The Picture of Rosacea Symptoms

The symptoms of rosacea include facial redness or flushing. In the beginning the flushing will come and go, gradually becoming more permanent. The skin develops telangiectasia or an appearance of spidery viens on the facial skin. The skin becomes more sensitive and reactive to chemicals, cleansers, etc…. Gradually the skin texture may change taking on an orange-peel appearance. You may experience facial swelling and a sensation of heat or burning on the skin. Some rosacea sufferers may have pimples; papules which are a solid raised bump that may open when scratched, becoming crusty and infected; or pustules which are a dome-shaped, fragile lesion containing pus that typically consists of a mixture of white blood cells, dead skin cells, and bacteria. A component of rosacea more often seen in men, rhinopyma or a condition in which the nose develops bumps, becomes swollen and has a misshapen appearance. Not all rosacea sufferers develop all symptoms of rosacea. Rosacea is often very customized and each person rosacea is different.

When Rosacea was Just Another Word for Acne

The first written reference to rosacea came in 1812 when Dr. Thomas Bateman referred to "acne rosacea" in an English medical text, and noted: "The perfect cure of acne rosacea is, in fact, never accomplished." Other 19th century references commonly listed rosacea among the various forms of acne.

Finally in 1891, Dr. Henri G. Piffard, a professor of dermatology in New York, called for distinctions among different forms of acne to more truly differentiate symptoms. Hence the "birth" of the term rosacea.

Dermatologists now know that rosacea is a different skin condition from acne, and that treatment for acne can often make rosacea worse. Although the precise cause of rosacea is still unknown, most experts believe it is caused by a vascular disorder that seems to be related to flushing.



Research has also dispelled the centuries-old myth that rosacea is caused by heavy consumption of alcohol. While alcohol may aggravate rosacea, the symptoms of rosacea can be just as severe in a teetotaler.

Historical References to Rosacea

The French surgeon, Dr. Guy de Chauliac, in the 14th century, was the first person known to describe rosacea medically as a skin condition. Dr. de Chauliac talked about "red lesions in the face, particularly on the nose and cheeks." He called the condition "goutterose" (French for "pink droplet") or "couperose" (now a common French term for rosacea).

Others referred to rosacea as "gutta rosa" (the Latin version of "goutterose") or "pustule de vin" (French for "pimples of wine"). Whatever the name, rosacea was well-known and commonly "attributed to the excessive consumption of alcoholic drinks," according to Dr. de Bersaques.

References to rosacea were also known in early literature. Chaucer's Canterbury Tales and Shakespeare's Henry V include descriptions of men with red faces and enlarged noses. Artists through the centuries also have depicted rosacea in paintings of red faces and bulbous red noses. A painting in the Louvre, "The Old Man and His Grandson" by Ghirlandiao around the year 1480, is a well-known example of rosacea.

Referenced from: de Bersaques, J: Historical Notes on Rosacea. European Journal of Dermatology. 1995;5:16-22.

Keeping Rosacea Out of The Picture

Do you avoid family photos because of your rosacea? Here are some tips for making you and your rosacea look its best.

Red or plain black-and-white clothing accentuate your redness. Try wearing softer hues like blues, yellows, khakis and other neutral colors.

When scheduling a portrait session, choose a time of year when your rosacea tends to be well under control.

Full-service beauty salons offer makeup artists who can give individual advice about preparing for a portrait. You can even schedule a full makeup session directly before the shoot.

When applying makeup keep it simple. Apply a contrasting concealer, usually a green or yellowish tone to offset rosacea's red appearance. Choose and apply a good foundation in the correct skin tone -- most people mistakenly match foundation to the back of their hand, but a truer color match is made by testing foundation colors under the chin. Blend the foundation and concealer down the neckline and out toward the ears and hairline to provide a natural look and prevent a "mask" appearance. Follow with a loose powder to finish, making blemishes less striking or noticeable. Emphasize your eyes to draw attention away from other areas by using natural eye shadow shades that match your coloring. Apply two colors -- one for contrast and one for contour.

Put yourself at ease and be as natural as possible. The camera will capture you at your best if your smile is stress-free when your rosacea tends to be well under control.

GOT ROSACEA?

"The picture of health" usually brings to mind a clear skinned person with slightly rosey cheeks. The picture of health may in fact be a clinical picture of rosacea.

Rosacea often begins with slightly pink or rosey-colored cheeks with a color that comes and goes. As time goes on it can progress to a picture of constant facial redness, almost a permanent wind-blown look.

The many treatment options available can be very confusing. Each treatment seems to have it's own side effects and pitfalls. To heal the skin in as natural way as possible may in fact be the best treatment option.

Follow the simple guideline to cleanse, moisturize and protect the skin from further harm. Find a cleanser that will not irritate or cause further damage to the skin. Some have found that Nutrogena or cetaphil cleansing bars work well.

Moisturize from the inside out by increasing the moisture in the body by drinking more water. Add surface moisture to the skin with a natural product such as jojoba oil.

Protect the skin from further damage by applying a sun screen before going out in the sun.

The Physiology of Rosacea

The precise pathophysiology of rosacea remains unknown. In the clinical picture, rosacea manifests itself primarily as a cutaneous vascular disorder; however, inflammatory changes are a hallmark of severe rosacea.

Therefore rosacea may be thought of as a disease spectrum with 2 primary etiologic components, vascular and inflammatory. The earliest manifestations of the disease are cutaneous vascular dilatory changes with subsequent increased blood flow in the form of telangiectasias and erythema. Sunlight-induced small vessel damage may contribute to this underlying vascular instability.

In its later stages, the rosacea picture is marked by inflammatory changes in the form of papules and pustules in the midface, rhinophyma (bullous nose), blepharitis and meibomitis, and corneal vascularization. A type 4, cell-mediated hypersensitivity reaction has been hypothesized as a possible mechanism.

Demodex mites also have been implicated as a possible inflammatory stimulus in the overall picture of rosacea.

Added to the picture, Helicobacter pylori has been postulated to be a causative factor in a subset of patients. Whatever the underlying mechanism, there is a fundamental abnormality in the sebaceous glands of the face and eyelids, which leads to the inflammatory changes exhibited.

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