What is it?
Rosacea is a chronic inflammatory disease that mainly affects adults over 30 years of age, being more frequent in women. The cause is unknown. The parasite Demodex folliculorum, present in the pilo-sebaceous follicles, seems to be involved with the disease only opportunistically. Personal predisposition and gastrointestinal disorders may also be involved in the disease.
Certain foods may worsen the condition in some patients (coffee, alcoholic beverages, pickles, pepper and hot sauces). Moreover, cold and heat, as well as sun exposure may be implicated in the worsening of the lesions. Sun damage may also predispose to the disease onset.
Characteristics and symptoms
The disease occurs mainly in the central region of the face. It begins with redness, transient at first, which later becomes persistent. With disease progression, appears small dilated blood vessels (telangiectasia), elevated red lesions (papules) and pustules, which look like pimples, hence the name acne rosacea, for the similarity with acne.
More severe cases may reach large areas of the face, with inflammation and swelling of the skin, forming red plaques and nodules. Some patients may experience ocular inflammatory conditions such as conjunctivitis or inflammation of the cornea, eyelid and iris.
In men, the disease may be more severe and may lead to the appearance of rhinophyma, which occurs when the nose increases in size due to skin infiltration, with dilated pores and elevated lesions.
Rosacea is a chronic disease and there is no treatment to cure it permanently, but it can be kept under control. Patients should avoid factors that trigger the exacerbation, such as: cold, sun exposure and foods mentioned in the beginning of the text, if they perceive that they worsen the condition.
Medication includes the use of oral antibiotics until improvement, when the dose should be gradually decreased. Maintenance can be done with topical antibiotics.
Eventually, if there is worsening of the lesions, oral medication should be reintroduced. The indication of adequate treatment and its duration will depend on the intensity of each case and should be defined by a dermatologist.
Telangiectasia may be treated by fulguration or laser. The treatment of rhinophyma is surgical and dermabrasion, CO2 laser or shaving may be used.