hot, spicy food or beverages. Alcohol, more specifically, Red wine.
  • Emotions like stress, anger.
  • Physical activities like aerobic exercises, running, etc
  • Smoking.
  • Certain types of skin infections

  • Change in the immune status
  • Increase in the production of a gastric hormone called ‘gastrin’ which increases the production of H.pylori in the stomach , in-turn causing increased skin sensitivity
  • Studies have found that people with Rosacea have a higher number of Demodex mites on their skin. This suggests a strong correlation to the sensitivity of the skin to this mite.
  • Redness and swelling being a prominent in certain individuals suggests that the processing of a certain protein called ‘cathelicidin’ can determine if a person is predisposed to develop Rosacea.
  • Hereditary : Rosacea is a skin condition that can run in the family. You can notify the dermatologist at DNA Skin Clinic if you are already aware of it.

What are the different subtypes of Rosacea ?

  • Vascular : This type is characterized by visible redness, facial flushing and broken blood vessels. There can be increased sensitivity of the skin with burning and stinging. The skin might be swollen with a tendency to blush or flush, easily. Dryness with visible flaking or roughness can also be present in some cases.
  • Inflammatory : This is associated with extreme redness, swelling and characteristic appearance of pus- filled acne which can be associated with episodic flare ups. This is seen in oily skin types with extreme skin sensitivity. Visible broken vessels ( telengiectesias) may also be present along with raised reddish patches of skin called plaques.
  • Phymatous : This is a rare subtype which presents with evident thickening of the skin most commonly on the nose. Externally the skin can feel bumpy in texture. In long-standing cases there is structural changes to the nose that lead to a visible deformity known as Rhinophyma which develops due to the proliferation of underlying sebaceous glands and connective tissue.
  • Ocular : This is subtype that concerns the eye. There can be redness, grittiness, irritation in the eye with increased sensitivity to light. There can be swelling around the eyes that can lead to sore eyelids, watery and bloodshot eyes as well as crusting around the base of the eyelashes which can in turn lead to blepharitis.

How can it be treated?

  • Medications: Depending on the severity of symptoms, mild variants of rosacea can be treated with a combination of topical creams and anti-inflammatory agents for symptomatic relief. Depending on the skin type, you will be receiving a personally customized skin care routine along with the required medications. In moderate or severe cases, when symptoms persist more than a day, certain oral medications will help to reduce the intensity of symptoms and provide immediate relief.
  • Procedures: The use of IPL (Intense Pulse Light Laser) is a device that can help to reduce the visibility of the enlarged and visible blood vessels on the skin. This is type of vascular laser which targets the hemoglobin present in the blood vessels specifically without any other effects on the skin surface. Electrodessication is a minimally invasive method in which an electrocautery device is used to ablate the overactive sebaceous tissue and blood vessels. Certain physical resurfacing methods like dermabrasion also help to remove excess skin layers and also prevent overgrowth of tissue on the surface.

Long term Outcome of the condition

Rosacea is a skin condition with a prolonged duration that can become aggressive if left untreated. As this concern is chronic in nature , it can cause impairment of the quality of life and this often limit one’s social interactions and promote anxiety and depression . Identifying an individual’s triggers and enabling then to manage their episodes better with the help of a personalized skin care routine as advised the dermatologists at DNA with adequate emotional support is key to managing this condition in the long-run.

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