Is Rosacea a Lifelong Skin Condition?
Yes, rosacea is one of the most common chronic skin conditions that affect nearly 16 million people in the United States alone and about 45 million worldwide. The exact cause of rosacea is not known, but there are several theories suggested by many experts regarding rosacea and its pathophysiology.
The disease mainly affects the face first, initially, by triggering some redness on your nose, followed by your cheeks, chin, and forehead. Rosacea causes facial swelling that is associated with bumps, similar to pimples, giving an appearance of acne. It may also be associated with a burning sensation of the face and eyes. In severe cases, the skin may become more thickened causing the nose to appear enlarged. Moreover, small blood vessels dilate and become visible on the face.
The symptoms of rosacea appear intermittently during the initial phase of the disease. Firstly, it is a disease with periods of flare-ups and remissions, which may then progress into permanent redness or flushing of the facial skin.
Flare-ups of rosacea can be triggered by factors like exposure to sunlight, alcoholic beverages, stress, cosmetic products, extreme weather condition, and spicy foods. During remissions, the symptoms disappear, and the patient appears completely normal. However, rosacea rarely reverses itself. It continues for years and years and may become worse if it is left untreated.
There are four types of rosacea. Not everyone gets affected by every type of rosacea; some may only develop one type, whereas a few others may develop 2, more than 2 or all 4 types of rosacea all at once. The four different types of rosacea are:
1. Vascular rosacea or Erythematotelangiectatic rosacea
This is the initial phase of rosacea, which is also referred to as pre-rosacea. This phase of the disease is characterized by intermittent flushing of the skin and chronic redness. Some people notice visible blood vessels on the face, known as telangiectasia.
Vascular rosacea is a mild condition with minor symptoms that can be easily treated with topical or oral rosacea drugs such as doxycycline. For those with telangiectasia, laser treatment can be used to shrink the dilated blood vessels. Although these treatment methods do not completely cure rosacea, they will certainly relieve the symptoms.
2. Inflammatory rosacea or Papulopustular rosacea
This is the second stage of rosacea, which is characterized by chronic redness of the facial skin along with some papules and pustules on the face. Even though this appearance may be similar to an acne breakout, the treatment plan will be different from that of acne.
Inflammatory rosacea is often treated with topical gels such as metronidazole.
3. Phymatous rosacea
If rosacea is not treated during the early phases of the disease, then it will gradually progress and worsens into phymatous rosacea. In this stage, new skin begins to grow over the nose, cheeks, and forehead. An overgrowth of thickened and enlarged skin on the nose is known as rhinophyma. Phymatous rosacea is more common among males than females. This problem is often addressed with laser treatment or surgery where they aim to remove the thickened skin.
4. Ocular rosacea
As the name suggests, ocular rosacea affects the eyes. The symptoms are tearing, swelling, irritation, stinging, and burning sensation of the eyes. This type of rosacea is very dangerous as it can damage the cornea. Vision may be blurred initially, but can progress to blindness if not treated soon. Ocular rosacea is typically treated for long-term using low-dose antibiotics.
Anyone can develop all forms of rosacea all at once, or in sequence if the skin disease is not treated. However, there is no treatment for rosacea that provides a complete cure; its symptoms can only be controlled with medications and other forms of treatment.