How to treat rosacea

Rosacea is a chronic disease that usually appears between the ages of 30 and 50. Dr. Pampín, an expert in Dermatology, explains in this article the different types of rosacea, as well as the treatment indicated depending on the intensity of the outbreak.

Rosacea is a chronic inflammatory skin disease that occurs in outbreaks and mainly affects the central area of the face.

What causes rosacea

The causes of rosacea are not entirely clear. There is a certain genetic predisposition that leads to an increased reactivity of the blood vessels and environmental factors also play a role, such as chronic sun damage or the continuous use of topical corticosteroids. In addition, the Demodex folliculorum mite present on the skin can cause an exaggerated inflammatory reaction, also contributing to the appearance of rosacea.

Symptoms of rosacea

The most common clinical forms of rosacea are:

– Erythematous-telangiectatic rosacea: consists of the appearance of intermittent or persistent redness in the area of the cheeks, forehead or chin, accompanied by telangiectasias or dilated capillaries.

– Papulo-pustular rosacea: outbreaks of papules and pustules, with lesions similar to acne, although unlike acne, there are no comedones.

– Finomatous rosacea: can be observed in late and severe stages of the disease and consists of a permanent thickening of an affected area of skin. It is more frequent in males, and the most common location is the nose (rhinophyma).

– Ocular rosacea: redness and itching of the eyes.

There are also other less frequent variants such as granulomatous rosacea and rosacea fulminans.

Who is affected by rosacea?

Rosacea can appear at any age, but is most common among adults between 30 and 50 years of age. It is also more frequent in women and in people with fair skin or low skin phototypes (I and II). Moreover, one third of rosacea patients have a family history.

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It is difficult to estimate the total population affected, but it usually affects one in ten people. This pathology is more common in people from northern or eastern Europe.

How is it treated?

The treatment of rosacea includes a series of general measures to avoid triggering factors: cold, sudden changes in temperature, excessive heat, corticosteroids, alcohol, among many others. In addition, it is advisable to use sunscreen daily, and the use of specific cosmetics both for hygiene and moisturizers that include vasoconstrictor substances that reduce vascular reactivity.

The treatment of rosacea should be selected according to its clinical form and severity. In many cases a combination of topical, oral, light source or surgical treatments will be necessary to obtain the best results.

In mild cases topical treatments including antibiotics such as metronidazole, azelaic acid, permethrin or ivermectin are used. In more persistent cases systemic treatments such as tetracyclines, metronidazole or isotretinoin may be used.

Light therapies such as intense pulsed light (IPL) or pulsed dye laser have shown very significant reduction of erythema, flushing and telangiectasias. Surgical procedures such as electrosurgery and ablative lasers such as the CO2 laser can also be used in cases of finomatous rosacea.