Rosacea is a common, yet often misunderstood, inflammatory skin disease that may cause facial redness, sensitive skin, burning, stinging, swelling, papules, pustules, visible red capillary veins, red gritty eyes, and in more advanced cases, a disfiguring bulbous nose. Often misdiagnosed as adult acne, allergy or eczema, Rosacea, if left untreated, tends to worsen over time. Men and women of all ages can be affected, with over 45 million estimated sufferers of Rosacea worldwide.
What is Acne Rosacea?
It is a chronic but treatable condition that primarily affects the central face, and is often characterized by flare-ups and remissions. It typically begins any time after age 30 as a flushing or redness on the cheeks, nose, chin or forehead that may come and go. Over time, the redness tends to become ruddier and more persistent, and visible blood vessels may appear. Left untreated, bumps and pimples often develop, and in severe cases - particularly in men - the nose may grow swollen and bumpy from excess tissue. In many people the eyes are also affected, feeling irritated and appearing watery or bloodshot. Although Rosacea can affect all segments of the population, individuals with fair skin who tend to flush or blush easily are believed to be at greatest risk. The disorder is more frequently diagnosed in women, but tends to be more severe in men. There is also evidence that Rosacea may tend to run in families, and may be especially prevalent in people of Northern or Eastern European descent.
Subtype One (Erythematotelangiectatic Rosacea) -
Flushing and persistent redness of the central third of the face, typically with visible capillaries.
Subtype Two (Papulopustular rosacea) -
Persistent redness of the central third of the face accompanied by papules and pustules.
Subtype Three (Phymatous Rosacea) -
Thickening of the skin, irregular surface nodularities and enlargement. Most commonly presented as an enlargement of the nose but may affect other locations, such as the chin.
Subtype Four (Ocular Rosacea) -
Irritation of the eye area, including watery, bloodshot eyes, foreign body sensation, burning, stinging, dryness, itching and frequent sties, that may result in blepharitis, conjunctivitis or irregularity of the eyelid margins.
Potential causes of Rosacea
Studies performed on Rosacea patients demonstrated a variety of potential contributors to the Rosacea pathway. There have been no conclusive findings as the cause of Rosacea. The most common theories are listed below although some are more substantiated than others.
Vascular dysfunction -
Studies have shown that people with Rosacea may experience increased blood flow to the blood vessels of the face. There is an increase in the number of blood vessels and blood vessels may be closer to the surface of the face, making redness and broken capillaries more common. Certain pro-inflammatory mediators found naturally within the skin may be more prominent or active in Rosacea sufferers.
Vascular endothelial growth factor (VEGF) -
Stimulates the growth and development of new blood vessels, which is proven to play a role in the pathogenesis of Rosacea. VEGF also encourages microcapillary leakiness. Studies suggest that plasma leaking to surrounding tissues may induce an inflammatory response, causing redness and irritation.
Prosxtaglandin E2 (PGE2) -
A group of hormone-like substances that participate in the dilation of blood vessels. PGE2 is released by blood vessel walls in response to inflammation.
Pro-inflammatory cytokines -
Also known to be involved in Rosacea. They are part of the flushing and chronic inflammatory responses. There are many potential cytokines involved in this inflammatory pathway.
Domdex Mites –
Human skin is inhabited by the demodex mite that lives within the sebaceous follicles. It is thought by some that in Rosacea, these mites proliferate and create inflammation. Studies have shown that Rosacea sufferers do have more of the parasite than individuals without the condition. Recent studies have many experts convinced that the domedex mite could be a result of Rosacea rather than the cause. Vascular and connective tissue changes caused by Rosacea may create a favorable environment for the proliferation of the mites.
Helicobacter Pylori -
Early studies suggested a possible connection between Rosacea and the bacteria responsible for ulcers. Although this theory is still noted in some textbooks, further research indicates the correlation was merely two common conditions which responded to the same oral antibiotic medications.
Common Triggers for Rosacea and Sensitive Skin
- Sun exposure
- Emotional stress
- Wind and cold weather
- Heavy exercise
- Excessive alcohol consumption
- Certain skin care products
All skins are unique and require individual, customized attention to determine the most appropriate path to take toward healthier skin and relieve the signs and symptoms of Rosacea.