How do I cure rosacea

Rosacea (Rosacea, Couperose, Copper rose, Face rose)

Rosacea is a chronic inflammatory skin condition that occurs primarily on the face. Depending on the stage, redness, inflammation, blisters or nodules appear on the skin. Rosacea is not curable, but it is treatable.

Short version:

  • Rosacea is a chronic skin condition that shows up as redness, sores, blisters, or nodules on the face.
  • The disease mainly affects adults over 40 years of age.
  • Rosacea takes place in phases and has different symptoms depending on the stage of the disease.
  • Possible triggers for the symptoms are heat, strong temperature fluctuations, alcohol and spicy foods.
  • There is no cure for rosacea.
  • Treatment options range from creams and tablets to laser treatments and surgery.

Rosacea is a common inflammatory, chronic skin condition affecting primarily the face. It runs in phases and is divided into three phases - depending on the severity, the skin of the person affected changes. Around 400,000 people in Austria have rosacea, 60% of them are women. In men, the disease often takes the form of a bulbous nose. Rosacea rarely develops in children; adults over 40 years of age are most frequently affected; light-skinned northern Europeans fall ill more often than dark-skinned southern Europeans.

What are the causes of rosacea?

The inflammation of the skin in rosacea is probably based on an exaggerated immune response. However, the exact causes are still unclear. However, it is likely that genetic factors, such as a disorder in the innate immune system, play a role.

What are the symptoms of rosacea?

Characteristic reddening of the skin (erythema) occurs in the initial stage, affecting the cheeks, nose, chin and middle forehead. Initially, the redness disappears after a few hours. Later on, they become more common and eventually persist.

In the further course, inflammation, nodules and pimples or even thickening of the skin can occur. Rosacea rarely occurs in other parts of the body, such as the eyes, scalp, chest and neck.

The typical reddening is caused by enlarged blood vessels and the resulting increased blood flow. Burning pain and itching can also occur. The symptoms vary in severity depending on the stage of the disease:
 

  • Stage 1: reddening of the skin, enlarged veins

In the initial stage or with a slight progression, there is reddening on the cheeks, forehead and chin. At the beginning, the redness occurs only occasionally, as the disease progresses, it increases. Often enlarged veins are also visible. In addition, there may be burning, stinging, itching or dryness and flaking of the affected areas. The redness occurs symmetrically.
 

  • Stage 2: redness, purulent pimples, small pimples and blisters

In the advanced stage, pimples and inflammatory nodules appear in addition to facial redness. These symptoms last for weeks or months and sometimes come on in bouts. The chest, neck and scalp are rarely affected. At this stage, rosacea is often mistaken for acne. In contrast to acne, blackheads (comedones) do not form in rosacea. If blackheads still occur, it can also be a mixed form of the disease.
 

  • Stage 3: skin thickening, growths of tissue and sebum glands

In the case of a severe course of the disease, growths and thickening can also occur. These occur mainly on the nose (bulbous nose - "rhinophyma"), but also on the chin, jaw, forehead, ears or eyelids.

Special form: ophthalmorosacea

30–50% of patients with rosacea also develop eye involvement. The following symptoms occur:

  • Foreign body sensation
  • dry, burning, watery eyes
  • reddened eyelid margin
  • Visual disturbances
  • Conjunctivitis

What triggers a rosacea flare-up?

Certain behaviors can trigger flare-ups. This includes everything that stimulates blood flow and dilates the blood vessels. The most common triggers for rosacea are:

  • Sun: Avoid direct sunlight and use a good sunscreen.
  • Temperature change: Avoid hot baths, saunas, and extreme weather conditions.
  • Certain foods: Spicy, spicy foods and menthol can have a vasodilator effect.
  • Alcohol and hot drinks: Limit your alcohol consumption and only drink coffee and tea lukewarm.
  • Psychological stress: Excitement can add to the blushing of the skin.

How does the doctor make a diagnosis?

If you suspect rosacea, the dermatologist is the right contact. This can usually make a diagnosis by taking a detailed anamnesis (taking the medical history) and examining the complexion of the skin. An examination of the skin tissue as part of a biopsy is rarely necessary. A tissue sample is taken from the relevant skin area under local anesthesia.

Treatment of Rosacea

There is no cure for rosacea, but it can be treated well. If left untreated, the disease usually worsens. The aim of therapy is to relieve symptoms and reduce the flare-ups. Different treatment options are available for this:

  • External treatment: In the mild form, topical, local treatment with creams, lotions or gels is usually sufficient. The two most important active ingredients are metronidazole (an antibiotic) and azelaic acid; both have an anti-inflammatory effect. In addition, the overreacting immune system is slowed down. In addition, brimonidine and ivermectin have also become well established in stage 1.
     
  • Medication: If the rosacea is already advanced, the external antibiotic therapy is supplemented by a drug treatment. Among other things, very low-dose antibiotics (mostly tetracyclines) are used. These have an anti-inflammatory effect.
     
  • Other treatment options: In the case of permanently visible changes, there is the option of laser treatment or surgery. With laser, veins and redness can be removed or alleviated. If skin thickening occurs in a severe course, it can be surgically removed.

Those affected can also do this:

  • Eat a healthy, balanced diet and avoid spicy spices, very hot food and drinks, and alcohol.
  • Reduce your fat and sugar consumption.
  • Only clean the skin of the face with lukewarm water and soap-free and pH-neutral washing lotions.
  • Avoid facial peelings and facial toners that contain alcohol.
  • After washing, gently pat the skin of the face dry with a towel instead of rubbing it with the towel.
  • Refrain from going to the solarium.

+++ More on the topic: Purpura Schönlein-Henoch +++

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Authors:
Silke Brenner
Medical review:
Prim. Dr. Daniel Blagojevic
Editorial editing:
Tanja Unterberger, Bakk. phil.

Status of medical information:

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