Definition, symptoms, diagnosis and treatment

Rosacea is a skin condition that affects the small blood vessels in the face. It is the cause of persistent redness to one degree or another. Rosacea is diagnosed by the attending physician or dermatologist in the presence of the characteristic manifestations of the condition. Its management includes ruling out factors that aggravate or trigger seizures. A vasoconstrictor gel may be prescribed to reduce redness. The use of a laser can also reduce symptoms of the disease. Rosacea treatments are effective but require maintenance.

Define rosacea and its symptoms

Benign, but ugly

Rosacea is a chronic skin disease that affects the blood vessels of the face. The most affected areas are the forehead, nose, cheeks and chin. It produces redness on the face, at first episodic and then persistent.

To know! Rosacea is the most common type of rosacea. It is also referred to as the vascular form of rosacea. Rosacea is common, affecting up to 3% of the population.

The origin of rosacea is not yet well established and many pathways have been considered including the influence of the environment (light), genetic characteristics (color of the skin and eyes) or even the mite, Demodex.

On the other hand, several factors are already known to promote the occurrence of rosacea through hot flashes: wind or sun on the face, sudden temperature changes, intense physical activity, fever, very hot baths, strong emotions, consumption of alcohol or spices, etc.

In addition, once the condition is identified, certain factors can aggravate it, for example the use of cosmetics containing alcohol or perfumes, and certain medications or foods.

blushing

Rosacea affects the central part of the face. It is characterized by the occurrence of persistent erythema on the nose, cheeks, forehead and/or chin. The eye and mouth contours are not affected. We talk about telangiectasia to refer to the visible dilation of small blood vessels under the surface of the skin. It looks red, even purple.

At first, the redness quickly fades. However, by repeating themselves, they end up settling down in a permanent way. In this case, we are talking about erysipelas.

A burning or tingling sensation is described by patients. Finally, the skin takes on a rough appearance and tends to peel off.

In certain situations, such as a sudden change in temperature or eating certain foods, hot flashes associated with flushing (temporary redness) may occur. In this case, the whole face, and sometimes the neck too, suddenly turns red with an unpleasant feeling of heat. However, this type of symptom tends to disappear with age.

Rosacea, diagnosis and treatment

Diagnosis

The diagnosis of rosacea is considered clinical and is made by the attending physician or dermatologist.

The patient’s face is examined by the healthcare professional to ensure that there is no symmetrical redness in the central area of ​​the face. The lesions must have been present for at least 3 months and be associated with other manifestations such as hot flashes or skin lesions.

Sometimes the doctor struggles to identify the disease with certainty and may then prescribe a skin biopsy.

Eliminate factors that aggravate rosacea

To reduce the symptoms of rosacea, it is necessary to identify the factors that aggravate the condition in order to eliminate them in daily life.

Certain foods are often implicated in the condition, notably liver, cheese, dairy products, certain vegetables (spinach, peas, beans, tomatoes, and eggplant), fruits (bananas, grapes, avocados, citrus, and figs), chocolate, and condiments including soy sauce or vinegar. Very hot foods and drinks or spicy dishes should also often be avoided. Just like alcohol consumption should be kept to a minimum.

Physical activity should be done sensibly, and excessive intensity exercises should be avoided.

It is possible to take walks outdoors in cold or windy weather, provided you cover your face well. Exposure to the sun is recommended only under certain precautions (sunscreen, sunglasses, etc.).

In addition, applying some hygiene measures can improve the appearance of the skin.

The first procedure is to remove from the daily routine all cosmetics containing perfume or alcohol, which cause severe irritation to the skin. It is best to use skin gels or bars instead. Aggressive skin care, for example facial scrubs or massages, should be avoided.

As for the makeup, you need to make sure that it says “non-comedogenic” on the packaging.

Finally, the skin of the face should be cleansed morning and evening, even without applying makeup. It should be dried well without rubbing, and finished by applying a moisturizer.

Treat rosacea with laser or brimonidine

Rosacea treatment aims to relieve symptoms, keep flare-ups at bay, and slow the progression of the disease.

The treatments offered do not permanently cure the condition. Indeed, once treatment is stopped, there is a risk of relapse.

Laser treatment can significantly reduce the redness of rosacea

It is preferable to conduct sessions on untanned skin, in winter, when exposure to the sun is less. Being for aesthetic purposes, it is not covered by Social Security. Several types of lasers are able to treat rosacea:

– KTP laser based on the principle of photocoagulation. Its beam is green. From 1 to 4 sessions are necessary during the first year of treatment. annual maintenance is necessary;

• Pulsed dye lasers operate by either photocoagulation or thermocoagulation. The second type of procedure is reserved for more severe forms of couperose but only requires one or two sessions. On the other hand, it causes the formation of purple spots that can remain visible for up to three weeks after treatment. Note that photocoagulation and thermocoagulation can be used simultaneously during the session.
• Yag is the latest technology. It is based on thermal coagulation. Primarily used for deep rosaries reaching larger diameter vessels. Two to four sessions are necessary to get a satisfactory result.

The practitioner’s experience allows the identification of the most appropriate technology for each case.

The doctor may also prescribe a vasoconstrictor gel, brimonidine, to be used several times a day to reduce redness. Note that although it is only available by prescription, it is not reimbursed. It works in 30 minutes, and its action lasts several hours. Note that this treatment has no effect on telangiectasias (visible expansions of vessels). It is described for forms of roseola red.

Charlene D. Doctor of Pharmacy

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