Acne rosacea, often simply called rosacea, is a chronic skin condition that primarily affects adults with fair skin and light hair . It is characterized by inflammation of the face, leading to persistent redness, red spots , and sometimes small pustules.
There are several forms of rosacea , and it is crucial to understand the specificities of each to adapt the appropriate local treatment . Here is a complete guide to better understand and treat acne rosacea.
What is acne rosacea?
Acne rosacea, commonly referred to as rosacea, is a chronic inflammatory skin condition that primarily affects the face. It most commonly affects adults with fair skin, often between the ages of 30 and 50, and is more common in women than men. However, the most severe forms tend to occur in men. Unlike juvenile acne, rosacea does not have comedones (blackheads and whiteheads).
Symptoms of Acne Rosacea
Symptoms of rosacea vary depending on the clinical form, but typically include:
- Persistent redness : Frequent redness (erythema) appears on the cheeks, nose, forehead and chin.
- Red pimples : Acne-like papules and pustules may appear.
- Small vessels visible : Telangiectasias, or small dilated blood vessels, are often visible in affected areas.
- Skin thickening : In severe cases, particularly in men, the skin on the nose may become thickened (rhinophyma), giving a bulbous appearance.
- Eye symptoms : About 50% of people with rosacea have eye symptoms, such as dryness, irritation, swollen eyelids, and sensitivity to light.
Triggering factors
The exact cause of rosacea is unknown, but several factors contribute to its development:
- Genetic factors : A family history of rosacea may increase the risk.
- Abnormal immune reactions : An excessive immune response to mites or bacteria on the skin may play a role.
- Blood vessel abnormalities : Problems with the blood vessels in the face can contribute to persistent redness.
- Environmental factors : Exposure to sun, extreme temperatures, alcohol, spicy foods, and stress can trigger or worsen symptoms.
The Different Types of Rosacea
- Erythematotelangiectatic rosacea or vascular rosacea
Features : This form is mainly marked by diffuse redness and dilated blood vessels. Affected individuals may feel a sensation of heat or burning on the affected skin.
Symptoms :
- Persistent redness (erythema) on the face, especially the cheeks, nose, forehead and chin.
- Appearance of small visible blood vessels (telangiectasias).
- Burning or tingling sensation.
2. Papulopustular rosacea
Features : This type of rosacea is often confused with juvenile acne, although there are no comedones (blackheads or whiteheads). Inflammatory rashes are present in the same areas as the vascular form.
Symptoms :
- Red pimples (papules) and pustules resembling acne.
- Persistent redness.
3. Hypertrophic (phymatous) rosacea
Characteristics : Hypertrophic rosacea is more common in men. It is characterized by thickened skin and enlarged sebaceous glands, mainly on the nose, but also on the chin, forehead, cheeks and ears.
Symptoms :
- Thickening of the skin, especially on the nose (rhinophyma).
- Bumpy, rough appearance of the skin.
4. Ocular rosacea
Features : Ocular rosacea affects the eyes and eyelids. It may precede or accompany the skin symptoms of rosacea. Eye symptoms can range from mild to severe and often require consultation with an ophthalmologist.
Symptoms :
- Redness and irritation of the eyes.
- Dry eyes.
- Sensation of a foreign body in the eye.
- Sensitivity to light (photophobia).
- Swollen and inflamed upper eyelids (blepharitis).
5. Granulomatous rosacea
Features : This form of rosacea is rarer and is characterized by resistant granulomatous nodules that can lead to scarring. Lesions are often located around the eyes and mouth.
Symptoms :
- Solid, red, brown, or yellow nodules or papules.
- Thickened and often permanently affected skin.
What is the difference between acne and rosacea?
Acne is a common skin condition characterized by the presence of comedones (blackheads and whiteheads), papules (red spots), and pustules (pus-filled spots). It occurs mainly in adolescents and young adults due to overproduction of sebum, clogged hair follicles, and the growth of Cutibacterium acnes bacteria. Hormonal factors, such as puberty and hormonal fluctuations, as well as genetic factors, play an important role in its development.
In contrast, acne rosacea is distinguished by the absence of comedones . It manifests as persistent redness (erythema) on the face, particularly on the cheeks, nose, forehead, and chin. It may also present with papules and pustules (papulopustular rosacea), but without the comedones typical of juvenile acne. Rosacea typically affects adults, mainly between the ages of 30 and 50, and can be exacerbated by environmental factors such as sun exposure, extreme temperatures, alcohol, and stress. The exact causes of rosacea are not completely understood, but are related to chronic skin inflammation and vascular hypersensitivity, as well as genetic factors and abnormal immune responses.
Treatment of rosacea
When it comes to management, acne is often treated with topical medications such as retinoids, benzoyl peroxides, and topical antibiotics, as well as oral antibiotics such as doxycycline and minocycline for more severe cases. Laser and light therapies are also used to treat persistent acne scars.
In contrast, treatment for acne rosacea involves the use of topical medications such as metronidazole, azelaic acid, and ivermectin to reduce inflammation and redness. Oral antibiotics, primarily tetracyclines, may be prescribed to control more severe symptoms. Laser and pulsed light therapies are also used to reduce redness and visible blood vessels on the affected skin.
In case of ocular rosacea, specific eye care such as the use of artificial tears and warm water compresses may be recommended to relieve associated eye symptoms.
In conclusion, although acne and rosacea may present similar skin symptoms like red pimples, their clinical features, underlying causes, and treatment approaches are distinct. It is essential to consult a dermatologist to get an accurate diagnosis and a treatment plan tailored to your specific condition.