Rosacea is a very common skin condition that can affect anyone, especially women over the age of 30. In this article, we will share a range of information about rosacea prevention and treatment.
So, follow this guide to the end and discover everything you need to know about rosacea. From understanding what this skin condition is, to learning about its causes, symptoms, and treatment options. Let’s dive in!
Rosacea – Dr. Szerman Explains:
After all, what is rosacea?
Rosacea: What Is It?
Rosacea, also known as facial erythema, is a chronic vascular inflammatory condition that manifests on the skin or eyes. It appears as erythema (redness), edema (swelling), papules, pustules (pus-filled or non-pus-filled “blisters”), telangiectasias (dilated small blood vessels on the skin’s surface), or even phymatous changes (thickened, deformed, and enlarged nose).
This condition occurs when an inflammatory process begins, often associated with vascular alterations. According to the Brazilian Society of Dermatology, rosacea affects between 1.5% and 10% of the population and is more common in women aged 30 to 50 with lighter skin tones.
However, it can affect anyone, and in men, the cases can be more severe, potentially progressing to rhinophyma, a condition characterized by the gradual enlargement of the nose due to thickening and dilation of the follicles.
Rosacea tends to worsen over time and can lead to permanent changes in appearance, significantly impacting the well-being and, especially, the self-esteem of those affected.
Rosacea Causes
The truth is that, despite extensive research and studies on rosacea cases, its exact cause remains uncertain. In other words, so far no potential triggers for rosacea have been identified. However, it is speculated that one of the primary factors contributing to cause rosacea on the face is related to genetic predisposition.
In addition to genetics, other factors may influence the development of rosacea. For instance, reactions to mites and external allergens, as well as fragile blood vessels, are among the potential triggers.
Anomalies in the immune system, excessive exposure to ultraviolet radiation, vascular hyper-reactivity, and inflammatory responses to various microorganisms are also possible causes. Furthermore, rosacea may be associated with other conditions, such as autoimmune diseases.
Certain triggers that cause vasodilation (the widening of blood vessels) can exacerbate the condition, including:
- Alcohol consumption
- Prolonged exposure to ultraviolet rays
- Extreme cold or hot temperatures
- Stress, anger, or embarrassment
- Intense physical exercise
- Very hot baths or sauna use
- Vasodilator or angiogenic medications
- Spicy foods
- Very hot foods or beverages
Signs of rosacea
Rosacea is a chronic skin condition that primarily affects the face, causing a range of symptoms that vary from person to person. Here are some common to help identify the condition:
- Facial Redness: Persistent redness, especially on the cheeks, nose, chin, or forehead, is one of the most common signs. It may look like a blush or sunburn that doesn’t go away.
- Visible Blood Vessels: Small, visible blood vessels, known as telangiectasia, often appear on the surface of the skin in areas affected by rosacea.
- Bumps and Pimples: Many people with rosacea experience acne-like breakouts, which may include small, red, pus-filled bumps. Unlike acne, rosacea does not typically include blackheads.
- Thickened Skin: In more severe cases, the skin can become thickened, especially around the nose (a condition called rhinophyma). This is more common in men.
- Eye Irritation: Rosacea can affect the eyes, causing dryness, irritation, redness, or a gritty sensation, a condition known as ocular rosacea.
- Burning or Stinging Sensation: The affected areas of the skin may feel tender, itchy, or have a burning or stinging sensation.
- Swelling: Swelling of the face, particularly in areas with persistent redness, can also be a symptom.
If you notice these signs, it’s important to consult a dermatologist for an accurate diagnosis and treatment plan. Early intervention can help manage symptoms and prevent the condition from worsening.
What Are the Types of Rosacea?
Before diving into rosacea treatments, it’s essential to understand that this skin condition has five different types, classified according to how it manifests. The five types of rosacea are: Erythematotelangiectatic Rosacea, Papulopustular-Rosacea, Phymatous Rosacea, Ocular Rosacea, and Granulomatous Rosacea.
Below is a closer look at each type:
1. Erythematotelangiectatic Rosacea
This type of rosacea is characterized by redness or a pinkish tone on the skin, with small dilated blood vessels becoming visible, especially in the central areas of the face, such as near the sides of the nose.
The redness tends to worsen due to factors like alcohol consumption, sun exposure, physical exercise, stress, and heat.
People with this type of rosacea often experience sensations like stinging or burning on the skin, and their skin becomes highly sensitive. Abrasive or acidic products cannot be used, as they may irritate the skin further.
2. Papulopustular-Rosacea
This type of rosacea combines skin redness with the appearance of papulopustular lesions that occur in outbreaks, resembling acne. For a long time, this type was referred to as “Acne Rosacea” because of its similarity to acne symptoms.
She is more commonly observed in men and typically alternates between periods of improvement and worsening.
3. Phymatous Rosacea
Phymatous Rosacea is the least common type and is considered the final stage of the condition. At this stage, the skin not only becomes red but also thickened and hardened, with enlarged pores.
The hallmark of Phymatous Rosacea is the buildup of tissue in areas with sebaceous glands, particularly around the nose, which may even double in size, a condition known as rhinophyma. Other areas, such as the chin, may also be affected.
This type of rosacea is far more prevalent in men than in women and usually appears between the ages of 50 and 60.
4. Ocular Rosacea
This type of rosacea primarily affects the eye region and can often be identified during a visit to an ophthalmologist.
Ocular rosacea occurs due to blepharitis, an inflammation that causes redness and flaking around the eyelashes. If left untreated, it can progress to more severe stages, potentially leading to vision loss.
5. Granulomatous Rosacea
Granulomatous Rosacea is one of the rarest forms of the condition. Its primary characteristic is the appearance of small brownish nodules on the facial skin. In some cases, these nodules may also appear on other parts of the body.
Diagnosing this type of rosacea can be more challenging and often requires a high degree of suspicion from a dermatologist. Additionally, treatment tends to be more complex compared to other types.
Which Areas Are Most Affected by Rosacea?
The symptoms of rosacea manifest at various levels, depending on the type of rosacea. However, redness is the most common symptom and typically affects the central areas of the face, often sparing the eye area, except in the case of ocular rosacea.
Lesions such as papules and pustules also tend to appear on the face, especially on the cheeks, near the wings of the nose, the nose itself, and the chin. Edema and swelling can also occur on the neck, ears, and even the upper chest.
In more severe cases, there may be thickening of the nose, resulting in the skin becoming thick, hard, rough, and swollen, a condition known as rhinophyma.
Symptoms of Rosacea
The most common symptoms reported by patients with rosacea include:
- Redness on the face.
- Small, swollen, and visible blood vessels, particularly on the nose and cheeks.
- Bumps on the face resembling acne.
- Reddened eyelids.
- Irritation and swelling around the eyes.
- Dry eyes.
- Enlarged nose with thickened skin.
- Itching in affected areas.
- Small brown spots or nodules that may appear on the face and other parts of the body.
- Flaking on the eyelid area.
- Peeling skin in affected regions.
- Hardened skin.
- Dilated pores.
If you notice any of these symptoms, it is important to consult a dermatologist. Only a professional can properly diagnose your condition, confirm whether it is rosacea, and establish the most effective treatment plan for you.
Risk Factors for Rosacea
Rosacea is more likely to occur in individuals with lighter skin, i.e., those with lower phototypes who have been exposed to the sun over the years. The condition is more common in women between the ages of 30 and 60. However, men can also develop rosacea, often with more severe manifestations, typically between the ages of 40 and 60.
The main risk factors for developing rosacea include fair skin and excessive exposure to ultraviolet rays. However, since the exact causes of rosacea are still unknown, there is also the genetic predisposition factor to consider.
Key risk groups for rosacea development include:
- People with fair skin, blue eyes, or light hair.
- Family history of rosacea.
- Personal history of severe acne.
- Men and women between 30 and 50 years old, though it is more common in women.
- Descendants of Scandinavian and Celtic ancestry.
How is Rosacea Diagnosed?
The first step in diagnosing rosacea is to observe persistent redness on the face. If this symptom is evident, it is important to schedule a medical consultation for an accurate diagnosis.
Consult a dermatologist, who will be able to diagnose rosacea through a physical examination of your skin and determine which type of rosacea you may have.
To assist the dermatologist during the consultation, it’s helpful to have information about:
- The list of symptoms.
- The duration of symptoms.
- Your medical history, including any other health conditions and medications or supplements you regularly take.
During the diagnosis, the dermatologist will not only conduct a physical exam but will also ask questions about the symptoms, their intensity, frequency, and any factors that seem to improve or worsen the symptoms.
It is crucial to clarify any doubts you may have during the consultation, such as the causes of rosacea, possible tests to confirm the diagnosis, the ideal treatment, whether it is a temporary or chronic condition, recommended care going forward, and alternatives for medications.
Can Rosacea Be Prevented?
Rosacea is a condition that cannot be fully prevented, but there are steps you can take to minimize its effects and manage the symptoms. Some measures include:
- Avoid exposure to extreme temperatures (both hot and cold).
- Avoid hot showers or baths.
- Use sunscreen with a high SPF (Sun Protection Factor) every day.
- Avoid strenuous physical exercises that can increase facial redness.
- Wash your face with lukewarm water.
- Use non-soap cleansers with a neutral pH.
- Moisturize your skin regularly with products specifically designed for rosacea.
- Manage stress as it can exacerbate symptoms.
- Follow a healthy and balanced diet.
- Avoid spicy foods.
- Avoid very hot foods or beverages.
- Avoid alcohol consumption.
- Do not smoke.
- Avoid products with fragrances, alcohol, parabens, or any ingredients that may irritate the skin.
- Use calming dermocosmetics, like thermal water.
- Choose hypoallergenic corrective makeup to conceal redness without causing further irritation.
- Use anti-redness products to help reduce facial redness.
Does Rosacea Have a Cure?
While there are preventive measures and treatments that can alleviate the condition, rosacea does not have a definitive cure.
However, with the right treatment and care, significant improvement in symptoms and signs is possible. It is essential to consult with a dermatologist for the best management plan.
Rosacea Therapy
Although it is a disease with no cure, facial rosacea has several treatments available, and when properly managed, it can yield good results, significantly reducing its incidence and alleviating the resulting symptoms. Here are some types of rosacea treatments.
Intense Pulsed Light (IPL) Harmony
Intense Pulsed Light (IPL) Treatment for Rosacea
Intense Pulsed Light (IPL) is one of the most effective and common treatments for rosacea. Essentially, the technique involves directing small beams of light toward the dilated blood vessels in the affected area of the skin.
The mechanism used in IPL treatment is photothermolysis, utilizing specific wavelengths that selectively destroy blood vessels while preventing damage to surrounding tissues.
At Clínica de Pele in Rio de Janeiro, we use the Harmony Intense Pulsed Light system, which features advanced technology. It reaches the deeper layers of the skin through its light beams, making it one of the most effective and safe treatments for alleviating the effects of rosacea.
IPL treatment for rosacea is one of the few methods approved by both the American and Brazilian Health Councils.
The results of IPL for rosacea treatment are excellent. It is especially useful for reducing erythema (redness) or telangiectasia (visible blood vessels) and even treating rhinophyma, a condition that causes the nose to enlarge.
Additionally, IPL treatment has more benefits for the skin, including reducing hyperpigmentation, stimulating collagen production, and improving skin texture.
Using Harmony Intense Pulsed Light for treatment offers several advantages. Here are some of the benefits this treatment provides:
- Painless.
- Helps rejuvenate the skin.
- Stimulates collagen production.
- Treats blood vessels and vascular stains.
- Reduces sunspots and other skin blemishes.
- Helps remove unwanted hair.
- Treats acne.
- Speeds up the healing process.
- Requires very few sessions.
- A safe treatment.
- High-precision technique.
- Não danifica a superfície da pele.
- Não é necessário tempo de inatividade após a sessão.
- Improves skin sagging.
- Reduz o tamanho dos poros.
- Reduces and smooths dark circles.
Além disso, é importante observar que o tratamento IPL para rosácea pode ser aplicado em qualquer parte do rosto, principalmente no nariz e nas bochechas.
Surgical Treatments
Outro método de tratamento para rosácea usado para aliviar seus sintomas é a cirurgia. Esta alternativa é recomendada principalmente para casos de rinofima (espessamento da pele) e, em algumas situações, para rosácea ocular.
Surgical treatment involves correcting the effects of rosacea and requires local anesthesia, along with post-surgical rest. While it is an invasive procedure, it is not complicated, and after the procedure, proper aftercare is essential to continue treating and alleviating the disease’s effects.
Antibiotics and Medications
The use of medications, rosacea creams and antibiotics is the most common and basic treatment for rosacea. The goal is to reduce inflammation, control redness, and lessen other symptoms to improve the overall appearance of the skin.
It is important to note that only a doctor can determine which medication and therapeutic approach a rosacea patient should adopt. Using the wrong treatment can worsen the condition and seriously harm your health.
For cases of papulopustular rosacea, ocular rosacea, and rhinophyma, antibiotics from the tetracycline group may be necessary for clinical control of the disease, with doses gradually decreasing over time.
Treatments typically last 3 to 6 months. However, it is recommended to combine medication use with intense pulsed light treatment to ensure better results.
Evolution of Treatment
Overall, the evolution of treatment and its results depend on the type of treatment selected by the patient. For treatments with Intense Pulsed Light (IPL), the evolution is generally very positive.
This is because the light pulses from the IPL target and progressively destroy the microvessels responsible for the redness on the face. As a result, after just a few sessions, significant improvement is often noticeable.
FAQ
How long does rosacea treatment last?
The duration of rosacea treatment depends on the type of treatment chosen. For example, with Intense Pulsed Light (IPL), the treatment can last from a few weeks to several months, depending on the severity, intensity, and type of rosacea being treated.
How many sessions are required?
For IPL treatment, the number of sessions varies based on the condition and intensity of rosacea in the patient. On average, about 5 sessions are needed every 30 days to achieve the desired results. Each session typically lasts between 30 to 45 minutes.
Is rosacea a contagious disease?
Many people wonder if rosacea can be transmitted from one person to another, but this is a myth. In reality, rosacea is not contagious or transmissible. It develops due to various factors, as mentioned earlier, and while it can be treated, it does not have a cure.
Does Intense Pulsed Light (IPL) hurt?
The IPL treatment is not painful. Patients may experience a sensation of warmth on their face during the procedure. To minimize this sensation, a topical anesthetic cream is applied one hour before each session.
What does the skin look like after each IPL session?
Generally, the skin responds well to IPL treatment for rosacea. After each session, the skin may appear slightly red, but this effect usually fades within a few hours. Occasionally, small scabs may form, but they will disappear over time. These signs are part of the skin’s natural healing process. If you notice any unusual skin changes after the session, it’s important to consult a dermatologist.
Treatment Statistics
According to the Brazilian Society of Dermatology, rosacea affects between 1.5% and 10% of the population, with women aged 30 to 50 years and lighter skin being more frequently affected.
In 2002, the National Rosacea Society (NRS) conducted a study with 1,066 rosacea patients to identify the most common triggers. The most frequently reported factors were:
- Sun exposure (81%)
- Emotional stress (79%)
- Hot weather (75%)
- Wind (57%)
- Intense physical exercise (56%)
- Alcohol consumption (52%)
- Hot showers (51%)
- Cold weather (46%)
- Spicy foods (45%)
- Humidity (44%)
- Certain skin care products (41%)
- Hot drinks (36%)
- Certain cosmetics (27%)
- Medications (15%)
- Medical conditions (15%), among others.
Rosacea Before and After
Among the most recommended treatments for rosacea, Intense Pulsed Light (IPL) offers the best results. Check out the before and after photos of patients who underwent IPL treatment at our Skin Clinic:
Testimonials
Here are some testimonials from people who underwent and approved the rosacea treatment offered at the Skin Clinic in Rio de Janeiro:
Therefore, rosacea is a skin condition that occurs more frequently than one might think. It can affect both men and women, and although it has no cure, it can be treated and its effects alleviated, thus offering a better quality of life to its sufferers.
At the Skin Clinic, we use the latest technologies and a skilled medical team to ensure the best treatments for rosacea and other skin problems. Contact us to learn more about our procedures.
