Consult by instant messaging with a Rosacea

Rosacea: symptoms, causes, when to see a doctor?

Rosacea is a chronic inflammatory condition; because of its symptoms, it is sometimes mistakenly called acne rosacea or couperose. Rosacea mainly causes redness on the face, hot flushes, the formation of papules (spots) and visible blood vessels under the skin. This facial redness typically appears in the central area of the face.

What causes rosacea?

The precise causes of rosacea are not fully understood, even though certain physiological mechanisms have been observed, along with certain triggering factors (spicy food, alcohol, coffee, sun exposure, etc.). During a rosacea flare-up, doctors generally observe:
   • A decrease in blood flow to the face (venous drainage);
   • A dysfunction or instability of vasomotor activity;
   • An increase in the number of follicular mites (Demodex folliculorum) causing ocular rosacea;
   • Angiogenesis: an increased formation of new blood vessels from an already-existing venous network;
   • A dysfunction of the immune system and its response, linked to antimicrobial peptides;
Several factors can also encourage the appearance of papulopustular rosacea - when it is not linked to diet - including:
   • High doses of vitamins B6 and B12;
   • Spicy food, coffee or alcohol;
   • The use of nasal or topical corticosteroids.

Symptoms of rosacea

The symptoms of rosacea mainly affect the skin of the face and the scalp. They develop in 4 phases:
nbsp;  • The symptoms of pre-rosacea;
   • The vascular phase;
   • The inflammatory phase;
   • Then the late phase.
The symptoms of the various phases of rosacea generally appear in flare-ups and include:
   • Hot flushes;
   • Erythema (red patches on the skin of the cheeks and nose);
   • Unpleasant tingling;
   • Facial oedema (red, swollen skin);
   • Telangiectasia (visible blood vessels under the skin);
   • Papules (spots);
   • Pustules;
   • Rhinophyma (thickening of the skin around the nose)
Lastly, itching (pruritus) may also be noticed, as well as swelling of the eye, in cases of ocular rosacea.

Treatment of skin redness

Prevention is the first step in treating rosacea. This involves identifying, with the help of a doctor, the factors that trigger rosacea. The treatments then aim to control and relieve the symptoms. The various medical or surgical treatments for rosacea are:
nbsp;  • Topical antibiotics applied to the skin, or taken orally for inflammatory rosacea (metronidazole, benzoyl peroxide, minocycline). Azelaic acid and ivermectin may also be used. However, the use of corticosteroids is not recommended, as this generally worsens symptoms;
   • An oxymetazoline-based cream or a brimonidine gel for persistent redness;
   • Surgery: laser or electrocoagulation for visible blood vessels under the facial skin;
   • Or removal of excess tissue, dermabrasion, or laser treatment in cases of rhinophyma.
Oral antibiotics may also be prescribed for people with numerous pustules or ocular rosacea. Any side effects should be monitored. In cases of severe rhinophyma, surgery is often necessary. Dermabrasion may be performed in addition to medication. Dermabrasion involves rubbing the surface of the excess skin with an abrasive metal instrument. The aim is to remove the top layer of skin in order to encourage its regeneration.

Who should you see?

As skin conditions can often be confused with, associated with other conditions, or misdiagnosed, it is advisable to consult a dermatologist to confirm a diagnosis of rosacea. In general, any skin rash should prompt a consultation. An online consultation lets you consult a dermatologist without an appointment and get a diagnosis within a few hours. If necessary, dermatologists can then prescribe treatment. Skin conditions are fairly common and do not all have the same level of severity. Acne is a common condition that can cause psychosocial distress, particularly during puberty. Psychological support can also be provided by the dermatologist. Psoriasis is another common condition that can be difficult to live with day-to-day without treatment. However, in most cases the symptoms can be relieved or controlled. Lastly, we can mention fungal infections (which are not always STIs) or warts, which are relatively mild conditions. Take care of your health with an online dermatologist from Feeli!