Contents
Rosacea is a chronic dermatological disease that is accompanied by damage to the vascular network of the face. Pathology is manifested by redness and thickening of the skin, purulent rashes and deterioration of the natural exfoliation process.
The disease becomes chronic with periods of exacerbation and calm. If there is no therapy, then rosacea can cause the formation of a pronounced cosmetic defect.
Causes of Rosacea
To date, the exact cause of rosacea has not been established by scientists. Previously, doctors believed that rosacea is a consequence of demodicosis. However, later it was found that these two completely different diagnoses. Therefore, modern medicine classifies rosacea as a polyetiological disease. This means that several factors can provoke its development at once.
Those people who have hypersensitive skin from birth are prone to rosacea: if it reacts too violently to environmental factors such as temperature changes, increased dryness of the air and mechanical injuries, then the risk of rosacea will be higher.
The following reasons can influence the development of the disease:
The use of creams and ointments containing hormonal components. If a person uses such drugs too often and unreasonably, this leads to thinning of the skin and blood vessels, increased capillary fragility, which can trigger rosacea.
Diseases of the digestive system. Pathologies such as gastritis and duodenitis increase the risk of developing rosacea. Doctors have established a direct relationship between rosacea and infection with Helicobacter pylori.
Dermatological diseases. In terms of the occurrence of rosacea, contact and allergic dermatitis are dangerous, which contribute to the disruption of the normal state of the skin.
Diseases of the endocrine system.
genetic predisposition. It has been proven that rosacea is 1,5 times more likely to be registered in people who live in the North.
Vegetovascular dystonia proceeding according to the cardiovascular type.
People with red and blond hair are at risk for developing rosacea, as their skin is hypersensitive.
A woman’s entry into menopause can affect the occurrence of rosacea. Although rosacea occurs with the same frequency in women and men, the fragility of blood vessels increases during menopause, which can start the disease.
Living in adverse weather conditions, when the skin is often exposed to frost and dry air, contributes to the development of rosacea.
Experts are sure that any negative factors that affect the body as a whole are capable of provoking the appearance of this disease:
Transferred stress;
Frequent contact with too hot or icy water on the skin of the face;
Regular drinking of alcoholic beverages;
Sudden changes in temperature and humidity of the environment.
During the period of bearing a child, women often develop a fulminant form of the disease. After delivery, such rosacea goes away on its own. The more often a woman becomes pregnant, the higher the risk of recurrence of the disease.
Rosacea symptoms
The main symptom of rosacea is red patches on the face. They appear immediately after the skin has been exposed to a provoking factor. The forehead and cheeks, the bridge of the nose and chin blush. If a person has rosacea, then the spots do not go away for a long time, but in the early stages of the development of the disease, they do not cause the patient any physical discomfort. It is not difficult to disguise them, it is enough to use the usual foundation.
As the disease progresses, spots appear more and more often. Moreover, a slight effect on the skin of the face is enough to cause intense redness. In parallel, a burning sensation joins.
Since the blood supply to the face increases, this will provoke the activation of microorganisms that constantly exist on the skin. As a result, small tubercles and pustules will appear on the face.
Depending on the stage of the disease, the following symptoms of rosacea are distinguished:
Prerosacea. Erythema and hyperemia of the skin is transient.
Vascular rosacea. Edema is formed, ophthalmic rosacea develops with the transition to the eyelids, cornea and conjunctiva. Superficial vessels of the skin expand (telangiectasia), erythema becomes persistent.
Inflammatory rosacea. Pustules and papules form on the face.
Late rosacea with rhinophyma formation. The entire surface of the nose becomes hypertrophied, which can disinfect a person’s face. Most often, rhinophyma occurs in men. If this condition is ignored, then blindness may develop.
The further course of the disease leads to the fact that the skin becomes rough to the touch, thickens. The vascular network on the face clearly shows through, it is no longer possible to hide it with the help of cosmetics.
The final phase of the disease is called lupoid. The rash extends to the area around the eyes and mouth. They are represented by spots and dark red nodules, able to merge. Rosacea in its final stages resembles the symptoms of systemic lupus erythematosus.
Associated symptoms of the disease:
Itching and burning in the area of the rash;
Dryness and tightness of the skin;
Feeling of “crawling” on the skin.
Edema with rosacea
One of the manifestations of rosacea is swelling of the face. It develops regardless of the form of the disease.
The formation of edema leads to the expansion of blood vessels on the skin, which occurs for the following reasons:
Eating spicy and spicy foods, drinking alcohol or very hot drinks.
Pathology of nervous regulation of vascular tone. Often this occurs after a stroke or neurosis, as well as after a head injury.
Allergy.
Hormonal surges.
Parasitic or bacterial infection affecting the skin of the face.
It is possible that rosacea develops against the background of simultaneous exposure to several provoking factors. Therefore, edema is always present, but in the acute stage of the disease it is poorly distinguishable, since inflammation of the skin is already very intense, and is also accompanied by the appearance of rashes.
Edema affects the following parts of the face:
Cheeks;
wings of the nose;
The skin around the eyes (against the background of the development of ophthalmic rosacea);
Forehead and cheekbones (against the background of Morbigan’s disease).
Edema comes to the fore precisely with the rare Morbigan’s disease, which is one of the forms of rosacea. Hypertrophied facial skin contributes to capillary clamping and venous outflow failure. If you press on the diseased skin, then dents remain on it. She herself has an unnatural color: from purple to bright pink.
Edema also causes itching, frequent hot flashes, pathological growth of the epithelium and engorgement of the skin of the face.
Only 10% of all patients with rosacea do not suffer from edema, in 90% of cases it does develop. To reduce the degree of its severity, treatment is necessary. Otherwise, the disease will continue to recur and progress. Normal skin cells are gradually replaced by scar tissue, the face loses its usual appearance.
Forms of rosacea
Rosacea has several forms, each of which differs in the mechanism of tissue damage and the degree of spread of inflammation. However, the appearance of acne is characteristic of all varieties of the disease.
Determining the form of rosacea allows you to choose the most effective treatment:
Episodic rosacea. With an episodic form of the disease, the skin on the nose and cheeks turns red. In this case, the patient indicates a feeling of heat and a slight tingling in the face. These manifestations can be aggravated by exposure to the skin of sunlight or wind.
The episodic form of the disease is characterized by periods of exacerbation and extinction. The classic course of the disease is accompanied by three stages:
Stage 1. Redness captures not only the cheeks, but also the chin and nose, telangiectasias are formed.
Stage 2. There are more telangiectasias, redness intensifies, red papules with a diameter of 3-5 mm begin to form. The skin gradually thickens due to the growth of collagen fibers.
Stage 3. Redness acquires a purple hue, rashes, spots and vascular networks merge, which greatly changes the appearance of the patient. Suppuration of the skin often joins, since the sebaceous glands are not able to work normally. Rhinophyma is a complication that most often develops precisely at stage 3 of rosacea. The skin on the nose thickens, becomes dry, flabby, cyanotic and loose.
Ophthalmorosacea. With this form of the disease, the skin surrounding the organs of vision suffers. First of all, the eyelids and eyebrows are involved in the pathological process. In this case, the skin turns red and thickens. Possible inflammation of the mucous membrane of the eye. This is accompanied by a burning sensation, cutting and pain in the conjunctiva. The appearance of excessive dryness of the eyes is not ruled out. Rarely, but still possible, the development of blindness.
Granulomatous rosacea. Acne in this form of the disease is localized around the lips and eyes. At first, the rashes are single, but as the disease progresses, they are able to multiply and merge, forming tubercles. Scientists came to the conclusion that tuberculosis bacteria that got on the face are capable of provoking this form of the disease. However, they are not cultured in all patients.
Steroid rosacea. This form of the disease is a consequence of the irrational use of hormonal preparations for topical application. People who use corticosteroid ointments with fluoride are most often affected. The skin gradually becomes thinner, begins to peel off, then persistent hyperemia forms on it. If the patient at this stage of the development of the disease does not begin to receive adequate therapy, then rosacea progresses and goes through all three stages of development. Treatment of the steroid form of the disease often requires the use of hormones.
Conglobate rosacea. This form of rosacea often affects the female population of the planet. The reason is a hormonal imbalance in the body or serious gynecological diseases. The face is covered with inflammatory nodules, but they form in small quantities. Over time, they merge, may be complicated by suppuration.
Lightning rosacea. This form of the disease is a type of conglobate rosacea. Only young girls suffer from it. Rashes appear on the skin in just a few days, quickly merge, suppuration often joins. In some cases, it is possible to cope with the disease only with the help of a surgeon. At the same time, the well-being of patients does not worsen, but the cosmetic defect makes the patients immediately contact the doctor.
Gram-negative rosacea This form of the disease develops under the condition that microorganisms that are atypical inhabitants have got on the skin of the face and have taken root. We are talking about enterobacteria, Pseudomonas aeruginosa or Proteus.
Rosacea with persistent edema. This form of rosacea is also called Morbigan’s disease. The disease goes through only two initial stages of development. The skin does not undergo hyperplasia. The skin of the face becomes swollen, dry and smooth, rashes appear on it. Gradually, engorgement occurs, which entails a change in the outlines of the face.
How to distinguish rosacea from rosacea?
Rosacea and rosacea are two different things. Rosacea is a disease that is characterized by a chronic course and is manifested by defects in the skin, and further leads to its coarsening. Couperose is one of the symptoms of rosacea, but it can also develop on its own.
Cosmetologists often talk about rosacea to their clients. By this term they understand a thin branched vessel that shines through the skin. Dermatologists often refer to this pathology as “telangiectasia”. Although the difference in fact exists only in the names.
Couperose can occur against the background of rosacea, and can be triggered by other reasons:
Persistent increase in blood pressure;
Chronic liver disease;
Violations in the work of the autonomic nervous system;
Errors in facial skin care;
Alcohol abuse;
Expressed physical activity.
Couperose cannot cause rosacea, but rosacea can cause rosacea. As the disease progresses, the vascular pattern becomes more prominent. With rosacea, itching and hyperemia of the skin joins, skin engorgement occurs. With rosacea, only the size of the vascular network increases. Therefore, these two conditions can be confused only at the initial stages of the development of pathology. To avoid this, you need to consult a dermatologist.
Complications
Rosacea is associated with a number of complications:
In the early stages of its development, rosacea can be complicated by increased dryness of the conjunctiva, pain in the eyes. In the future, lacrimation may join. In this case, doctors indicate the development of ocular rosacea.
The most formidable complication of the disease is characterized by damage to the cornea of the eye with the formation of ulcers and seals on it. If this condition is ignored, it can lead to complete blindness of the patient.
Diagnostics
Most often, the diagnosis does not cause difficulties for the doctor. A standard examination is enough for a dermatologist to understand what kind of disease the patient has.
The leading symptoms are:
The presence of acne in the affected area;
Hyperemia of the skin on the cheeks and on the nose;
Complaints of the patient about itching and flushes of heat to the face;
Pathological dryness of the skin.
Most often, the disease manifests itself in people over the age of 30 years. Gradually, the symptoms are gaining strength. Over time, a secondary bacterial infection joins, pustules appear.
It is not possible to stop the process with the help of anti-inflammatory drugs. A noticeable effect occurs only after the therapy is supplemented with antibiotics. Acne with rosacea does not spread to other parts of the body, but is localized exclusively in the face area. Moreover, even the forehead, chin, neck and scalp most often do not suffer.
Additional studies are needed to confirm the correctness of the diagnosis. The same tests make it possible to establish the form of the disease.
This includes:
Bacterioscopy. During the procedure, the doctor takes a smear from the patient’s skin and sends it to the laboratory. There, a smear is examined under a microscope to determine the type of infectious agent. This diagnostic method becomes relevant when rosacea rashes are complicated by suppuration.
BAK sowing. This method has a higher accuracy compared to bacterioscopy. The material obtained from the patient is placed in various nutrient media to determine which pathogen is present on the skin.
Conducting a study on the sensitivity of microorganisms to antibiotics. This allows you to choose the most effective drug and aim to treat the disease. The results of the antibiogram will be known no earlier than in a week. Therefore, such an analysis is performed only for those patients who did not help the first course of treatment with antibacterial drugs. Most likely, they have bacteria on their skin that have developed resistance to a particular drug, so it needs to be replaced with a stronger drug.
Histological examination allows you to distinguish rosacea from tumor formations of the skin. This method becomes relevant when the rashes begin to merge. To conduct a study, you will need a scraping from the patient’s skin. The laboratory assistant examines the obtained material under a microscope and analyzes it at the cellular level.
Demodicosis analysis. This disease is characterized by colonization of the ciliary bed by mites. Rosacea and demodicosis often accompany each other.
To detect the parasite, you will need to perform one of the following studies:
PCR for the detection of mite DNA elements in skin scrapings.
Serological blood test for the detection of antibodies to the tick.
Examination of a skin scraping under a microscope to detect the parasite.
If, according to the results of the study, a ciliary mite was detected, then specific treatment is necessary using ointments based on Metronidazole.
As a rule, after the diagnosis of rosacea is made, a number of other studies and visits to narrow specialists are required. This will identify the cause of the disease and eliminate it. Otherwise, rosacea will recur again and again. A dermatologist can refer a patient for a consultation with an endocrinologist, gastroenterologist, hepatologist, etc.
Additional examination includes the following procedures:
Passage of FGDS to detect diseases of the upper parts of the digestive system. Approximately 70% of patients with rosacea have gastritis, either a stomach ulcer, or esophagitis.
Radiography of the stomach (provided that it is impossible to perform EGD).
Blood test for hormones. It’s no secret that rosacea often manifests against a background of hormonal imbalance. Such a study allows you to identify various disorders in the hormonal sphere.
Immunological tests evaluate the state of the immune system. Sometimes, in order to permanently get rid of relapses of rosacea, it is enough to strengthen local and general immunity.
Of course, not every patient with rosacea will need to undergo all of the above studies. Most often, a standard examination and anamnesis is sufficient. However, if the ongoing treatment does not give lasting results, then it will not be possible to do without additional tests.
Treatment
The earlier the patient turned to the doctor, the more effective the treatment will be. If the disease is running, then more complex therapy will be required. This is especially true of the stages at which telangiectasias or rhinophyma have already formed.
To get rid of purulent rashes, the doctor recommends topical application of antibacterial ointments. If they do not have the desired effect, then systemic antibiotics are required.
Self-treatment of rosacea is dangerous for the development of complications, so a preliminary consultation with a specialist is necessary. If you ignore medical recommendations, then it is possible to form an abscess of the skin against the background of its suppuration. An abscess will require the help of a surgeon. The abscess is opened, cleaned and drained.
If the disease is in the acute stage, then it is necessary to remove the inflammation. As a rule, this takes several weeks. Further therapy is reduced to the prevention of recurrence of rosacea and to the elimination of a cosmetic defect in the form of dilated blood vessels.
To get rid of telangiectasias, you can go through the following procedures:
Cryotherapy. The skin is exposed to extremely low temperatures, which causes vasospasm. After several sessions, the dilated capillaries overgrow.
Laser therapy It is an effective treatment for rosacea. If the disease is in the early stages of development, then the effectiveness of the procedure is equal to 95%.
You will not be able to achieve instant results. However, after several visits to the doctor, it will be possible to evaluate the first effect. The spots turn pale, the burning sensation and itching disappear. If the period of treatment of rosacea falls on the warm season, then sunscreen should be used before going outside.
Redness remains after rosacea treatment, what should I do?
Getting rid of such a symptom of rosacea as redness of the face can sometimes be quite difficult. It can persist even after all rashes and acne have disappeared.
The reasons why the redness does not go away for a long period of time may be:
Allergization of the body With rosacea, the skin becomes vulnerable to any influences, including the effects of allergens. An allergic reaction can provoke a variety of substances: cosmetics, antibacterial drugs, skin care products, the use of certain foods. To make sure that the redness after rosacea treatment is the result of an allergic reaction, you need to go to the doctor. After finding out the cause, the doctor will prescribe a hormonal ointment to the patient, which will reduce the inflammatory response. It should be taken into account that the application of corticosteroid preparations to the skin is possible only if rosacea has been completely eliminated. If the disease has not receded, then this can aggravate its course.
Joining the infection Pathogenic microorganisms can provoke reddening of the skin. Moreover, the presence of acne is an optional condition for the development of inflammation.
To get rid of the infection, you can use the following drugs:
Application of Metroruboryl, Tetracycline or Erythromycin ointment.
Use of drugs Rozamet or Rozeks.
Most often, dermatologists prescribe these drugs in the treatment of rosacea. Therefore, if the redness does not go away immediately after completing the course of therapy, it may just take time.
Skin changes at the morphological level Morphological changes occur at the third stage of the development of the disease. The skin becomes rough as it undergoes inflammation for a long time. Against this background, redness persists. You can get rid of the redness caused by morphological changes with the help of laser therapy. The doctor removes the top layer of the epidermis without affecting the tissues located under it. Over time, a new epithelium is formed, which has a normal color.
Edema Dense edema is characteristic of Morbigan’s disease. At the same time, the rash is absent, or passes quickly, but the redness can persist for a long time. This atypical form of the disease requires specific treatment. The causes of redness on the skin of the face after getting rid of rosacea can be many. To find out what exactly led to the problem, you need to contact a specialist. If necessary, the doctor will make adjustments to the treatment. Normally, redness should disappear after a few weeks from the start of therapy.
Prevention of rosacea
It is impossible to guarantee the absence of recurrence of the disease, but it is possible to reduce the risk of their occurrence. To do this, you should regularly undergo cryo- and laser therapy sessions.
To appear less often at the appointment with a beautician, you need to follow these recommendations:
Avoid prolonged exposure to the sun. If this is not possible, sunscreen must be used.
In winter, you should not allow hypothermia of the skin of the face, protect it with the help of special creams.
From the menu you need to exclude spicy, fatty and fried foods, enrich your diet with vitamins A and E.
All diseases of the digestive system should be treated promptly.
Without medical advice, you can not use ointments containing a hormonal component.
Can you sunbathe with rosacea?
Sunburn can cause the development of rosacea, or provoke an exacerbation of the disease. If a person is under the sun for a long time, he receives an impressive dose of ultraviolet radiation. The skin of patients with rosacea is highly sensitive to such radiation, which contributes to the aggravation of the course of the disease.
Mutagenic effects of sunlight on the skin. The longer the skin is exposed to solar radiation, the worse its cells work. Metabolic processes are disturbed in them, natural regeneration and protection suffer, and the process of tissue engorgement starts. All this increases the risk of infection, which is the cause of increased inflammation, acne and suppuration. In addition, a failure in the regenerative processes at the cellular level can lead to the fact that the defects caused by rosacea cannot be stopped.
Dilation of small vessels With rosacea, the capillaries expand and their permeability increases. As a result, part of the blood elements can leave their course. This leads to the formation of redness and increased itching. The sun contributes to the fact that the vessels are damaged even more, which negatively affects the course of the disease.
Reduced local protection Ultraviolet weakens the protective function of epidermal cells, which is favorable conditions for the development of a bacterial infection. If a person is infected with demodicosis, then tanning will increase the number of ticks. In addition, the risk of infection with staphylococci, Pseudomonas aeruginosa, streptococci, enterococci and Proteus increases.
cell death When the bright sun is exposed to the skin for a long time, it can cause it to burn. The cells that form the top layer of the epidermis die. This increases swelling, redness and itching of the face. The more often a person is exposed to such effects, the faster the disease will begin to progress.
Dehydration of the skin Fluid from skin cells evaporates faster when exposed to sunlight. Even in healthy people, sunburn contributes to increased dryness of the skin. In patients with rosacea, this negative effect is even more pronounced. In addition, not all moisturizing ointments and creams can be used by patients, as they have a higher risk of developing an allergic reaction. Therefore, your pastime in the sun should be limited.
So, sunbathing is not recommended for people with rosacea, as this will provoke an increase in the symptoms of the disease. The influence of the sun on the skin should be moderate, it cannot be completely abandoned. After all, only under the influence of the sun in the body vitamin D is produced.
Sun exposure tips for people with rosacea:
You can be in the sun until 11-00 am and after 18-00 pm. At this time, the activity of the sun’s rays is minimal, and they do not harm the skin.
If you have to stay in the sun for a long time, you should use sunscreen. You need to choose hypoallergenic products.
The face must be covered with a wide-brimmed hat. Exposure to sunlight on other parts of the body does not aggravate the course of the disease.