Rosacea

Rosacea is a skin condition that affects especially the central part of the face, runs a relapsing course and can become chronic over time. It is characterised by redness, prominence of small blood vessels, spot-like eruptions, and a burning and sensitivity most often seen on the cheeks, nose, forehead and chin. Some patients may also have complaints such as redness, dryness, stinging and watering of the eyes.

Although the exact cause of the condition is not fully known, genetic predisposition, changes in the immune system, abnormalities in the blood-vessel structure and environmental factors are thought to play a part together.

Rosacea symptoms can flare with many factors. Sunlight, hot weather, sudden temperature changes, hot drinks, spicy foods, alcohol, intense exercise, stress and unsuitable cosmetic products are among the most common triggers. Because triggers can differ from patient to patient, identifying them and avoiding them as far as possible is an important part of treatment.

Rosacea can often be confused with acne. Unlike acne, however, there are no blackheads or whiteheads (comedones). In addition, demodicosis, seborrhoeic dermatitis and some other skin conditions can produce similar findings; for this reason, an accurate diagnosis is very important so that appropriate treatment can be planned.

One of the conditions most often confused with rosacea is demodicosis. Demodicosis develops when the microscopic mites called Demodex — normally present on the skin — multiply more than usual; it causes facial redness, spot-like eruptions, burning, stinging, itching, dryness and sensitivity that closely resemble rosacea. In some patients demodicosis accompanies rosacea, causing it to run a more severe course or to respond insufficiently to treatment. For this reason, the possibility of demodicosis should always be considered in cases that persist, recur frequently or fail to improve despite standard rosacea treatments. In patients where it is needed, the diagnosis is made quickly with a Demodex test and treatment is planned accordingly.

Treatment is planned individually according to the severity of the condition and the predominant findings. Topical creams, oral medications and suitable skincare products are among the treatment options. Although rosacea is not a condition that can be eliminated entirely, with the right treatment and regular follow-up the flares can be brought largely under control and the redness and inflammatory lesions markedly reduced.