Rosacea
Rosacea typically begins as redness on the central face across the cheeks, nose, or forehead, but can also less commonly affect the neck, chest, ears, and scalp. In some cases, additional symptoms, such as semi-permanent redness, telangiectasia (dilation of superficial blood vessels on the face), red domed papules (small bumps) and pustules, red gritty eyes, burning and stinging sensations, and in some advanced cases, a red lobulated nose (rhinophyma), may develop.
- There are four identified rosacea subtypes and patients may have more than one subtype present:
- Erythematotelangiectatic rosacea: Permanent redness (erythema) with a tendency to flush and blush easily. It is also common to have small widened blood vessels visible near the surface of the skin (telangiectasias) and possibly intense burning, stinging, and/or itching sensations. People with this ETR type often have sensitive skin. Skin can also become very dry and flaky. In addition to the face, symptoms can also appear on the ears neck, chest, upper back, and scalp.
- Papulopustular rosacea: Some permanent redness with red bumps (papules) with some pus filled (pustules) (can last 1–4 days or longer; extremely varied syptoms); this subtype can be easily confused with acne.
- Phymatous rosacea: This subtype is most commonly associated with rhinophyma, an enlargement of the nose. Symptoms include thickening skin, irregular surface nodularities, and enlargement. Phymatous rosacea can also affect the chin (gnathophyma), forehead (metophyma), cheeks, eyelids (blepharophyma), and ears (otophyma).[10] Small blood vessels visible near the surface of the skin (telangiectasias) may be present.
- Ocular rosacea: Red (due to telangiectasias), dry, irritated or gritty, eyes and eyelids. Watery eyes. Eyelids often develop cysts. Some other symptoms include foreign body sensations, itching, burning, stinging, and sensitivity to light. Eyes can become more susceptible to infection. About half of the people with subtypes 1-3 also have eye symptoms. Blurry vision and loss of vision can occur.
- There are a number of variants of rosacea, including:
- Rosacea conglobata
- Rosacea fulminans
- Phymatous rosacea
Treatment for Rosacea
- Treating rosacea varies depending on severity and subtypes.
- A subtype-directed approach to treating rosacea patients is recommended to dermatologists. Mild cases are often not treated at all, or are simply covered up with normal cosmetics.
- Therapy for the treatment of rosacea is not curative, and is best measured in terms of reduction in the amount of erythema and inflammatory lesions, decrease in the number, duration, and intensity of flares, and concomitant symptoms of itching, burning, and tenderness.
- The two primary modalities of rosacea treatment are topical and oral antibiotic agents.
- While medications often produce a temporary remission of redness within a few weeks, the redness typically returns shortly after treatment is suspended.
- Long-term treatment, usually one to two years, may result in permanent control of the condition for some patients.
- Lifelong treatment is often necessary, although some cases resolve after a while and go into a permanent remission.
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