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Woman with rosacea

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This characterizes the skin disease Rosacea

Rosacea is a chronic inflammation that makes your face red. Symptoms include flushing, pimples and swelling. The condition can be transient, recurrent or permanent. With the right treatment, you can achieve good symptom relief.

The first symptom of rosacea is transient flushing that lasts for about 5 minutes. Eventually, the symptoms will usually include pimples and swelling. Many people will also find that dilated blood vessels become visible in the skin.

Rosacea is one of them most common skin diseases in Norway. The figures show that around 5-10% of the population in Scandinavia has rosacea.

Rosacea rash usually affects the area above the nose, forehead and cheeks. In some people, the skin on the eyelids also becomes red and irritated.

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What is the cause of rosacea?

It is still uncertain what is the cause of rosacea. Probably both heredity and environment play a role in why some people develop rosacea.

If you have rosacea in a close family, there is therefore an increased risk that you will also get rosacea. It can also seem that people with oily and light skin are more exposed than people with darker skin.

Many patients with rosacea have a higher incidence of the facial mite demodex folliculorum.

We also know that the symptoms can appear after a day in the sun, after you have drunk a hot drink or alcohol or eaten strong food. In addition, stress, large temperature fluctuations, perfume-containing products, and vasodilators can provoke rosacea. Some facial scrubs, skin tones and moisturizers with glycolic acid can also be decisive.

Common to the environmental factors is that they increase blood flow to the skin surface of the face. This is the reason why they worsen the condition.

These factors are not considered to be the cause of rosacea, although they can trigger or aggravate the rash when you have the disease.

Symptoms and course of the disease

Most people develop rosacea at the age of 30-50. Women, especially those with fair skin and blue eyes, are affected somewhat more often than men. The men who get rosacea are often hit harder than women.

As mentioned, the vast majority of people who get symptoms of rosacea will start by blushing fleetingly. There are several symptoms, but not everyone experiences all the symptoms.

Symptoms of rosacea are:

  • Redness / redness in the cheeks, nose, chin and forehead
  • Pimples and red bumps
  • Warm, burning sensation in the skin
  • Swellings
  • Blood vessels become visible
  • Sore, dry and irritated eyes, some also get inflammation along the edge of the eye
  • In older men, the nose can become very large because the sebaceous glands are greatly enlarged with the simultaneous development of increased connective tissue formation.

Rosacea can have varying degrees of severity where some only get mild rashes, while others get more severe rashes that worsen over time. Annoying skin changes can also occur. Studies show that 77% of patients with rosacea are significantly affected by the skin condition. 37% had low self-esteem and 46% were worried about what other people thought about their appearance. Approximately 22% felt directly depressed due to rosacea.

Many people find that they fluctuate between good and bad periods.

It is important to talk to your dermatologist if you suspect you may have rosacea. This is important to be able to make the right diagnosis and provide the right treatment.

The course of the disease can vary

Depending on the symptoms and the course of the disease, rosacea is divided into four types. It is quite possible to experience only one or a combination of several types at the same time.

Erythemato-telangiectatic rosacea

This type of rosacea starts with slight flushing as a symptom. It will later develop into permanent redness of the face - mainly nose, cheeks, chin and forehead. The cause of the redness is that the blood vessels in the skin surface dilate. Dilated blood vessels may eventually become visible over the nose and in the cheeks.

Papulopustular rosacea

The typical redness is accompanied by red swellings or "pimples" that contain plaster in the red areas. 

Fymatous rosacea

A complication where the sebaceous glands in the nose grow and become large and lumpy (referred to as rhinophyma). The condition develops slowly over several years, and is most prevalent among men.

Ocular rosacea

Inflammation occurs in and around the eyes, possibly on the eyelids. About half of those affected by rosacea develop these symptoms.

Treatment of rosacea

Rosacea is a chronic inflammation and can rarely be treated so that it disappears completely. Nevertheless, with the right medication and preventive habits, good symptom relief can be achieved.

If there is a need for medical treatment, your dermatologist will make a treatment plan for you.

Treatment will usually involve the use of specific creams topically on the affected areas. The creams are mostly anti-inflammatory and antibacterial. This often has a good effect, and most people get much milder symptoms after a few weeks of treatment.

If this treatment is not enough, your dermatologist will consider whether you should be prescribed an antibiotic regimen. How long the treatment is and how to take the treatment will vary somewhat between the different types of antibiotics. You will receive additional information about this from your dermatologist.

In addition to treatment with medication, the best treatment for rosacea is to avoid factors that trigger the rash.

Since various factors can trigger rosacea rash, it is necessary to try to find the cause.

Some of the most common triggers are:

  • Strong sunlight
  • Hot food and drinks
  • Hot food
  • Alcohol
  • Stress
  • Strong physical exertion
  • Large fluctuations in temperature / extreme temperatures
  • Some medicines such as corticosteroids (anti-inflammatory drugs) and medicines that dilate the blood vessels (for example some blood pressure medicines)

Some people manage to avoid all environmental factors that trigger or aggravate the rash, and these people can live almost without noticing that they have the disease.

Self-treatment

Since we know that certain external factors can trigger or aggravate the rash, it is important that you try to reduce the exposure to these factors.

This means, among other things, to:

  • Do not stay too long in strong sunlight and use sunscreen all year round, preferably SPF30 + in the summer. Use a sunscreen that is adapted to sensitive skin.
  • Use skin care products that are adapted to sensitive skin.
  • Avoid scrubbing the skin and using peeling, this can irritate the skin.
  • Limit your intake of strong foods, hot drinks and alcohol.
  • Try to avoid strong temperature fluctuations
  • Talk to your doctor about the best options if you have to use corticosteroids or medications that dilate your blood vessels.

Video consultation with a dermatologist

If you want to talk to one of our dermatologists on video, you can reserve an appointment here. Our dermatologists can treat all skin diseases and ailments as well as prescribe medicines if necessary for the treatment.

Treatment with medication

Depending on the severity of your rosacea, there may be different treatment methods available. Common to most treatments is that it will often take around 6 weeks before you see the effect of the treatment.

In milder cases, the disease is often treated with cream or gel. In more severe cases, treatment with cream or gel is often combined with a course of antibiotics. Then it is common to use tetracyclines in the treatment.

If you have had enlarged sebaceous glands on your nose or permanent changes in your blood vessels, this can be treated with a laser. Enlarged sebaceous glands can also be surgically removed and redness can be reduced with IPL light therapy.

Drugs for the treatment of rosacea

Rosacea is treated either with medication for external use or with a tablet cure. The medicines for external use come in the form of creams, gels or ointments.

External treatment

Finacea: This product contains azelaic acid and probably treats rosacea through its anti-inflammatory and antibacterial properties. The skin must be washed with water or a mild cleanser before the drug is applied to the skin.

Rosazol / Rozex: These are creams with anti-inflammatory and antibacterial properties. They contain the active substance metronidazole. The skin is thoroughly cleansed before the agents are applied, and you should be careful about sunbathing a lot while using these medications.

mirvaso: The active substance in this medicine is brimonidine. The cream makes the blood vessels narrower, which reduces blood flow. Therefore, the redness is also reduced. If desired, you can apply cosmetics after the cream has dried.

Soolantra: An anti-inflammatory cream where ivermectin is the active ingredient. Also works against mites. Should be applied in a thin layer where it is important that you avoid eyes, lips and mucous membranes. Hands should be washed after application. If you want to apply cosmetics, you can do this after the cream has dried.

Terramycin-polymyxin B: An eye ointment that contains two different antibiotics (contains oxytetracylin polymyxin B). Used for ocular rosacea, in and around the eyes.

Tablet cures  

Tetracyclines (antibiotics): Doxylin / Doxcycline / Oracea / Vibranord (with Doxycycline), Tetralysal / Lymecylin (with Lymecycline). May increase the risk of sunburn, so be careful when staying in the sun if you go on such a cure. Dairy products, iron, zinc, calcium tablets and antacids must be taken either 1 hour before or 2-3 hours after taking the antibiotic tablets.

Macrolides (antibiotics): Ery-Max (with erythromycin). Should preferably be taken just before a meal.

Isotretinoin (retinoids in tablet form): Has an anti-inflammatory effect, but is used mainly because it reduces sebum production and brings the conditions in the sebaceous glands' exit passages back to normal. Due to the risk of serious side effects, this drug is used only in the most severe cases. Due to this, you must be closely followed up by a doctor throughout the treatment.

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