Rosacea

Rosacea is a chronic, acne-like condition of the hair follicles and sebaceous glands of the face. It also involves increased sensitivity of the small blood vessels of the face, which can result in a sudden blush or flush under stress or on consumption of alcohol, hot drinks or spicy foods. A process of gradual dilation of the blood vessels occurs. The condition usually develops between the ages of 30 and 50. Most patients find rosacea extremely stressful as the flush reactions and, subsequently, a permanent bluish-red discoloration of the face, are cosmetically conspicuous. Patients are not infrequently taken by other people for alcoholics.

Rosacea

Rosacea

Rosacea can be divided into three stages. In the first stage, dilation of the blood vessels occurs, resulting in permanent redness especially in the middle area of the face, i.e. on the forehead, nose and cheeks. The second stage is characterised by the development of small red papules (nodules), which may gradually join up to form bigger areas, and sometimes also festering spots (pustules). Additionally, some patients, especially men, suffer from enlargement and profileration of the sebaceous glands, particularly on the nose. This results in a rhinophyma, or “potato nose”. Some patients also tend to chronic conjuntivitis and corneitis as well as inflammation of the eyelids, requiring ophthalmological treatment.

Treatment: As alcohol, hot drinks and spicy foods can increase the flow of blood to the small vessels of the face and so cause flush, consumption of them should be avoided. Creams are used for local treatment, containing antibiotics such as metronidazol, erythromycin or tetracycline. However, rosacea is not a bacterial infection, even if it is sometimes accompanied by spots. These are usually sterile. Rather, the antibiotics are used for their immuno-modulating effect. In severe cases, in addition to local treatment, antibiotics such as tetracycline, minocycline or doxycycline are also given orally in tablet form. In very severe cases of rosacea, the vitamin A acid isotretinoin is the recommended treatment.

Local and internal therapy is of little help against pronounced rhinophyma. In these cases, the only possibility is plastic surgery to correct the nodular, often bluish-red growths in the area of the nose. Good results can be achieved by removing tissue with an electric loop, scalpel or laser. These procedures usually leave little scar tissue.