Acne Rosacea is a chronic inflammatory skin condition of unknown cause. It occurs in persons whose skin is prone to flushing therefore it has been postulated that the underlying defect is vascular in nature. Acne Rosacea affects 1–10% of the population, it is more predominant in the middle aged and females.
Paler skin types, such as celts, northern European and the fair skinned are more prone to developing Acne Rosacea. It is characterised by the development of a red rash on the cheeks. The nose, forehead, scalp and eyes can become affected. The facial redness becomes persistent often with the presence of dilated blood vessels over cheeks. Acute attacks of papules,
pustules and edema can occur in response to various triggers. These attacks can persist for weeks.
Three distinct phases are recognised in the development of Acne Rosacea:
* phase 1
– Persistent facial redness
– Telangiectasia on cheeks, nose, forehead
– Sensitive, irritable skin
– Stinging and burning sensation on application of cosmetics and treatment creams
* phase 2
– Development of papules, pustules and lymphedema
– Skin follicles affected and sebaceous glands enlarged
– Prominent facial pores
– Extension of rash over face and scalp
* phase 3
– Persistent edematous, inflamed facial skin
– Facial contours become thickened, coarse and irregular
– Tissue overgrowth especially nose, chin, eyelids, ears and forehead
– Eye involvement with inflammation, irritation, redness, discomfort,
photosensitivity
– Inflamation of the cornea with disturbed vision
Triggers to acute flares
Certain substances and conditions are thought to trigger acute attacks of Acne Rosacea:
* Foods triggers
– Coffee, tea, chocolate, cold drinks, alcohol, soy sauce, cheese, citrus fruits,
curries, vinegar, tomatoes, red meat, yogurt
– Large meals
– Thermal heat
– Highly spiced foods, pickled foods, smoked foods, fermented foods
* Chemical triggers
– Caffeine, vasodilators, perfumes, aftershaves, astringents, cosmetics
* Environmental triggers
– Resident Demodex skin mite in follicles and sebaceous glands
– Gastrointestinal upset (e.g. diarrhoea, cholecystitis, gastritis)
– Weather conditions (e.g. Sunlight, wind)
– Heat and cold
* Other triggers
– Topical corticosteroids