Rosacea Health Article

Definition

Rosacea is a skin disease typically appearing in persons during their 30s and 40s. It is marked by redness (erythema) of the face, flushing of the skin, and the presence of hard pimples (papules) or pus-filled pimples (pustules) as well as small, visible spider-like veins called telangiectasia. In later stages of the disease, the face may swell and the nose may take on a bulbous appearance, a condition called rhinophyma.

Description

Rosacea produces redness and flushing of the skin, as well as pustules and papules. Areas of the face, including the nose, cheeks, forehead, and chin, are the primary sites, but some persons experience symptoms on their necks, backs, scalp, arms, and legs. It is a common disease that afflicts one out of every 20 Americans.

The similarity in appearance of rosacea to acne led people in the past to erroneously call the disease acne rosacea or adult acne. Like acne, the skin can have pimples

and papules. Unlike acne, however, persons with rosacea do not have blackheads.

Causes & symptoms

There is no known specific cause of rosacea. A history of redness and flushing precedes the disease in most patients. The consensus among many experts is that multiple factors may lead to an overreaction of the facial blood vessels, which triggers flushing. Over time, persistent episodes of redness and flushing leave the face continually inflamed. Pimples and blood-vessel changes follow.

Unidentified genetic factors may also come into play because 40% of rosacea sufferers have a family member who has rosacea. The disease is more common in women and in persons with light skin and fair hair. It may be more common in persons with a Celtic, English, Scandinavian, Swedish, Welsh, Polish, Lithuanian, or Balkan background.

Because certain antibiotics are useful in the treatment of rosacea, some researchers suspect a bacterium or other infectious agent may be the cause. One of the newest suspects is a bacterium called Helicobacter pylori, which has been implicated in causing stomach ulcers. The evidence supporting this suspicion is mixed.

Other investigators have observed that a particular parasite, the microscopic mite Demodex folliculorum, can be found on areas of the skin affected by rosacea. However, this mite can also be detected in the skin of persons who do not have the disease. It is likely that this mite does not cause rosacea, but merely aggravates it.

Rosacea may be caused by factors such as a deficiency of B-complex vitamins or hydrochloric acid (HCl) in the stomach. Some researchers suspect that yeast may cause rosacea.

In early stages of rosacea, patients typically experience repeated episodes of flushing. Later, areas of the face are persistently red and telangiectasia, as well as inflamed papules and pustules, appear on the nose and cheeks. Over time, the skin may take on a roughened, orange-peel texture. Very late in the disorder, a small group of patients with rosacea will develop rhinophyma, which can give the nose a reddened, bulbous appearance. The late actor W.C. Fields was affected with this condition. Men are three times more likely than women to develop rhinophyma.

Up to one-half of patients with rosacea may experience symptoms related to their eyes. Ocular rosacea, as it is called, frequently precedes the other manifestations on the skin. Telangiectasia may appear around the borders of the eyelid, the eyelids may be chronically inflamed, and small lumps called chalazions may develop. The cornea of the eye (the transparent covering over the lens) can also be affected, and in some cases vision will be affected. Most of these eye symptoms do not threaten sight, however.