jautri oda, veido rožinė - May 7, 2024

Rosacea and its symptoms

Rosacea is a chronic skin condition characterized by a variety of skin symptoms, usually affecting areas of the face such as the cheeks, nose, forehead and chin. This condition is most common among middle-aged people, especially women, but can occur at any age. Rosacea is characterized by periods of exacerbations and remissions , where symptoms may worsen or improve.

Types of facial rosacea

Facial rosacea is divided into several main types , depending on the nature of the symptoms and the affected areas of the skin. Each type of symptom can have a different impact on the patient's quality of life and may require a specific treatment plan.

Erythematous-telangiectatic pink

This type of facial rosacea is characterized by persistent or intermittent facial redness that is often most prominent on the cheeks, nose, and forehead. The erythematous-telangiectatic form also includes telangiectasias, which are small, dilated capillaries visible on the surface of the skin, creating a spider web-like appearance. This condition can cause discomfort and self-perception problems due to the noticeable redness of the face.

Papulopustular pink

Papulopustular rosacea is characterized by facial redness accompanied by purulent papules and pustules. These skin bumps usually appear on the cheeks, chin and forehead. Papules and pustules can be painful, and their appearance and disappearance can cause significant discomfort and challenges in treatment. This type is often mistaken for inflammatory acne, but rosacea does not have the comedones that are characteristic of acne.

Phymatous pink (rhinophyma)

Rosacea, also known as rhinophyma, is characterized by thickening of the skin of the nose due to hyperplasia of the sebaceous glands. It is more common in older men and can be very noticeable. The skin of the nose becomes uneven, thicker, sometimes red and porous. This type of facial rosacea may require surgical intervention or specialized skin treatments to reduce thickening and improve the appearance of the skin.

Eye pink

Pink eye, or ocular pink, affects the eyes and the areas around the eye. Patients may experience eye redness, dryness, burning sensation, feeling of a foreign body in the eyeball, lacrimation and sensitivity to light. This type can make everyday activities such as reading or driving difficult, and require specialized eye drops or other treatments to control symptoms and prevent more serious eye health problems.

Symptoms

The main symptoms of facial rosacea are complex and varied , and each of them can affect patients' quality of life and emotional well-being. These symptoms include:

Redness or erythema is one of the most noticeable and common symptoms of facial rosacea. Most often, the nose, cheeks, forehead and chin are temporarily or permanently reddened. It can be caused by both external factors, such as temperature changes or emotional stress, and an internal inflammatory response. Redness can appear and disappear episodically or remain as a permanent symptom that visually affects the appearance of a person's face and can cause discomfort.
Pustules and papules are inflammatory skin growths that appear as small, red or skin-colored bumps that may be filled with pus. These formations can be painful and red, often causing discomfort. Although they can visually resemble acne, it is important to emphasize that in the case of facial rosacea there are no comedones. The appearance of these bumps can be cyclical, with periods of active inflammation and periods of rest.
Telangiectasia refers to dilated or bulging blood vessel networks that appear on the surface of the skin as red or blue spider-like lines. This symptom is common in the erythematous-telangiectatic form of facial rosacea and can be aesthetically unattractive, sometimes causing emotional discomfort to patients. Telangiectasia often results from long-term skin inflammation and capillary damage.
Rhinophyma is a more serious form of facial rosacea that usually affects older men. It is a condition in which the skin, especially around the nose, becomes thickened, uneven and porous due to hyperplasia of the sebaceous glands and inflammation of the skin. Rhinophyma can cause significant changes in facial contours, which require special treatment methods, sometimes even surgical intervention.

These symptoms are the basis of the diagnosis and treatment of facial rosacea, and their management and control are necessary to ensure a better quality of life for patients and to reduce the impact of this disease.

Causes and pathogenesis

The causes of facial rosacea are still not fully understood, but there are several theories and identified factors that may contribute to the onset and progression of this disease:

Genetic factors: Rosacea often runs in families, suggesting that genetic predisposition may play a role. Research suggests that certain genetic mutations related to immune system function and the regulation of inflammatory substances may increase the risk of facial rosacea.
Immune system reactions: Increased activity of proinflammatory cytokines, such as interleukins and tumor necrosis factor, has been observed in areas of skin affected by facial rosacea . This may indicate that autoimmune or overactive immune responses may play a role in the development of the disease.
Environmental Factors: Exposure to UV rays, hot or cold weather, wind, and fluctuations in humidity are known to be potential triggers for rosacea flare-ups. UV rays can damage the skin barrier and trigger inflammatory processes, while extreme weather conditions can irritate the skin and cause redness.
Diet and lifestyle factors: Spicy foods, alcohol, and caffeine are perceived as factors that can trigger or worsen the symptoms of facial rosacea. Also, stress is known to be an important factor that can influence the course of the disease, as it can stimulate an inflammatory response in the body.

Immunological aspects

It is important to emphasize that facial rosacea is not just an external skin problem. Research suggests that certain components of the immune system, such as neutrophils and macrophages, may be activated during facial rosacea, which contribute to inflammation and skin damage. Also, microscopic skin mites ( Demodex folliculorum ), which naturally live on human skin, can cause an overactive immune response in facial rosacea.

Possible consequences of the disease

Long-term uncontrolled facial rosacea can cause changes in the structure and appearance of the skin, such as thickening of the skin or rhinophyma. In addition, some patients experience emotional and psychological difficulties due to their skin condition, which can significantly affect the quality of life.

Each type of facial rosacea requires an individualized approach to treatment , focused on symptom control and improving quality of life. Treatment may include topical medications, systemic therapy, lifestyle modification, and sometimes surgical procedures.

Lifestyle adjustments

For patients with facial rosacea, it is important to recognize and avoid triggers that can worsen symptoms. This includes:

Avoid spicy food and alcohol, which can cause facial redness and a feeling of heat.
Protect your face from the sun by using hats and high SPF sunscreens, as UV rays can make symptoms worse.
Manage stress, as emotional stress can cause or worsen facial rosacea outbreaks. Techniques such as deep breathing, yoga or meditation can help reduce the effects of stress.
Choose gentle skin care , avoiding irritating substances and products that can cause skin sensitivity or irritation.