What is rosacea? A dermatologist explains

LLike many skin conditions, rosacea is a complexion problem that justifies many, a lot questions. After all, what is rosacea and what causes it? Are there different types of rosacea? Is any facial flushing a sign of rosacea in its own right?

All of these are among the seven most common questions asked regularly by New York-based cosmetic dermatologist Michele Green, MD. Luckily for us, finding out the answers won’t require an in-person visit – just keep reading to learn more about rosacea misconceptions and how to manage the inflammatory skin condition.

1. First things first: What is rosacea?

Rosacea is a common chronic skin condition that typically develops between the ages of 30 and 50, says Dr. Green. “Rosacea is considered a form of adult acne that is characterized by acne breakouts, facial redness, flushing, and prominent facial blood vessels,” she explains, noting that breakouts typically appear on cheeks, nose, forehead, chin and chest. . According to the American Academy of Dermatology, it affects up to 14 million Americans, so know that if you’re dealing with it, you’re definitely not alone.

2. So, is rosacea a form of acne?

While rosacea is considered a form of adult acne, Dr. Green is quick to point out that there is a big difference between acne vulgaris and acne rosacea. “Acne vulgaris, commonly known as acne, occurs when hair follicles become clogged with dead skin cells, debris and oils leading to inflammation,” she says, pointing out that causes of acne can include genetics, hormonal function and bacterial growth. “Acne rosacea, commonly known as rosacea, is characterized by redness, papules, pustules and swelling.”

That way, some might say it’s misleading to think of rosacea as a form of acne, but that’s just because most people assume that all acne is related to pus-filled breakouts, and This is not the case.

“A common misconception with rosacea is that rosacea is a severe form of acne. [vulgaris]“, reiterates Dr. Green. “It is important to note that acne [vulgaris] and rosacea are completely different skin conditions that require different treatments. Rosacea is usually a lifelong condition that occurs in middle age. Acne [vulgaris] is usually a temporary skin condition that begins during puberty.

Also, unlike acne vulgaris, which can occur anywhere, acne rosacea typically occurs in the midsection of the face and is characterized by redness, broken capillaries and spider veins, adds Dr. Green.

3. Is any type of facial redness considered rosacea?

Since the number one symptom of rosacea is severe redness, some people assume that any visible redness is a sign of the skin condition. In fact, Dr. Green says it is characterized by persistent sunburn-like redness in the center of the face that will not go away. And it doesn’t mean days or even weeks, because some contact dermatitis and inflammation from using the wrong product can last that long. Instead, she says a person could be dealing with rosacea if the central redness lasts for at least three months.

“Rosacea can also occur on the eyes – called ocular rosacea – and is characterized by itchy, dry, irritated and red eyes,” says Dr. Green. “Eyes can also become photophobic and present with blepharitis or swelling of the eyelids.” So if the center of your face isn’t red but your eyes are consistently red, that should be reason to schedule an appointment with your dermatologist to find out how best to proceed.

Of course, you should also consult a doctor for your skin. “If you experience any redness on your face, it’s important to see a board-certified dermatologist for a proper diagnosis of any skin condition and the right treatment plan,” says Dr. Green.

4. What causes rosacea?

Although it’s an incredibly common skin problem, the exact cause of rosacea is unknown.

According to Dr. Green, several contributing factors are currently being researched. “First, rosacea can be hereditary, suggesting a genetic component. People with a family history of rosacea have been observed to have an increased risk of rosacea,” says Dr. Green. “Second, rosacea can also be caused by an overactive immune system. The researchers found that the Bacillus oleronius the bacteria stimulated an immune response in 79% of 22 patients with rosacea subtype two. Third, microscopic mites, called Demodex folliculorum, which normally live on the skin of 20-80% of adults, can increase in population with skin changes due to age, stress or disease. Finally, the bacterium Helicobacter pylori, which lives naturally in our gut, can produce an enzyme that causes facial flushing and rosacea flare-ups.

Simply put, there are a number of potential causes of rosacea, but there isn’t enough substantial research to say for sure that the cause is a standalone factor.

5. Are there different types of rosacea?

Because of the complexity (and frequency) of rosacea, Dr. Green says it has been classified into four subtypes based on the appearance of the skin. “It’s important to note that people with rosacea often have symptoms of more than one subtype at the same time,” she says.

Subtype 1: Erythematotelangiectatic rosacea

Dr. Green says this form of rosacea is “characterized by persistent facial redness (erythema) which is sometimes accompanied by broken blood vessels (telangiectasia). The skin can be irritated, sensitive and uncomfortable like a sunburn.

Subtype 2: Papulo-pustular rosacea

This form of rosacea is characterized by facial redness as well as acne-like bumps and pimples,” says Dr. Green. “Subtype 2 rosacea tends to occur in people with oilier skin and can cause raised patches of skin.”

Subtype 3: phymatous rosacea

“This form of rosacea is characterized by thickening and enlargement of the skin, especially around the nose,” shares Dr. Green. “When the nose is affected in this subtype, it’s called a rhinophyma, and it tends to occur more frequently in men than in women. As the rhinophyma grows and gets worse with age, patients may observe increased facial redness, thickening of the skin, rough and waxy appearance of the epidermis, enlarged facial pores, and an increase in the number and size of sebaceous glands.

Subtype 4: Ocular rosacea

Remember that rosacea can also affect the eyes. “Ocular rosacea is characterized by redness, swelling, and discomfort in the form of dry eyes, cysts, inflammation, and infection,” says Dr. Green. “Ocular rosacea can occur alone or in association with cutaneous rosacea. There is no permanent cure for ocular rosacea; however, treatment is available to manage symptoms.

6. What triggers flare-ups?

1. Dietary factors

“Dietary factors include hot or spicy foods, caffeine, hot beverages, dairy products, spices and seasonings containing cayenne pepper or red bell pepper, and foods containing cinnamaldehyde, such as citrus fruits, tomatoes and chocolate,” says Dr. Green.

2. Lifestyle factors

“Lifestyle factors include stress, genetics, smoking, alcohol, exercise (i.e. hot yoga) and strenuous exercise, steam rooms, hot baths, hormonal or endocrine problems, including thyroid disease or menopause), high blood pressure, drugs that widen blood vessels, including certain blood pressure medications, and some skincare products such as Retin-A creams or scented or alcohol-based creams,” she reveals.

3. Environmental factors

Additionally, Dr. Green says the environment can also promote rosacea flare-ups. “Environmental factors include extreme heat or cold, wind exposure, and sun exposure,” she says.

Either way, Dr. Green says it’s important to identify the triggers that may be making your rosacea worse so you can avoid them to avoid flare-ups. But remember: Not everyone is triggered by the same things, so while alcohol may exacerbate one person’s rosacea, it may not affect another’s at all.

7. What are the best ways to treat rosacea?

The good news is that there are several ways to soothe the discomfort and minimize the redness associated with rosacea. The bad news is that there is no permanent cure for the skin condition.

“The first goal of rosacea treatment is to control the inflammation and irritation caused by rosacea,” says Dr. Green. “The second goal is to address the appearance of flushed skin, redness and broken blood vessels.” With that in mind, she says treatment can include a combination of topical medications (like Metrogel, Soolantra and Mirvaso, all of which require a prescription), oral medications (including antibiotics and Accutane) photodynamic treatments (which , according to her, “use a photosensitizing molecule with intense blue light to heal the skin”), and laser treatments (like the V-Beam Pulsed Dye Laser, which she says “absorbs and treats whatever is red “).

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