what is Rosacea
Rosacea is a common chronic inflammatory disorder of the hair follicles, sebaceous glands and vasculature of the face. The role of Demodex mite in the pathogenesis of Rosacea is controversial.
Rosacea sufferers have recurrent flushing, exacerbated by heat (shower, hot drinks), spicy foods, sunlight, cold, alcohol, and stress. They have sensitive skin, and may complain of dry and gritty eyes.
The peak incidence of Rosacea is 30—50 yr; Females being more affected than Males.
Rosacea sufferers may develop erythema, telangiectases, papules, and pustules of central face; there are no comedones in contrast to acne. Sebaceous hyperplasia, seborrheic dermatitis and facial lymphedema are also more common.
There are 4 Major Subtypes of Rosacea:
Erythematotelangiectatic, papulopustular, ocular, and phymatous.
Chronic inflammation may progress to rhinophyma (enlarged nose; in males). Ocular involvement is also common (e.g., gritty, conjunctival injection, styes, photophobia).
Investigations include clinical diagnosis; uncommonly, skin biopsy is indicated to rule out lupus or sarcoidosis.
Similar conditions that needs to be differentiated from Rosacea are: Acne, lupus erythematosus, perioral dermatitis, sarcoidosis, seborrheic dermatitis.
Treatment of Rosacea is based on severity and subtype.
Lifestyle modification:
Avoid triggers; sun protection and avoidance; facial massage for lymphedema.
Topical antibiotics:
Metronidazole 0.75% gel or 1% cream bid.
Sodium sulfacetamide lotion 10% bid.
Oral antibiotics (moderate to severe cases with inflammatory papulopustular component):
Tetracycline 500 mg po bid
Minocycline 100 mg po od—bid.
Doxycycline 20 mg po bid (subantimicrobial dose therapy) or 100 mg po qd–bid.
Isotretinoin (low dose); less commonly, topical retinoids may be used.
Laser therapy (e.g., PDL, IPL) for telangiectases and ablative laser (e.g., CO2) for rhinophyma.
Camouflage makeup (e.g., Dermablend, Covermark) for erythema.
Ophthalmologist to assess for ocular Rosacea (blepharitis, conjunctivitis, episcleritis).
Saturday, June 21, 2008
Rosacea causes (2)
Acne Rosacea is usually preceded by degenerative changes of the perivascular, and possibly vascular, collagen and elastic tissues in inherently susceptible individuals exposed to climatic factors. These dermal changes are believed to lead to small vessel dilatation resulting in flushing, apparent vessels under the skin surface, and redness. Eventually, the dilated vessels become incompetent with perivascular leakage of potentially inflammatory substances.
Different mediators, including the neurotransmitter peptide substance P, histamine, serotonin, and prostaglandins, have been proposed to be involved in the erythematous response. It is also possible that none of these is responsible but that the reaction is triggered by another, still unknown mechanism.
The presence of microorganisms has also been examined as a potential contributing factor to Acne Rosacea, but results have been inconclusive. Demodex folliculorum mites are merely commensals and do not, in contrast to former belief, play a significant part in the development of Acne Rosacea, although an inflammatory reaction to the mites may be important in this condition. This is different from Demodex folliculorum folliculitis (demodicosis, demodicidosis). Some reports suggest that patients with Acne Rosacea have an increased prevalence of Helicobacter pylori infection, although other reports fail to confirm this association. Eradication of H. pylori has been occasionally associated with an improvement of Acne Rosacea symptoms. Study results are inconsistent, but it has been suggested that H. pylori synthesizes gastrin, which may stimulate flushing.
Acne Rosacea is considered by some authors as a seborrheic disease. Many patients with Acne Rosacea, however, do not show signs of excessive sebaceous activity although others do. One report says that there is no significant association between Acne Rosacea and seborrhea. It is not a primary disease of sebaceous follicles in contrast to acne vulgaris. Comedones are absent and the initial findings are not related to follicles, though papulopustules are follicular bound.
No acceptable evidence of genetic predisposition has been reported so far, although more than one case in a family is often encountered.
Different mediators, including the neurotransmitter peptide substance P, histamine, serotonin, and prostaglandins, have been proposed to be involved in the erythematous response. It is also possible that none of these is responsible but that the reaction is triggered by another, still unknown mechanism.
The presence of microorganisms has also been examined as a potential contributing factor to Acne Rosacea, but results have been inconclusive. Demodex folliculorum mites are merely commensals and do not, in contrast to former belief, play a significant part in the development of Acne Rosacea, although an inflammatory reaction to the mites may be important in this condition. This is different from Demodex folliculorum folliculitis (demodicosis, demodicidosis). Some reports suggest that patients with Acne Rosacea have an increased prevalence of Helicobacter pylori infection, although other reports fail to confirm this association. Eradication of H. pylori has been occasionally associated with an improvement of Acne Rosacea symptoms. Study results are inconsistent, but it has been suggested that H. pylori synthesizes gastrin, which may stimulate flushing.
Acne Rosacea is considered by some authors as a seborrheic disease. Many patients with Acne Rosacea, however, do not show signs of excessive sebaceous activity although others do. One report says that there is no significant association between Acne Rosacea and seborrhea. It is not a primary disease of sebaceous follicles in contrast to acne vulgaris. Comedones are absent and the initial findings are not related to follicles, though papulopustules are follicular bound.
No acceptable evidence of genetic predisposition has been reported so far, although more than one case in a family is often encountered.
Friday, June 20, 2008
WHAT IS ROSACEA?
Acne Rosacea is a chronic disease involving the central face including the cheeks, chin, nose, and central forehead. There are various combinations of flushing, redness, apparent vessels under the skin surface, edema, papules, pustules, ocular changes, and deep inflammation of the nose.
These symptoms may be temporary and each may occur independently. One or more of the features may be present. There are remissions and exacerbations. The causes and mechanism of development are unknown and there are no tissue or serum markers.
Acne Rosacea is common with a prevalence as high as 10% in some populations. It appears to be more common in people with fair skin. Acne Rosacea may occur at any age but most patients are over 30.
Acne Rosacea has been divided into four types. Progression from one subtype to another may occur. It is important to treat Acne Rosacea to prevent development of disease.
These symptoms may be temporary and each may occur independently. One or more of the features may be present. There are remissions and exacerbations. The causes and mechanism of development are unknown and there are no tissue or serum markers.
Acne Rosacea is common with a prevalence as high as 10% in some populations. It appears to be more common in people with fair skin. Acne Rosacea may occur at any age but most patients are over 30.
Acne Rosacea has been divided into four types. Progression from one subtype to another may occur. It is important to treat Acne Rosacea to prevent development of disease.
Thursday, June 19, 2008
Rosacea causes
Acne Rosacea is a relatively common disease, especially in fair-skinned people of Celtic or northern European heritage, hence the term curse of the Celts. It is rarer in dark-skinned people, particularly so with American and African blacks. The disease is estimated to affect at least 5 percent of Americans, or some 13 million people. Although it is said that women are more often affected than men in earlier stages (3:1 ratio), men develop the tissue and sebaceous gland hyperplasia leading to rhinophyma much more frequently. Although Acne Rosacea tends to be milder in women, it can lead to severe emotional distress owing to its chronic course.
The importance of sun-damaged skin in Acne Rosacea cannot be stressed enough. Acne Rosacea is always associated with solar elastosis and often with heliodermatosis. This is a consistent background on which Acne Rosacea is superimposed. However, an increase in ultraviolet sensitivity has not been demonstrated in Acne Rosacea sufferers, nor is the disease more common in outdoor workers.
There is also a wide spectrum of Acne Rosacea manifestations. Especially in young sufferers there may be a history of acne giving rise to variants of two independent facial diseases that are difficult to recognize and treat. It is important to realize that Acne Rosacea and acne can coexist, though normally Acne Rosacea begins and reaches its peak incidence decades after acne declines.
Although the precise cause of Acne Rosacea remains a mystery, various factors have been suspected to contribute to this condition. None of them, however, has been definitely confirmed. Acne Rosacea sufferers are constitutionally predisposed to flushing and blushing. Migraine headaches have been shown to be two or three times more common in Acne Rosacea sufferers than among age- and gender-matched control subjects, suggesting the possibility of a more generalized vascular pathogenesis. The fact that vasomotor lability is especially pronounced during menopause and that a significant number of Acne Rosacea sufferers are perimenopausal women supports this hypothesis. Experimental studies show that the involved skin responds normally to various vasoactive chemicals, with facial blood vessels maintaining their capacity for dilatation and constriction. The basic abnormality seems to be a microcirculatory disturbance of the function of the facial angular veins directly involved in the brain-cooling vascular mechanism.
The importance of sun-damaged skin in Acne Rosacea cannot be stressed enough. Acne Rosacea is always associated with solar elastosis and often with heliodermatosis. This is a consistent background on which Acne Rosacea is superimposed. However, an increase in ultraviolet sensitivity has not been demonstrated in Acne Rosacea sufferers, nor is the disease more common in outdoor workers.
There is also a wide spectrum of Acne Rosacea manifestations. Especially in young sufferers there may be a history of acne giving rise to variants of two independent facial diseases that are difficult to recognize and treat. It is important to realize that Acne Rosacea and acne can coexist, though normally Acne Rosacea begins and reaches its peak incidence decades after acne declines.
Although the precise cause of Acne Rosacea remains a mystery, various factors have been suspected to contribute to this condition. None of them, however, has been definitely confirmed. Acne Rosacea sufferers are constitutionally predisposed to flushing and blushing. Migraine headaches have been shown to be two or three times more common in Acne Rosacea sufferers than among age- and gender-matched control subjects, suggesting the possibility of a more generalized vascular pathogenesis. The fact that vasomotor lability is especially pronounced during menopause and that a significant number of Acne Rosacea sufferers are perimenopausal women supports this hypothesis. Experimental studies show that the involved skin responds normally to various vasoactive chemicals, with facial blood vessels maintaining their capacity for dilatation and constriction. The basic abnormality seems to be a microcirculatory disturbance of the function of the facial angular veins directly involved in the brain-cooling vascular mechanism.
How to Cover Redness & Rosacea
This video to learn how to cover redness and rosacea in a natural way. You aren't going to cover all of it, but it just makes your face look better.
WHAT IS ROSACEA?
The disease was originally called acne rosacea. Papules and pustules occur in the central region of the face against a livid erythematous background with telangiectases. Later, there may occur diffuse hyperplasia of connective tissue with enlarged sebaceous glands. The disease evolves in stages. The early signs are recurrent episodes of blushing that finally become persistent dark red erythema, particularly on the nose and cheeks, often before the age of 20 years. These persons are the so-called flushers and blushers. Rosacea is common in the third and fourth decades and peaks between the ages of 40 and 50 years. In the worst cases, nonpitting edema (fibrosis), particularly of the nose (rhinophyma), may develop after many years. Early diagnosis and appropriate management are required to minimize patient discomfort and psychological distress.
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