Rosacea is a chronic facial skin inflammatory disease that results from a genetic predisposition and is triggered as well as aggravated by various environmental factors (such as wind, extreme cold, sun exposure, etc). Its exact physiopathology remains somewhat unclear.
More often than not it affects people with fair skin, eyes and hair, and is referred to as the “Celtic curse”. Women between the ages of 30 and 50 are also the most affected.
It must be distinguished from acne, with which it has long been confused. It does not include seborrhea, comedones or superficial or deep cysts. It is limited to the face, unlike acne, which can extend to the upper chest.
The first symptoms are intermittent redness, also known as “flushes”. They then become permanent and embarrassing. Dilated vessels may develop on top of this redness. A thickening of the skin can also be observed, which is particularly unsightly around the nose. The disease may be accompanied by associated ocular rosacea, with symptoms similar to those found in conjunctivitis.
It is important to note that a red face does not always point to rosacea, especially if the redness appears suddenly and if there is no family history.
Factors that trigger and/or develop the disease
Several factors exacerbate the disease such as alcohol, sun exposure, sports, spicy food, stress, emotions and temperature changes.
Exposure to the sun is doubly harmful for people with rosacea. Infrared rays increase the temperature, whereas ultraviolet rays directly damage the vascular walls. It is therefore imperative for patients to protect themselves extremely effectively from the sun’s rays. It is advisable to cut down exposure to the sun to a minimum and to systematically apply a very high factor sunscreen.
Treatments for rosacea
There are several types of treatment depending on the stage and type of rosacea. Rosacea must be treated holistically, integrating a tailored skin hygiene right from the start. It is essential to avoid specific triggers, as these also aggravate existing symptoms.
Topical treatment with Metronidazole can be prescribed as a first-line treatment to slow down and stabilize the evolution of stage I rosacea. As the disease worsens, anti-inflammatory drugs such as oral cyclins may be offered. These treatments stabilize the progression of symptoms but will not erase the unsightly dilated vessels (telangiectasias) that line the nasal wings and the cheekbones. To erase these small vessels, treatment with a Vascular Laser is necessary.
The currently recommended and effective method is vascular laser. The principle of the laser is based on the use of a light beam which, when directed specifically at the vessels, is transformed into heat, causing them to close.
The light beam respects the surrounding tissue (unlike electrocoagulation) and causes fewer side effects, such as fibrosis or a whitish appearance in the treated area.
Vascular lasers is a very important advance in the treatment of rosacea redness. It helps to reduce redness by between 50% and 80% according to published studies, with an improvement in quality of life of more than 75%. However, it does not cure the cause of rosacea.
Vascular lasers therefore complement the medical treatment.