Rosacea is a chronic inflammatory condition affecting the blood vessels of the face. It particularly affects women with fair skin and light-coloured eyes. It manifests as redness that is intermittent at first and then permanent, sometimes accompanied by recurring skin breakouts. To limit its progression, early intervention is essential.
- Recognising the signsThe early warning signs of rosacea are intermittent bouts of redness called “flushes” or “vasomotor flushes”. They affect the face, sometimes extend down to the neck or the top of the chest, and are accompanied by a sensation of intense heat. After a few minutes, they disappear spontaneously and the skin recovers its normal appearance.
Over time, an increase in the number of flushes may lead to erythro-couperose: the redness becomes chronic on the face (erythrosis), and a network of small blood vessels becomes visible to the naked eye on the cheeks, the sides of the nose, the chin, and the medio-frontal area (couperose).
In certain cases, the disorder then becomes actual rosacea: periodically, red pimples (papules) or pimples with a white head (pustules) will appear, particularly in the reddened areas.
In the most severe cases and mainly in men, rosacea can lead to rhinophyma: the sebaceous glands in the nose become permanently enlarged, and the skin becomes very red and thick.
- Understanding the causesAn abnormality in the blood circulation of the face is believed to be responsible for the first stages of rosacea: as the cutaneous vessels are hypersensitive, they dilate excessively when subjected to various stimuli and this causes redness.
An increase in flushes can gradually lead to a loss of elasticity in the blood vessels: they are no longer able to contract and they remain permanently dilated. The redness then becomes persistent: this is the erythro-couperose stage. The inflammatory bouts with skin breakouts that are typical of rosacea are still poorly understood.
Rosacea is still sometimes called “acne rosacea” because of how similar its skin breakouts are to those of acne. Nevertheless, this term is inappropriate, as rosacea is not acne and nor is it an infectious disease.
- Predisposing factorsRosacea mainly occurs in women: 15% of women are affected, compared with only 5% of men. On the other hand, the most severe cases are generally found among men. Individuals with fair skin and light-coloured eyes are the most commonly affected, which is why rosacea is often called “the curse of the Celts”. Rosacea generally begins around 40 or 50 years of age, but can sometimes appear in individuals as young as 20.
The flushes can be triggered by a variety of stimuli, such as heat, cold, temperature variations, strong emotions, alcohol, eating spicy food, intense physical activity, hot baths, steam rooms and saunas.
- Managing the conditionRosacea is a progressive, chronic condition. Nevertheless, not all sufferers develop permanent redness. To prevent it from becoming a chronic condition that is unsightly and can affect quality of life, adopting suitable everyday habits plays an important role: observe which factors trigger flushes and avoid these as much as possible to make the bouts of redness less frequent. By caring for your skin in this way, you will reduce the risk of the redness becoming permanent. Remember to systematically use a strong sunscreen when exposing your skin to the sun, as UV rays exacerbate the symptoms of rosacea. Along with these precautions, it is very important to see a skin specialist. The treatment will depend on the severity of the symptoms: electrocoagulation, laser or dermabrasion for couperose, and a topical treatment (cream or gel) or oral antibiotics for inflammatory skin breakouts. Treatments generally need to be repeated, as no radical permanent solution exists for rosacea. See your doctor as early as possible: the advice and special care they provide will help you optimise the treatment, sustain its results and protect your skin as much as possible.
B Cribier. Rosacée. Encycl Méd Chir (Elsévier, Paris), Dermatologie, 12-495-A-10, 1997, 7p. CEDEF. Dermatoses faciales : rosacée. Item 232. Ann Dermatol Vénéreol 2008; 135 S, F193-F196 F. Lemarchand-Venencie . Couperose, angiome stellaire et autres télangiectasies. In Thérapeutiques dermatologique, L. Dubertret, Médecines-Sciences, Flammarion, Paris, 2001.p 149.