Rosacea

Rosacea is a common chronic cutaneous disease primarily of the facial skin. It is common in the third and fourth decade of life, peaking at the age of 40 and 50 years. Rosacea can affect people of any skin type but occurs most in fair-skinned individuals (skin type I-II).

The causes of rosacea are still not identified. Among others, an important factor seems to be a microcirculatory disturbance. There are different clinical features of rosacea. In stage I rosacea is characterized by flushing or persistent erythema and angiectasia, or prominently dilated facial blood vessels, predominantly of the cheeks. The vascular dilation can be triggered by alcohol, spicy food, caffeine, nicotine, hormonal changes, UV-light, heat and cold. Stage II of rosacea is characterized by papules and papulopustules and persistent erythema. Stage III may develop independent of earlier stages and shows diffuse hyperplasia of connective tissue and sebaceous glands. This can cause a hypertrophy of the nose, a so called rhinophyma. Rosacea occurs in stages and may effect the eyes, most commonly resulting in blepharitis and conjunctivitis.

Only in rare cases are areas besides the face such as chest or trunk also affected. The clinical appearance can be similar to acne, but in contrast rosacea is not a primary follicular disease. Although there is currently no cure for rosacea when left untreated, it may become worse and even more difficult to treat - especially if it progresses to rhinophyma. Patients should avoid rosacea triggers which can include sun exposure, emotional stress, alcohol, spicy or hot foods, hot drinks, hot bathes, exercise and cold wind.