Definition
Acne rosacea tends to have a progressive course, so the symptoms tend to worsen over time: the redness tends to increase until it becomes persistent. If not properly treated, acne rosacea can cause skin lesions, swelling of the nose and also affect the region around the eyes (ocular rosacea). For some subjects the course of rosacea is cyclical: the symptoms can become acute for a period limited to a few weeks or months, and then diminished before worsening again.
Acne rosacea can be confused with other dermatological disorders, such as a skin allergy or eczema. Treatment of the disease can control and reduce the signs and symptoms characteristic of the disease.
Symptoms
To learn more: Symptoms Rosacea
The signs that characterize rosacea are of different nature and can manifest themselves with different gravity, involving in some cases also eyes and nose. Often, the area of the skin affected by acne rosacea can present swelling, heat and redness. Symptoms tend to be more severe in male subjects, probably because they reach advanced stages of the disorder without undergoing early diagnosis and adequate medical treatment (women, even if disadvantaged by the greater incidence of the disease, about three times higher than men, first resort to therapies).
Rosacea has several symptoms, among which we can find:
- Redness on the face (or hot flushes ): the redness can be sudden or persistent and is localized to the center of the face. The appearance of this symptom may be accompanied by burning and slight swelling.
- Appearance of lesions and papules (small reliefs of the skin) or pustules (when the bulges contain pus).
- Rinofima : swelling of the nose.
- Teleangestasia : small blood vessels visible on the nose and cheeks (due to their dilation).
- Thickening of the skin : acne rosacea can make the skin of the forehead, chin, cheeks or other areas thicken.
- Irritation and burning sensation in the eyes ( ocular rosacea ): when the inflammation also affects the ocular region and the eyelids. The symptoms on the eyes are: redness, dryness, burning, itching, swelling of the eyelids, heightened sensitivity to light and tearing. Ocular rosacea affects almost half of people with acne rosacea.
- Some symptoms of acne rosacea can also develop on the neck, chest, scalp and ears.
Classification of the "US National Rosacea Society" | |
Based on the association of these manifestations, we distinguish four subtypes of rosacea: | |
Erythematous telangectasica | Persistent erythema, teleangestasia, itching and burning |
Papulopustular | Similar to common acne, association of pustules and papules with erythema |
Filmed rosacea | Rhinophyma and thickening of the skin of the face |
Ocular rosacea | Conjunctivitis, blepharitis, photophobia |
Acne rosacea usually develops in four stages :
- Pre-rosacea: it can start with a tendency to blush easily, and then develop into a persistent redness in the central part of the face. The redness is the result of the dilation of the blood vessels closest to the surface of the skin.
- Vascular rosacea: when the signs and symptoms get worse teleangestasia can develop, small blood vessels appear on the nose and cheeks, visible on the skin (like small red lines). This phase is characterized by the presence of swelling and marked sensitivity of the affected area.
- Inflammatory rosacea: papules can appear (small red bulges) spread to the whole nose, cheeks, forehead and chin. At this stage, pustules may also appear (pus-filled reliefs). Note: the appearance of these two symptoms makes acne rosacea similar to common acne, although the two conditions are totally different and require specific treatments.
- Advanced Rosacea: the disease manifests the previous symptoms more intensely. They increase the redness of the skin and the number of visible blood vessels. In this phase, the skin can thicken and determine the rhinophyma (the sebaceous glands of the nose and, sometimes, the cheeks swell to cause an accumulation of tissue above and around the nose, which appears bulbous). This last condition is more common in men and develops slowly over the years.
To consider :
- Due to the progressive course of rosacea, early diagnosis is important and treatments tend to be more effective if started earlier. If left untreated, rosacea tends to worsen over time. In the event of persistent redness of the face it would be useful to consult a specialist to undergo adequate treatment.
- Many skin care products contain ingredients, such as acids, alcohol and irritants, which contribute to worsening acne rosacea.
Causes
The causes that determine the pathological condition are unknown and probably multifactorial: there is a combination of hereditary, environmental, psychological and immunological factors that make it susceptible to the onset of this dermatological disorder.
Some factors can aggravate or worsen acne rosacea, helping to increase blood flow to the surface of the skin (blood vessels dilate too easily, thus causing hot flushes). The causes that can contribute to the redness of the skin or a progression of acne rosacea, include:
- hot, spicy or spicy foods or drinks;
- alcohol intake;
- extreme temperatures: too cold or too hot;
- exposure to sunlight, wind;
- emotional states: stress, anger or embarrassment;
- excessive exercise;
- hot baths, sauna;
- menopause;
- familiarity;
- microcirculation disorders;
- Helicobacter pylori infections ;
- proliferation of the mite Demodex follicolorum (present due to changes in the connective tissue that create an environment favorable to its reproduction);
- prolonged use of corticosteroids and drugs that dilate blood vessels (to control blood pressure).
Acne rosacea and microcirculation disorders .
Acne rosacea is a primitively vascular disorder: the early disorders are the typical redness, due to changes in venous flows; the first lesions in the skin are pathological dilations of the blood capillaries.
Acne rosacea and infection with Helicobacter pylori.
There is a relationship between Hp positive gastric ulcer and acne rosacea: the metabolism of the bacterium is able to release nitrates that induce the formation of nitric oxide, a powerful vasodilator. Following the systemic antibiotic treatment of Helicobacter pylori infection (and its consequent eradication) it is possible to report an improvement in the symptoms of acne rosacea, especially at the ocular level.
Risk factors
Anyone can develop acne rosacea, but the categories most at risk seem to be:
- individuals with skin, hair and light-colored eyes (for this reason called the " Curse of the Celts ");
- the appearance of the pathology is concentrated between 30 and 60 years of age, especially in women during menopause;
- subjects with a tendency to blush easily;
- hereditary propensity (it would be recurrent within the same family).
Acne rosacea: diagnosis, treatment and prevention "
