INTRODUCTION:

Rosacea is a chronic inflammatory skin condition that usually affects the face. People may mistake rosacea for acne, eczema, or an allergic skin reaction. Rosacea is common, affecting around 1–20% of the population. However, people frequently receive the wrong diagnosis when they have rosacea, so the true incidence may be a lot higher.³

The National Rosacea Society (NRS) has designated April as Rosacea Awareness Month to educate the public on this potentially serious disorder estimated to affect more than 16 million Americans, and to urge those who suspect they may have it to see a dermatologist for the most up-to-date plan for effective therapy. Rosacea is now understood as a single disease with a wide variety of potential signs and symptoms, and fortunately there is a range of medical therapies that may effectively address each individual case²

What is Rosacea?

Rosacea is a chronic disorder of the facial skin with various potential signs and symptoms, often characterized by flare-ups and remissions. It typically begins at any time after age 30 as a flushing or redness on the cheeks, nose, chin or forehead that may come and go. Over time, the redness tends to become ruddier and more persistent, and small blood vessels may appear. Without treatment, bumps and pimples often develop, and in severe cases the nose may become swollen from excess tissue. In around half of patients, the eyes are also affected, feeling irritated and appearing watery or bloodshot.²

TYPES OF ROSACEA:

There are four main types of rosacea, according to the American Academy of Dermatology (AAD):³

1. Erythematotelangiectatic rosacea: Symptoms include skin discoloration, flushing, and visible blood vessels.

2. Papulopustular rosacea: Symptoms include flushing, swelling, and breakouts that resemble acne.

3. Phymatous rosacea: Symptoms include thickened, bumpy skin.

4. Ocular rosacea: Symptoms include eye redness and irritation and swollen eyelids.

· steroid rosacea can result from long-term use of corticosteroids, specifically when a person uses them to treat dermatitis and vitiligo.

CAUSES:

Experts are not sure what causes rosacea. However, many believe that the following factors may contribute:³

· Abnormalities in the blood vessels: Skin specialists suggest that facial flushing and spider veins are due to abnormalities in the blood vessels of the face

· A skin mite called Demodex folliculorum: This mite lives on the skin and usually causes no problems. However, people with rosacea tend to have more of these mites than others. It is unclear whether the mites cause the rosacea or the rosacea causes the increase in mites.

· Bacteria called Helicobacter pylori: These gut bacteria stimulate the production of bradykinin, a small polypeptide that causes blood vessels to dilate. Experts suggest that this bacterium may play a role in the development of rosacea.

· Family history:

TRIGGERS:

For many people, dietary factors can affect rosacea symptoms. Consuming the following foods and beverages may cause or worsen symptoms:³

· Hot foods and beverages

· Caffeine

· Dairy products

· Spices and seasonings that contain capsaicin, such as hot sauce, cayenne pepper, and red pepper

· Alcohol, including wines and hard liquors

· Foods containing cinnamaldehyde, such as tomatoes, chocolate, and citrus fruits

Avoiding one or more of these foods and beverages may reduce the risk of flare-ups and help control rosacea.

Other factors can aggravate rosacea by increasing blood flow to the surface of the skin. These include:⁴

· Extremes of temperature

· Sunlight, humidity, and wind

· Stress, anxiety, anger, and embarrassment

· Vigorous exercise

· Hot baths and saunas

· Some medications, such as corticosteroids and drugs for treating high blood pressure

· Acute medical conditions, such as a cold, cough, or fever

· Some chronic medical conditions, such as hypertension

SYMPTOMS:

The signs and symptoms of rosacea can vary considerably from person to person. Rosacea is more common in people with lighter skin.

The following symptoms tend to be present in most cases of rosacea:⁴

· Persistent skin discoloration: This may look like a blush or sunburn that does not go away. It happens when hundreds of tiny blood vessels near the surface of the skin expand.

· Skin thickening: The skin may get thicker from excess skin tissue. This usually affects the nose and can cause rhinophyma, which affects males much more than females.

· Flushing: This occurs when the face temporarily darkens. It may spread from the face down to the neck and chest, and the skin may feel unpleasantly hot.

· Skin bumps and pimples: Small, red, acne-like bumps may develop. These may contain pus.

· Visible blood vessels: Also called spider veins, or telangiectasia, this commonly affects the cheeks, bridge of the nose, and other parts of the central face.

· Eye irritation: People may have irritated, watery, or bloodshot eyes. The eyelids can become red and swollen (blepharitis), and styes are common. Rarely, vision can become blurred.

People may also have the following secondary symptoms of rosacea:

· Burning or stinging sensations in the skin

· Facial swelling, due to excess fluid and proteins leaking out of the blood vessels

· Dry or rough facial skin

The following symptoms may be useful indicators of rosacea in darker skin:

· A warm feeling most of the time

· Dry, swollen skin

· Patches of darker skin, or a dusky brown discoloration to the skin

· Persistent acne-like breakouts

· Hard, yellowish-brown bumps around the mouth, eyes, or both

· A burning or stinging sensation when applying skin care products

· Swollen or thicker skin on the forehead, nose, cheeks, or chin

DIAGNOSIS:

There is no clinical test for rosacea. A doctor can make a diagnosis after examining the person’s skin and asking about their symptoms and triggers.⁵

TREATMENTS:

A combination of medications and lifestyle changes generally gives the best results. The following are some possible treatment options for rosacea.⁵

· Skin creams : Skin creams can help reduce inflammation and skin discoloration. Examples include topical antibiotics, tretinoin, benzoyl peroxide, and azelaic acid.

· Eye drops: Eye drops can relieve eye symptoms, which occur in ocular rosacea.

For example, steroid eye drop like blephamide.

· Antibiotics: Oral antibiotics like tetracycline, minocycline, and erythromycin. Doxycycline helps improve dryness, itching, blurred vision, and sensitivity to light in people with ocular rosacea.

· Isotretinoin: Isotretinoin (Accutane) is an oral medication that people use in severe cases of rosacea (if other treatments have not worked).

· Laser treatment: Dermatologists can use laser treatment to help reduce visible blood vessels.

Although the procedure may cause some pain, most people will not need an anesthetic. Laser treatment can sometimes cause bruising, crusting of the skin, swelling, tenderness, and, very rarely, infection. Laser treatment or scalpel surgery can remove excess skin. A carbon dioxide laser can also shrink thickened tissue.

Natural Remedies⁶

· Minimizing exposure to rosacea triggers will help prevent its symptoms.

· The following lifestyle changes and home remedies may help control symptoms if a person uses them alongside medical treatments:

· Avoid rubbing or touching the face.

· Wash the face with a gentle cleanser, and avoid using products that contain irritants or alcohol.

· Avoid comedogenic products. These block the oil and sweat gland openings.

· Keep the skin hydrated with a gentle moisturizer. Wait for topical medications to dry before moisturizing.

· Wear a broad-spectrum sunscreen when outdoors.

· In cold weather, protect the face with a scarf or ski mask.

· Avoid extreme temperatures.

· Avoid foods and beverages that might trigger an outbreak.

· Avoid using over-the-counter steroid creams unless a doctor has recommended them. These may worsen symptoms in the mid to long term.

· Reducing stress

Stress is a common trigger of rosacea. People can reduce stress by following these tips:

· Get regular exercise.

· Get good quality sleep.

· Eat a healthful diet full of nutrients.

· Try yoga or meditation.

Rosacea can be a source of stress for many people. It can make a person feel embarrassed, frustrated, anxious, or low in self-confidence.

Becoming well informed about rosacea may help people manage their emotions, as they may feel more in control and better prepared to manage any possible complications or recurrences.

Seeking effective treatments, and speaking to a doctor or mental health professional if necessary, can also help.³

REFERENCES:

1. Rosacea Awareness Month. https://www.rosacea.org/ patients / rosacea-awareness-month

2. Rosacea Awareness Month To Highlight Broad Range Of Treatment Options. https://www.rosacea.org/blog/2021/february/rosacea-awareness-month-to-highlight-broad-range-of-treatment-options.

3. Sara Perkins. What is rosacea?. https://www.medicalnewstoday.com/articles/160281

4. ROSACEA.https://www.mayoclinic.org/diseases-conditions/rosacea/symptoms-causes/syc-20353815

5. Debra Jalima. Your Skin and Rosacea: January 27, 2021; https://www.webmd.com/skin-problems-and-treatments/guide/skin-conditions-rosacea

6. ROSACEA. https://www.nhs.uk/conditions/rosacea/

Received on 12.04.2022 Modified on 23.05.2022

Int. J. Nur. Edu. and Research. 2022; 10(3):264-266.

DOI: 10.52711/2454-2660.2022.00061