The Clinical Picture of Erythematotelangiectatic Rosacea

Subtype 1 rosacea is known as Erythematotelangiectatic rosacea. In the clinical picture of erythematotelangiectatic rosacea, the incidence of rosacea is mainly characterized by flushing and persistent central facial erythema. The appearance of telangiectases is common but not essential for a diagnosis of this subtype. Central facial edema, stinging and burning sensations, and roughness or scaling may also be reported. A history of flushing alone is common among patients presenting with erythematotelangiectatic rosacea.

The Picture of Pre-Rosacea

Dermatologists now recognize an early prelude to rosacea termed prerosacea. Prerosacea is the earliest noticeable stage of rosacea. Signs of this early stage of rosacea include frequent episodes of flushing or redness of the face and/or neck that come and go. Things that can cause an episode are exposure to the sun, emotional stress, alcohol, spicy foods, exercise, cold wind, hot foods and beverages, and hot baths. Again, each person is different and what might affect one person might not bother the next.

Prerosacea is often found in someone with a family history of rosacea, individuals with prerosacea experience frequent blushes or flushes that last longer than normal and their skin may be exceptionally sensitive.1 For example, the skin of a person with prerosacea may become irritated in response to inappropriate treatment with acne medications, and it therefore becomes very important to have a correct diagnosis.

Rosacea's Ocular Picture

The Picture of Ocular Rosacea is viewed as an inflammatory eye condition. The most frequent symptoms of ocular rosacea are red inflamed corners of the eyelids with scales and crusts. It is reported that 50 to 60% of all rosacea sufferers also have some sort of symptoms with their eyes which is known as ocular rosacea. In one study (Starr, McDonald 1969) it was found that ocular rosacea symptoms occurred in 58% of patients.

People with ocular rosacea have a tendency to be overall more dehydrated than others. The eye is 96% water and one of the first areas of the body to shown signs of dehydration. Increasing your water intake will increase the moisture in the eye (thereby decreasing irritation and dryness).

Theories in The Clinical Picture of Rosacea

In the clinical picture of rosacea many theories abound on the possible causes or triggers for rosacea. One such theory involves MSG.

Many people affected by MSG complain of Rosacea and other skin disorders, including a red, peeling rash with blisters. Rosacea, according to medical sources is based on vasoactivity, and inflammation. These two causes, are directly affected by MSG.

Glutamate is a calcium channel opener, and has proven vasoactive effects in the human body.

Glutamate is a nervous system stimulant. That is why it is used - it stimulates nerve cells in the mouth. However, there are glutamate receptors all over the body (the pancreas, the retina, the hypothalamus, even the hair cells of the ear) . Based on the latest research from Johns Hopkins in May 2001, nervous system stimulation can cause the immune system to over-react. Hypersensitivity of the nervous system triggers the immune system to release its arsenal of inflammation weapons.


Allergy and immune response are big triggers for rosacea according to the following links:

http://www.emedicine.com/derm/topic377.htm

http://www.medslides.com/member/Allergy_&_Immunology/allergic_skin.pdf

http://www.dermnet.org.nz/index.html

If MSG causes the body to unleash its inflammation response because of it's effect on the nervous system, and it also changes the dilation of the blood vessels because of its action on the calcium channels, it is not surprising that some people sensitive to MSG, would complain of rosacea symptoms.

The Rosacea Skin Care Picture

Rosacea Skin Care starts with a proper lifestyle. Sometimes the simple things in life are ignored. Over time, the lack of simple maintenance can have drastic effects on your skin and body. The foods we eat, the products we use, and our daily activities all have an effect on our body.

New Regulations For Accutane

WASHINGTON (Reuters) - Patients and doctors must register with manufacturers before using or prescribing Roche Holding AG's acne drug Accutane or its generic versions, U.S. regulators said on Friday.

The requirement is part of a plan to strengthen safeguards meant to keep pregnant women from taking Accutane, the Food and Drug Administration said in a statement. The drug can cause birth defects.

The FDA also said it approved changes to existing warnings "so that patients and prescribers can better identify and manage the risks of psychiatric symptoms and depression" before and after prescribing Accutane.

The FDA had announced plans for tighter controls on Accutane in November 2004.

Accutane also is known by the generic name isotretinoin. Mylan Laboratories Inc., Ranbaxy Laboratories Ltd. and Barr Pharmaceuticals sell generic versions of the drug.

Stress Can Affect The Rosacea Picture

The role of stress in the rosacea picture is very clear.Stress is the body's reaction to a perceived threat which is shown by a red face. Adrenaline and hormones are released, and the nervous system is activated, sharpening our senses, but simultaneously our pulse rises, our muscles tense and our immune system begins to shut down. Our sympathetic nervous system is in the "fight or flight" position or "charged to meet the goal". Many rosacea sufferers notice a flushing of the face as adrenal acid is added to the body system. Those who can "not relieve stress" as needed may experience fatigue, upset stomach, and frequent headaches in addition to rosacea redness or flushing, acne pimples, rosacea papules (without pus)and seborrheic dermatitis. To offset the sympathetic nervous system, the parasympathetic system needs to rest and restore the body for normal living and for the next 'fight or need of energy for conflict'. The proper alkaline foods and water helps so very much in buffering or alkalizing the many acids we encounter. Long term stress can contribute to family breakdown, job fatigue, with resulting long term health problems such as depression, heart disease, high blood pressure, and rosacea.

When the body becomes stressed from many causes, even dehydration, the adrenal cortex converts adrenal androgens to testosterone in BOTH men and women, resulting in overactive sebaceous glands. In the normal female, the ovaries produce 25% of the testosterone and 75% is converted from adrenal androgens. Women only have 10% of the testosterone that men have. Men have thicker skin and muscles than women and can handle much more testosterone. Under stress, however, the adrenal androgen conversion can almost double the testosterone in both men and women. This causes the T zone of the face to become oily, while other areas are still dry from dehydration. Adult acne and rosacea is sometimes a by-product of stress and/or dehydration. Water and estrogen calm the “body’s stress alarm system”. Both facial redness and rosacea are caused in part by high calorie carbohydrates (pastas, breads) and sugar spiking from all sweet foods. Most of us have heard of kids bouncing off the walls with hyperactivity after eating high sugar foods. So, if you think of things that give you a high burn rate, high energy, or foods that would most likely add fat to your body, and you will be able to identify the worst culprits which are always "acidic": foods and beverages that stimulate the sebaceous gland system and thus cause more oil and redness. Stimulants such as coffees, teas, soft drinks with caffeine, alcohol beverages and chocolates also stimulate this system, causing further facial redness, oily skin and rosacea. Consuming more water helps us to reduce reddening and sebaceous gland oils.

The Role of Dermatitis In The Rosacea Picture

Rosacea and seborrheic dermatitis are different skin disorders, sometimes they can coexist at the same time. Approximately 35% of people with rosacea have seborrheic dermatitis which makes for an even more sensitive skin condition.

Seborrheic dermatitis involves overactive sebaceous glands which cause inflammation, flaking and a red rash in the central portion of the face. If one looks closely, the flakes usually have a greasy look, smell and feel. The dryness of seborrheic dermatitis is perceived because of the flaking which consists of dried layers of accumulated oil.

Seborrheic dermatitis causes yellowish scales to develop on the scalp, the hairline and the eyebrows; which is often confused with the crusting and scaling on the eyelids that occur with ocular rosacea. A doctor should check any scaling around the eyes, as the potential side effects of ocular rosacea are more serious than those of seborrheic dermatitis.

Topical steroids used in the treatment of dermatitis can create steroid induced rosacea. This condition typically worsens when the steroid is stopped. In an unfortunate cycle the steroid may be reapplied to diminish the redness which only worsens the condition.