Rosacea is a skin condition resembling a bad case of acne. There are no blackheads or whiteheads, but there may be crusty pimples (papules), pus-filled pimples (pustules), or a cosmetically damaging called rhinophyma, a bulbous, enlarged red nose and puffy cheeks. Rosacea can also cause greasy skin (seborrhea) or spider veins (telangiectasia).
As many as 14 million people in North America alone may have rosacea. It typically first appears when people reach their 30s and 40s. There is a subtle redness, generally just mild flushing, on the nose, cheeks, chin or forehead.
Left untreated, rosacea tends to worsen over time. The redness lasts longer and longer. By the age of 60, rosacea involves the eyes, causing them to be irritated and bloodshot and to feel gritty. In advanced cases, the nose may become red and swollen from excess tissue, the condition known as rhinophyma.
The only way to explain the findings of researchers of rosacea is to conclude that the disease results from multiple factors. A number of investigations have linked rosacea to the presence of the bacterium Helicobacter pylori, the "bug" that causes peptic ulcers. A recent Japanese study found that this microorganism is found in 65 percent of rosacea patients, but in 70 percent of the population as a whole.
This would seem to suggest that the bacterium does not cause rosacea. Nonetheless, an antibody associated with eradication of Helicobacter pylori infection was found in 100 percent of patients who completely recovered from rosacea after antibiotic treatment.
These confusing results seem to suggest that getting infected with the bacterium does not cause rosacea, but killing the bacterium with antibiotics cures it. Most physicians who treat rosacea avoid prescribing antibiotics except on a short-term basis for severe symptoms.
Another large body of scientific investigation has linked rosacea to the house mite Demodex follicularum. This microscopic relative of spiders normally inhabits healthy skin. It feeds on sebum, an oil secreted by the skin, and the first place it will be noticed is under the eyelashes. (If you have mites under your eyelids you will definitely notice the symptoms: sticky eyes, burning eyes, itchy eyes.) The microscopic arachnid also likes facial skin, forehead, cheeks, the external ear channels of humans, or just about anywhere on dogs, where it causes mange.
Infestations of Demodex follicularum are probably found in only about 20 percent of people who have rosacea. Eliminating the mite from the skin, however, often cures the disease. Scientists testing laboratory animals in the late 1920's found that mite only infects riboflavin-deficient skin. You don't have to get rid of your mangy dog if both you and your pet get vitamin treatment.
Yet another stream of research has attempted to explain rosacea in terms of facial flushing. Medical textbooks will tell you that the disease is more common in cold climates, where people get red faces from exposure to the weather. Exposure to sun, however, is just as likely to cause rosacea as exposure to cold, and dry air poses unique problems.
If you've ever gone swimming on a 90ยบ day in, say, Phoenix (for readers outside the United States, I should explain that temperature is in Fahrenheit rather than Celsius, although the ground temperature can actually reach 90ยบ C), chances are you got the shivers when you got out of the pool. The extreme dryness of the air causes flash drying on the skin and a very rapid release of body heat. The skin reaction you would experience on a summer night in Arizona is the same as you would experience on a winter night in a northerly location.
People who have rosacea usually have sun-damaged skin, in which connective tissues have broken down. These loose tissues do not support the blood vessels of the skin, some scientists reason, and allow inflammatory cytokines from the immune system to accumulate and cause outbreaks.
Add to all these contributors to rosacea a final factor, stress. When people are under stress, microscopic packets in the ends of nerve cells serving the skin to break open and release adrenaline and Substance P, a chemical that helps nerve signals jump from cell to cell. Once in the bloodstream, Substance P eventually reaches the skin and signals the cells that make oils to grow not only in numbers but also in productivity. Under conditions of stress, greatly increased numbers of sebum glands pour out greatly increased amounts of oily sebum into follicles. Stress may be emotional, physical, or environmental. Simply becoming dehydrated on a hot summer day is enough stress to trigger an outbreak.
Who is at risk for rosacea? This skin condition is more frequently treated in women but occurs with equal frequency in men and women, and in all races. Symptoms are recognized at a later stage in persons of African descent. The eyes are affected in about 50 percent of people who have the disease.
Read more about skincare topics such exfoliating, ultrasound skin therapy, face roller and home use facial machine.