Rosacea

Fair-skinned people get the disease more often than southern skin types. This is why it is popularly known as the “curse of the Celts”. Many sufferers are unaware of their condition and are ashamed of the redness. Rosacea can be very distressing, but is easily treatable. Those affected can also look out for triggering factors themselves and visibly improve the appearance of their skin with the right care.

What is rosacea?

Rosacea, also known as rosacea, acne rosacea, facial rose, copper rose or copper fin, is a chronic inflammation of the facial skin. The name rosacea is derived from the Latin word rosaceus (= rose-colored), as the reddening of the face is reminiscent of the blossoming of a rose. The cheeks, forehead, chin and nose are particularly affected. Typical signs are red spots, papules and visible veins on the face. Rosacea is not contagious and usually occurs in episodes. As the skin disease progresses, it can also spread to the neck, back, chest and scalp. In men, a rhinophyma (= bulbous nose) can develop as a result of the progressive skin changes. In contrast to acne, rosacea does not cause blackheads.

Rosacea can also occur in various special forms:

• Rosacea conglobata
• Rosacea fulminans
• granulomatous (lupoid) rosacea
• Drug-induced rosacea (steroid rosacea, etc.)
• Gram-negative rosacea
• Morbihan’s disease
• Rosacea in childhood
• extrafacial rosacea (red scalp syndrome, red scrotum syndrome)

Rosacea: causes and risk factors

The causes of rosacea are not yet fully understood. Experts believe that various factors play a role in its development. These include:

• impaired protective function of the skin
• Inflammatory and immune reactions
• familial predisposition
• Changes in the blood vessels in the skin
• Hypersensitivity to certain mites or bacteria

The constant inflammation leads to an uneven skin tone and makes the skin flaky and dry. They also accelerate the skin’s ageing process. The disease occurs in episodes. Possible triggers for a new flare-up include sunlight, extreme heat and cold, alcohol, spicy food, hot drinks, skin-irritating care products and stress. In general, however, anything that leads to facial redness can also aggravate rosacea.

Symptoms of rosacea: What does rosacea look like?

Rosacea is a chronic inflammatory disease of the cheeks, chin, nose, forehead and often also the eyes. Less commonly, the scalp, neck or chest are affected. With rosacea, the skin tends to become dry, swollen and flaky. Burning, itching and increased sensitivity may also occur.

Experts divide the disease into four subtypes:

• Type 1: Reddened facial skin and partially visible veins.
• Type 2: In addition to the reddening of the skin, nodules (papules) and pustules form.
• Type 3: Thickened skin, sometimes inflammatory nodules form mainly on the nose.
• Type 4: The disease causes inflammation of the eyes and eyelids, sometimes without any other noticeable skin symptoms.

As rosacea is very diverse and mixed forms often occur, the classification into four types is only a rough guide. The individual symptoms and skin changes are always decisive for the treatment.

Rosacea: diagnosis and examinations

Rosacea is diagnosed following a clinical examination of the skin by a dermatologist. Typical symptoms such as redness, visible veins, papules or swellings are assessed. Special tests and examinations are not usually necessary, as a specialist can recognize the disease by its external appearance. In unclear cases, the doctor will suggest a skin biopsy or a differential diagnosis to differentiate it from other skin diseases.

Rosacea: prevention, early detection, prognosis

Rosacea cannot be completely prevented, but there are measures that can help to alleviate the symptoms or prevent their onset. This is because rosacea is aggravated by certain stimuli. To avoid a new flare-up, it is therefore important for those affected to pay attention to the known triggers. A rosacea diary can help you to identify your triggers.

Here’s what you can do to alleviate or prevent rosacea flare-ups:

Avoid triggers for facial redness

Many people with rosacea react to certain triggers that can make the symptoms worse. Common triggers are:

• Severe heat and cold
• Alcohol
• spicy food
• Hot drinks
• Skin-irritating care products
• Stress

Skin care for rosacea

Gentle skin care is important to prevent new rosacea flare-ups. This includes avoiding products that irritate the skin, adequate sun protection (sun protection factor 50) and soap-free cleansing products with a low, slightly acidic pH value (< 7).

Very important: Your care products should not contain alcohol, fragrances, colorants or other skin-irritating ingredients such as parabens. Ask your pharmacy for suitable products. The following also applies: sun is poison for facial skin with rosacea. You should therefore avoid direct sunlight, especially in the warmer months of the year. Visits to the solarium are also absolutely taboo for rosacea patients.

Skin cleansing for rosacea

If you suffer from rosacea, there are a few important points to bear in mind when cleansing your skin:

• Cleanse your face with lukewarm water only. Water that is too hot or too cold and extreme temperature changes can lead to sudden reddening of the skin (flushing).
• Avoid water with a high degree of hardness.
• Avoid mechanical facial peels. These can also irritate the skin.
• After washing, gently pat your face with a towel and do not rub your face with a towel.

Reduce stress with rosacea

Psychological stress is one of the main triggers for rosacea flare-ups. Typical signs of stress are irritability, nervous restlessness, excessive sweating, sleep problems, rapid exhaustion or dizziness. There are many ways to reduce stress. Good relaxation techniques are autogenic training, Qigong, progressive muscle relaxation and yoga. Even small breaks in everyday life are good for you. Relaxed exercise in the fresh air strengthens the immune system.

It also helps many sufferers to find out more about the disease and to talk to others. It is better to avoid strenuous sports and saunas. They can aggravate rosacea.

Nutrition for rosacea

There is no diet specifically recommended for rosacea. Nevertheless, those affected can do something. Dermatologists advise avoiding certain foods that promote blood circulation and thus lead to an expansion of the blood vessels in the face. We recommend foods that strengthen the immune system and help to reduce inflammation.

Stay tuned for the treatment of rosacea

The following applies to the treatment of rosacea: persevere and don’t give up. Rosacea is a condition that you can manage well with medication, the right skin care products and an adapted lifestyle. However, the treatment does not work overnight. Visible results usually only appear after a few weeks.

Rosacea: early detection not possible

There is no specific “early diagnosis” in the conventional sense for rosacea, as the symptoms often appear gradually and can easily be confused with other skin diseases. However, there are some signs to look out for to enable early detection:

• Redness on the face: An early sign of rosacea is recurring redness, especially on the cheeks, forehead and nose. This redness can be exacerbated by changes in temperature, stress or certain foods.
• Visible blood vessels: Small, dilated blood vessels (telangiectasias) may become visible on the surface of the skin, especially on the nose and cheeks.
• Skin rash and acne-like inflammation: In the early stages of rosacea, pimples or small pustules may appear that look like acne but do not contain blackheads.
• Burning or tingling: Those affected often report an unpleasant burning or tingling sensation on the skin, especially when there is redness.
• Changes in the skin structure: As the disease progresses, the skin may thicken, especially in the area of the nose(rhinophyma). However, this is rare in the early stages.

In the event of recurring redness or skin irritation that persists over a longer period of time, it is advisable to consult a dermatologist. They can make a diagnosis and, if necessary, recommend treatment to prevent the disease from progressing.

Rosacea: prognosis favorable in many cases

The prognosis of rosacea depends on the severity of the disease and the treatment. Factors such as lifestyle, stress, diet and dealing with triggers can have a strong influence on the course of the disease. With correct treatment and adherence to relapse-reducing measures, it is favorable in most cases.

Important: Rosacea tends to worsen over time if left untreated. In advanced stages, permanent skin changes may occur, e.g. thickening of the skin (especially on the nose) or visible blood vessels (telangiectasia). However, these changes can usually be avoided if you start treatment early.

Rosacea treatment: What helps with rosacea?

Rosacea is a chronic disease. It is therefore important to see a dermatologist regularly to monitor the symptoms and develop an individual treatment strategy. In this way you can prevent a possible progression of the disease. More severe skin changes can be treated well with medication. As a rule, products that are applied to the skin are sufficient. Depending on the stage of the disease, various active substances are available. In severe forms, the doctor will also prescribe antibiotics (tetracyclines). Laser or light therapy can be used to remove the annoying red veins. If your self-image suffers from facial redness, it can be helpful to talk to those affected and inform relatives about the condition.