Rosacea
What is rosacea?
It is a chronic and progressive inflammatory process that gives the skin an abnormally reddish appearance, with telangiectasias (commonly known as spider veins) and pustules in its more severe stages. Rosacea typically appears on the nose and cheeks and can develop in adulthood, starting around age 25, particularly in fair skin. Although it affects women up to three times more often, when it occurs in men, it can be more severe.
Types of rosacea
Type 1 / Erythematotelangiectatic
Redness in the central area of the face with the appearance of spider veins or telangiectasias. Burning or itching of the skin may occur.
Type 2 / Papulopustular
It is characterized by the appearance of pustules or eruptions.
Type 3 / Phymatous nodular
This type of rosacea develops when the condition has progressed, showing increased inflammation, as well as nodules and thickening of the skin, especially in the nasal area.
Ocular rosacea
It presents with redness and pus in the eyes, which can also affect children, causing irritation and light sensitivity. In addition, patients may experience a sensation of having a foreign object in the eye.
Causes of rosacea
Genetics
It has been observed that one-third of patients with rosacea have affected family members. This condition may be linked to a genetic factor related to an enzyme deficiency.
Blood vessel imbalances
Rosacea can also develop due to the production of sebum or oil, which causes inflammation and leads to an imbalance between vasodilation and the narrowing of blood vessels (vasoconstriction).
Gastrointestinals
Evidence has also shown a connection between Helicobacter pylori—the bacteria responsible for gastritis, and other gastric disorders, with the appearance of rosacea on the nose, cheeks, and eyes. Likewise, the condition can worsen with the consumption of very hot or spicy foods, which increase blood vessel dilation and, consequently, redness.
Environmental factors
Patients may experience flare-ups of facial rosacea if they have a genetic predisposition and are exposed to sunlight or extreme temperature conditions such as heat, cold, or wind. Certain foods or vitamin B deficiencies may also contribute. Chronic emotional conditions can trigger or worsen the problem; in other words, rosacea can intensify due to stress, anxiety, or depression.
Symptoms
The symptoms of rosacea include redness and outbreaks on the nose, forehead, and cheeks, which may be accompanied by a burning, itching, or stinging sensation. In more severe cases, the nose affected by rosacea may become excessively red and enlarged to the point of deformation, a condition that may require surgical intervention (rhinophyma).
Ocular rosacea may also occur, with symptoms such as conjunctivitis, dryness, burning, light sensitivity, blurred vision, and conjunctival telangiectasias, among others.
Diagnosis
A diagnosis of rosacea can be made by a specialized physician. For example, having fair skin is one of the first factors to consider. Then, the presence of visible blood vessels (spider veins), redness, or itching can help confirm the condition. However, additional tests may be requested to rule out other conditions such as lupus or psoriasis.
Rosacea treatments
Achieving positive results requires a physician with expertise, experience, and patience, while the patient must maintain consistency and discipline as key elements for success. Although rosacea is a chronic condition, proper treatment can lead to significant improvement.
Due to the established relationship between Helicobacter pylori and rosacea, it is important for patients to consult their gastroenterologist. At Dr. Juan Carlos Lloreda’s Aesthetic and Anti-Aging Medicine Clinic, a comprehensive treatment approach is implemented, which includes recommendations such as:
Vascular laser or IPL
Vascular lasers or intense pulsed light (IPL) devices work by emitting a pulse of light that penetrates the skin to close dilated blood vessels without damaging the surrounding tissue, providing a fast and safe treatment. The number of sessions required depends on the severity of the case.
Learn more about vascular laser / IPL >
Botulinum toxin
Some types of this medication work by removing the nerve stimulation from the blood vessels affected by rosacea. This technique, known as Skin Quality, involves hyper-diluting the toxin to help neuromodulate the blood vessels and improve the skin’s condition.
Diet
It is recommended to eliminate foods containing gluten, milk, alcohol, and spicy products, as they can stimulate inflammation and vasodilation of the skin. Additionally, increasing the intake of probiotics and vitamin C is beneficial. “I recommend that patients seek balance, as subjecting themselves to a strict regimen of prohibitions can also create stress, which is in turn a trigger for the condition. Although the foods mentioned promote rosacea, consuming them occasionally will not have a significant impact on the patient,” explains Dr. Juan Carlos Lloreda.
There are no natural treatments to cure rosacea, but controlling environmental factors can help improve the condition.
Expectations
Rosacea is not contagious, and its management focuses on reducing the intensity of symptoms. However, flare-ups may reappear; it all depends on the patient’s discipline in following the prescribed treatment.
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Frequently Asked Questions
Which creams are recommended for rosacea?
It is best for a specialist to recommend topical products for rosacea according to the patient’s skin type and condition, as antibiotics or other substances may be needed to treat pustules, while random creams could increase inflammation or the burning sensation.
What worsens rosacea?
- Environmental factors: heat, sun exposure, sudden temperature changes, wind, and hot baths.
- Dietary factors: alcohol, spicy foods, soy sauce, hot foods and beverages, and chocolate.
- Emotional and contextual factors: stress, anxiety, exercise, and menopause.
- Topical substances: cosmetics (especially those containing alcohol), acetones, retinoids, and corticosteroids.
Which food are bad for rosacea?
As mentioned, anything that increases blood vessel dilation, such as spicy foods, very hot meals, alcohol, chocolate, or soy sauce, can aggravate the condition.
What can I do to get rid of rosacea?
Find an experienced physician with a proven track record of positive patient outcomes, and approach the treatment with optimism and confidence to follow all recommendations with discipline. Successful management requires a combination of laser or IPL therapy, medication, and control of environmental factors, while keeping in mind that rosacea is a chronic condition.
Recommendations
It is ideal to use dermocosmetic products such as makeup or creams that are dermatologically tested to prevent their components from worsening the condition or increasing the burning sensation by causing more inflammation. In such cases, products containing alcohol are not recommended, and gel-based formulations are preferable.
The use of saunas, steam rooms, or very hot beverages is also not recommended, as they promote vasodilation and can worsen rosacea symptoms. Likewise, quitting smoking is strongly advised.
It is essential to protect yourself from the sun to prevent vasodilation and skin damage, as well as to maintain a consistent facial care routine recommended by a specialist.
Like all conditions that affect the face, rosacea can have a negative impact on self-perception and may even lead to social withdrawal. For this reason, treatment is more effective when the patient combines medical care with emotional work that helps strengthen confidence and build positive expectations regarding the results.
Post-treatment care
Avoid extreme weather conditions such as sun, wind, cold, or heat to reduce the risk of facial redness caused by vasodilation. It is recommended to use hats, caps, gel-based sunscreen products, and scarves to protect against the wind.
Eat healthy food at moderate temperatures and avoid alcohol.
Emotional support to address the effects of an appearance affected by redness and pustules.
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