Rosacea

Clinical Overview and Management

Understanding Rosacea and Treatment Options

Rosacea is a chronic inflammatory skin condition that primarily affects the central face.

It can cause persistent redness, flushing, visible blood vessels, inflammatory lesions and skin sensitivity. Symptoms can vary between individuals and may fluctuate over time.

Pathogenesis

The exact cause of rosacea is not fully understood. It is thought to involve a combination of:

Vascular hyperreactivity

Increased reactivity of the blood vessels, contributing to flushing and persistent redness.

Immune Dysregulation

Immune system imbalance and inflammation that may contribute to skin symptoms.

Demodex Overactivity

Increased Demodex activity, which may contribute to inflammation in some patients.

Skin Barrier Dysfunction

Impaired skin barrier function, resulting in increased sensitivity and irritation.

Types of Rosacea

Rosacea can present in several different clinical forms, including:

Erythematotelangiectatic rosacea (ETR)

Papulopustular rosacea (PPR)

Phymatous rosacea

Ocular rosacea

Some patients may experience features of more than one subtype.

Contributing Factors

Rosacea can be aggravated by a range of environmental and lifestyle factors. Common triggers include:

Genetic factors and Demodex may also contribute in some individuals.

Grading

Rosacea is assessed according to a number of clinical features, including:

Severity and persistence of erythema
Frequency of flushing
Inflammatory papules and pustules
Presence of telangiectasia
Ocular involvement
Skin thickening or phymatous change
Impact on quality of life