Rosacea Disease: What is it, Causes, Symptoms and Treatment
Laughing disease, also known as rosacea, is a skin disease that causes redness and acne-like lesions, especially on the cheeks and nose. Rosacea is a common disorder in society. This disease, which can affect people of all ages, is especially seen in middle-aged and light-skinned women. Treatment of rosacea is aimed at relieving symptoms.
What is Rosacea?
Rosacea is a chronic skin problem that causes skin redness and the capillaries under the skin to become visible. This disease causes small red lesions filled with pus on the skin. Laughing disease flares up from time to time and the symptoms caused by the disease become severe. This exacerbation period may last a few weeks or a few months. Once the exacerbation period has passed, the symptoms subside.
Rosacea disease can have different subtypes depending on the areas affected by the disease and the lesions formed on the skin. Subtypes of rosacea:
- Type 1: Erythema Telangiectatic Rosacea (ETR) subtype; It is characterized by facial redness and prominent capillaries near the skin surface.
- Type 2: In the inflammatory / papulopustular type, acne-like lesions are observed on the skin. This subtype is more common in middle-aged women.
- Type 3: The rosacea subtype called Phymatous Rosacea is rarely encountered. This subtype is usually recognized by thickening of the nasal skin (Rhinophima). Rhinophyma is more common in men and is often seen together with other rosacea subtypes.
- Type 4: In this subtype, called ocular rosacea, symptoms are usually concentrated in the eye.
What are the symptoms of rosacea?
Symptoms seen in rosacea vary according to subtypes.
Symptoms seen in the ETR subtype of rosacea:
- A redness in the middle of the face that is temporary at first but becomes permanent over time
- Fine capillaries becoming visible
- Skin edema/swelling
- sensitive skin
- Burning, tingling sensation on the skin
- It can be listed as dry, tense, rough skin.
Symptoms encountered in papulopustular type:
- Skin that looks quite red and has acne-like lesions
- Oily skin
- Sensitive skin, burning, stinging sensation
Symptoms seen in the type of rosacea characterized by rhinophyma, that is, thickened skin:
- Rough skin texture
- Thickening of the nose skin
- Large pores on the skin
- Thickening of the skin on the forehead, cheeks, chin and ears
- They can be listed as blood vessels that become visible.
The symptoms seen in ocular rosacea are as follows:
- Eye redness, watering
- Feeling of grittiness in the eyes
- Burning, stinging sensation in the eyes
- Dry, itchy eyes
- sensitivity to light
- decreased vision
- Broken blood vessels in the eyelids
What Causes Rosacea?
The mechanisms underlying the development of rosacea have not yet been fully elucidated. Genetic and environmental factors are thought to play a joint role in the development of the disease. Rosacea is not a disease that occurs due to inadequate hygiene conditions.
Some situations can cause this disease to flare up. Examples of these situations:
- Hot drinks
- spicy dishes
- Extremely hot or extremely cold environments
- sunlight, wind
- emotional changes
- Medicines that cause dilation of blood vessels (for example, some blood pressure medications)
- Some make-up items may be provided.
Laughing sickness can occur in anyone. However, women, people over the age of 30, light-skinned people, smokers and those with a family history of rosacea are at risk of this disease.
How to Diagnose Rosacea?
There is no specific test to diagnose rosacea. The doctor examines the patient and examines the lesions on the skin. The patient may be asked how long his symptoms have been present, whether they become more pronounced from time to time, and the factors that trigger the symptoms. An attempt is made to determine whether the patient’s skin lesions are due to other conditions such as lupus, psoriasis, and eczema. In the light of all this information, if the patient’s history and examination are compatible with Rosacea, a diagnosis is made.
What are the symptoms that occur with rosacea?
Rosacea can cause conjunctivitis, a condition in which the outermost layer of the eye becomes inflamed.
Conjunctivitis; It may cause symptoms such as itching, watering and redness in the eyes.
How to Treat Rosacea?
There is no definitive treatment for rosacea. The aim of treatment for rosacea patients is to alleviate the symptoms and ensure that their complaints regress. However, flare-ups may occur from time to time. Complaints may recur. Prescription medications and correct skin care practices should be carried out together in the treatment.
The duration of treatment for laughing disease varies depending on the severity of the disease and the intensity of the symptoms seen in the patient. Even in patients who have been treated successfully, the disease may relapse.
The drugs used in the treatment of rosacea are as follows.
- Redness relieving creams: In the treatment of mild to moderate rosacea, gel or cream-like medications applied to the affected parts of the face may be prescribed. Medicines containing brimonidine and oxymetazoline can reduce facial redness by preventing the dilation of capillaries. These drugs take effect within 12 hours after administration. However, since the effects of the drugs are temporary, the drugs must be applied to the skin at regular intervals to ensure continued healing.
In the treatment of mild rosacea, there are also creams that are not very effective on facial redness but help heal acne-like lesions. Azelaic acid, metronidazole and ivermectin are examples of these drugs. It takes 2-6 weeks for azelaic acid and metronidazole to have a visible effect on the skin. For ivermectin, this period may be even longer. However, with ivermectin, the disease may go into remission for a longer period of time.
- Oral Antibiotic: Antibiotics such as doxycycline can be used for acne-like lesions in the treatment of moderate and severe rosacea.
- Oral Acne Medication: Isotretinoin medication may be prescribed in severe cases of rosacea that do not respond to other treatment methods. This medicine is very powerful and helps heal acne-like lesions in rosacea. It is unsafe for pregnant women to use isotretinoin.
In the treatment of rosacea, laser and other light-based treatment methods can also be used to eliminate skin redness. These treatments may require repeated sessions for the skin to regain its natural appearance.
Rosacea patients can reduce the frequency of exacerbations of the disease and alleviate the symptoms of the disease with some skin care suggestions. Skin care applications that can be performed are as follows:
- Trigger situations, foods and drinks that cause rosacea attacks need to be identified and these triggers should be avoided. Consumption of foods with antioxidant properties and high amounts of vitamin B, such as avocado, ginger and cabbage, can be increased.
- Sunscreen should be used daily. When choosing a sunscreen, care should be taken to ensure that the cream provides protection against both Ultraviolet A (UVA) and Ultraviolet B (UVB) rays. In addition, the protection level of the cream must be 30 SPF and above. If sunscreen is used together with topical medication, the medication should be applied to the skin first and then sunscreen should be applied.
- To protect the face area from the sun, you should avoid going out at noon and wear a hat if going out. In cold weather, the face area should be protected from the wind by using a shawl or scarf.
- The face should not be touched too much and the facial area should not be scrubbed. Cleansing agents other than soap should be used to clean the face and the skin should be moisturized regularly. For skin care, products that do not contain alcohol or other irritating substances should be preferred.
Rosacea is a condition that reduces a person’s quality of life. Although there is no definitive solution to this disease, it is possible to reduce the patient’s complaints with appropriate treatment. For rosacea treatment, you should consult the dermatology department. Ocular rosacea can also affect the eye. Therefore, ocular rosacea patients may go to the ophthalmology department in addition to dermatology.