Rosacea is a chronic but treatable skin condition that primarily affects the central face. In as many as 50 percent of patients the eyes are also affected. Although rosacea may develop in many ways and at any age, patient surveys indicate that it typically begins any time after age 40 to 50 as flushing or redness on the cheeks, nose, chin or forehead that may come and go. The true cause of the disease is not yet known. It is a combination of genetic predisposition and more external factors ( food, stress, weather,…). Rosacea has nothing to do with acne,although it may be similar to it. Although rosacea can affect all segments of the population and all skin types, individuals with fair skin, blood type Rh A+ and people who suffer from migraines are believed to be at greatest risk. The disorder is more frequently diagnosed in women, but tends to be more severe in men. There is also evidence that rosacea may tend to run in families, people with genetic predisposition 30-40 % more often. The development of the disease takes place in stages.
What Causes Rosacea
- Heliobacter pylori – the presence of the pure growth of this bacterium may play a role in the development of subtype 2 rosacea. The often warmer facial skin temperature of rosacea patients was a possible factor in stimulating the pure growth of the bacterium to cause pustules. Helicobacter pylori, commonly associated with peptic ulcers and other gastric disorders, has often been considered a possible factor in rosacea in that the bacterium synthesizes gastrin, a hormone that causes flushing.
- Demodex folliculorum – While Demodex folliculorum are found on the skin of all humans, they frequently occur in greater numbers in those with rosacea. Demodex may possibly trigger an immune response in people with rosacea, or that the inflammation may be caused by certain bacteria.
- Genetic predisposition – Many people with rosacea have a close relative with the condition.
This means that there may be an inherited or genetic component. People who already have the disease in their family are more likely to get it.
- Sunlight – has a negative effect, rosacea is more common on damaged skin. The sun damages the skin and thus weakens the wall of the veins. This causes the veins to dilate and the disease to progress.
- Vascular changes – Skin specialists suggest that facial flushing and spider veins are due to abnormalities in the blood vessels of the face. However, they are unsure as to what causes inflammation in the blood vessels. But there is a link between migraines and rosacea.
Migraine has also been associated with vascular changes. Patients with ocular rosacea were 69 % more likely to develop migraine.
- Hormonal Imbalance– rosacea is aggravated by the hot flashes of menopause, hormonal changes during pregnancy and menstrual period.
- Medications – some medications, such as corticosteroids and drugs for treating high blood pressure or nitroglycerin may causes irritated skin.
Stages of Rosacea
There are four progressive stages of rosacea:
- First stage (predisposition)- Flushing and intermittent facial redness
- Second stage – persistent redness on the cheeks, nose, chin or forhead. 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.
- Third stage – small, pus-colored or red bumps, along with tiny blood vessels that appear as red, thin lines ( telangiectasias). People may have irritated, watery, or bloodshot eyes. The eyelids can become red and swollen , and styes are common. Rosacea affects the eyes in around 50 % of people with the condition. Rarely, vision can become blurred.
- Fourth stage – bumps and skin thickening of the nose. The skin may get thicker from excess skin tissue. This usually affects the nose and can cause rhinophyma, which affects males more than females.
- Persistent edema
- Ophthalmic rosacea
- Lupoid or granulomatous rosacea
- Steroid rosacea
- Gram-negative rosacea
- Rosacea fulminans
- Rosacea conglobata
- Halogen rosacea