Rosacea is a chronic disease characterized by increased capillary reactivity to heat. The clinical signs that characterize it are telangiectasia, papules, pustules up to the possible fima, in its most advanced forms.
The causes are not completely known, there are anyway certain risk factors: familiarity, light skin type with blond hair and blue eyes (in Sweden it affects 10% of the population), females (although in males it tends to be more severe), prolonged use of corticosteroids. There are controversial data about the possible implication of Helicobacter Pylori infection as a possible causal factor in the disease. Rosacea is clinically divided into four phases:
Flushing Phase: In this phase, those subjects who, due to excessive capillary reactivity, have a flushing effect, or a sudden reddening of the face in certain situations such as: thermal changes, emotional reactions, alcohol intake, hot drinks, spicy foods or caffeine, using alcohol-based cosmetics.
Erythrosis: the blood vessels of areas affected by flushing have been dilated permanently. At this stage, the redness is therefore constantly present. Telangiectasia may develop.
Papulo-pustal phase: in addition to erythrosis, injuries of the skin in relief (papula) appear, which may contain pus (in this case they are called pustules). The most affected areas are the centerpiece and the peripherial. The clinical picture may remind of acne, but in the case of papulo-pustular rosacea the subject is generally an adult.
Fima: This is the most serious stage of rosacea, rarely seen in feminine. It is characterized by skin thickening with nodules, enlargement of the sebaceous and rhino pharyngeal follicles (disproportionate enlargement of the nose, with a warty look). For the latter condition, there is no possibility of medical treatment but only surgical excision or vaporization with ablative laser.
The treatment for Rosacea consists of different options for each phase. Dermocosmesis can be used to mask or minimize the signs of the disease. Pharmacological options include the use of mouth medicines (β blockers, low-dose clonidine or aspirin, isotretinoin, short-term corticosteroids, antibiotic therapy for helicobacter pylori positive patients) or topically (azelaic acid, metronidazole, retinaldehyde). The use of "vascular" lasers (diode, laser dye, ktp, pulsed lights at 515-570 nm) is indicated in the treatment of early-intermediate stages of the disease (flushing-erythrosis). The fimatous stage can be trated surgically or with the use of ablative lasers.