A troublesome attribute of adulthood

Are your face reddened by heat or nervousness? It could be rosacea.

The changes affect the middle part of the face: nose area, medial part of the cheeks, chin, middle parts of the forehead. Erythematous eruptions occurring on the basis of seborrhoea and vasomotor disorders appear under the influence of physical and emotional stimuli, which results in easy reddening of the skin on the face.

Initially, the changes are erythematous, with transient reddening of the facial skin (erythematous period). Later the erythema becomes more permanent, it can last for many days or even permanently. In the further course, vascular symptoms become permanent in the form of telangiectasia (spider-like dilations of capillaries), papules and pustules appear (maculo-pustular period). There are no comedones in rosacea, and the pustules are usually sterile. The most advanced stage takes the form of inflammatory tumors. In rare cases, there are nasal hypertrophic changes, found only in men. In about 50 percent. of cases, there are eye complications: inflammation of the conjunctiva, eyelid margins, less often the cornea. Rosacea has a tendency to recur.

Causes and occurrence of rosacea

Rosacea (Latin rosacea), despite the similar name, has nothing to do with ordinary acne. Occasionally, both diseases can coexist, with acne vulgaris being gradually replaced by rosacea.

The disease is more common in women during the menopause. It usually appears around the age of 30, and its severity occurs between the ages of 40 and 60. On the other hand, in men, although it is not so common, its course is much more severe, leading to hypertrophic changes.

Rosacea is a disease of unknown etiology. It almost always develops against the background of skin damage caused by sunlight. The predisposing factors are vasomotor disorders related to the autonomic nervous system, disorders of the digestive system, especially H. pylori infection (most often gastric hyperacidity) and endocrine disorders, which is indicated by the absence of changes before puberty and their frequency during menopause in women. In some cases, yeasts or Demodex folliculorum are responsible for the occurrence of rosacea. The disease usually lasts for many years. In women, there may be exacerbations during menstruation and the intensification of symptoms is found in the period of menopause. Other factors exacerbating the disease include: changes in the hormonal balance during menopause, stress, changes in ambient temperature, inadequate cosmetics, improper diet.

Rosacea-like lesions, especially around the mouth, may result from frequent topical application of fluorinated steroids. This applies especially to people prone to strong vasomotor reactions, even without palpable changes in rosacea. Therefore, the use of facial steroids is contraindicated, and mild and moderate steroids may only be used very briefly.

Treatment of rosacea

In general treatment, it is recommended to remove factors that may be of causal importance (hyperacidity of gastric juice, hormonal disorders). The beneficial effects are obtained with metronidazole in doses of 250-500 mg / d over several weeks. This treatment can be repeated intermittently as the drug is hepatotoxic. In the case of pustular lesions, tetracycline, minocycline, doxycycline (eg Unidox Solutab) and erythromycin are recommended. If the pustular eruption is very extensive – isotretinoin (a derivative of vitamin A). This drug is hepatotoxic and teratogenic, hence the need to use contraception throughout the therapy. An additional benefit may be the inclusion of vitamins with anti-seborrheic properties (PP and B2).

In the case of the presence of Demodex, treatment with anti-scabies preparations gives good results, which, unfortunately, often cause irritation of the facial skin. In the case of lesions caused by yeasts, antifungal treatment is used. The form of overgrown acne requires surgical treatment. The best results are achieved by cutting the lumps with an electric knife.

Rosacea prophylaxis

Patients with rosacea should avoid very cold or very hot foods, spicy spices, strong tea and coffee, and alcoholic drinks, as well as chocolate, processed foods, citrus fruits, which can exacerbate the disease. However, it will be advantageous to drink at least 1,5 liters of mineral water every day. Proper care is also important, as well as the use of cosmetics for sensitive skin, free from dyes, fragrances and strong additives. Their composition should include, in particular: green tea, chamomile extract, as well as vitamins C, K, B3 and PP. These ingredients strengthen brittle capillaries and protect against the harmful effects of weather conditions.

The following are also beneficial to blood vessels: rutin preparations, extract of mountain arnica, wild myrtle flowers, ginkgo biloba extract and horse chestnut. It is beneficial to rinse your face with mineral or boiled water. 2% boric acid solution or lime water can be used for washing. The condition of the skin is also improved by enzyme peels, treatments that strengthen blood vessels as well as algae masks with vitamins C and K and containing red clay in their composition.

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