In the past, rosacea was also called acne rosacea, for the clinical resemblance of some stages of acne illness. In fact, acne and rosacea are two very different pathologies, both for causes and for therapeutic remedies.
While acne pathology originates in the pilosebaceous unit, rosacea originates in the superficial skin microcirculation. It is therefore two distinct pathologies and the term acne rosacea used much in the past should no longer be used. If the patient suffering from rosacea acne also has a seborrheic dermatitis, it is referred to mixed facial dermatosis. In these cases, some of the remedies used to treat seborrheic dermatitis (eg, application of topical corticosteroids for short periods, gradual sun exposure, etc.) may visibly deteriorate rosacea.
The patient suffering from rosacea should therefore avoid the use of cortisone creams and exposure to the sun or to other UV irradiated sources, eg. Tanning lamps. Current dermatological therapies, both systemic (metronidazole, tetracycline, etc.) and topical (eg metronidazole, retinaldehyde, azelaic acid, brimonidine, etc.), allow to control the various phases of the disease and improve the nakedness Not to erase the king definitively the disease, which as it is well known has run chronic. It is important to avoid applying cortisone or alcohol-based creams, which almost always worsen the course.
The prone is an early phase, characterized by flushing, without teleangectasia or pustules. Rosacea is essentially located in the central areas of the face (eg cheeks, nose, chin, etc.), sometimes at the ocular distemper (Arct’s ocular rosacea). This pathology is also called the “Curse of the Celts”, as it is much more visible in Nordic skin with lighter skin. Rosacea affects both sexes, with mild prevalence in women. In summer, tanning tends to uniformize facial color and then mask erythema, giving false perception of improvement. Exposure to the sun is always an aggravating factor for rosacea (photo-aggravated disease), although clinical deterioration becomes apparent in the colder months, especially when moving from a well-heated environment (eg home, office, school etc. .) To the wind or cold of the outdoor environment.
A very accurate dermatological examination generally allows the disease to be diagnosed both therapeutically and diagnostically, without forgetting prevention. Couperous sufferers should use a cream with a very high protection factor every morning, even in the colder months. Modern dermatological creams provide adequate protection, while being almost transparent. In women, for example, a good habit might be to replace your base makeup cream with a dermatologic vase-protector with a high sun protection factor. Many of these creams are great for normal make-up. In the evening, however, it is recommended to use a drug or cosmetic suitable for the individual patient, according to the clinical manifestations in progress.
There are no remedies that alone are able to eliminate rosacea once, but personalized therapy to single patients, usually helps reduce clinical manifestations and prevent worsening.
Clinical manifestations may be:
Subtype 1 (erythematous rosacea): erythema and teleangectasia visible at the level of the central facial regions, especially after meals, temperature fluctuations and emotional tension situations. In these moments, the patient tends to avoid hot spots (thermophobia).
Subtype 2 (edema rosacea): erythema is no longer only occasional, but persists. Edema (swelling) of the face may arise in the most demanding situations, the persistent edema of Morbihn’s disease, described in 1957 by the French dermatologist Robert Degos.
Subtype 3 (rosacea papillopustolosa): at this stage, milky papules and non-follicular pustules, are located in the central areas of the face, on an erythematosus background. In some cases, blepharitis and conjunctivitis (ocular or ophthalmic rosacea) may be observed. The pustular stage of rosacea has generated over the centuries a huge confusion between vulgar acne and rosacea.
Subtype 4 (hypertrophic phase): Fortunately rare situation, characterized by dermal fibrosis and deformation of the nose (rhinopharyngeal), eyelid (blefarofima), and ears (otofima).