Forms and stages
- Эритематозно-телеангиэктатическая: приливы, стойкое покраснение центра лица, сосудистые звёздочки, жжение и стянутость.
- Папуло-пустулёзная: на фоне красноты появляются воспалённые бугорки и гнойнички — стадия, которую путают с акне.
- Фиматозная: утолщение кожи и разрастание тканей, чаще носа (ринофима); почти исключительно у мужчин.
- Глазная (офтальморозацеа): сухость, резь, ощущение песка, покраснение век и конъюнктивы; может предшествовать кожным проявлениям.
Главное отличие от акне: при розацеа НЕТ комедонов — чёрных точек и белых пробок. Есть стойкая краснота, приливы и повышенная чувствительность кожи.
What provokes
- The sun and ultraviolet radiation are the most common and most significant trigger
- Heat, sauna, hot shower, sudden temperature change
- Hot drinks, spicy foods, alcohol (especially red wine)
- Stress and strong emotions
- Intense physical activity
- Cosmetics with alcohol, menthol, fragrances; scrubs and aggressive cleansing
- Long-term application of hormonal ointments to the face causes steroid rosacea
Triggers vary from person to person. It is useful to keep a diary for 2-3 weeks: what you ate, where you were, what you did - and note the days with hot flashes. Usually two or three key factors are identified, and their elimination significantly improves the course.
The role of demodex mites
Demodex is a mite that lives in the sebaceous glands of most people and normally does not cause problems. In rosacea, its abundance is often increased, and it supports inflammation, but is not the root cause. Therefore, “treating demodicosis” in isolation from therapy for rosacea does not give results, although drugs that reduce the number of mites are included in the regimen and work well.
Treatment
- Externally: metronidazole, azelaic acid, ivermectin - basic agents
- Vasoconstrictors - reduce redness for several hours
- Antibiotics orally in an anti-inflammatory dose - for papulopustular form in a course
- Isotretinoin in low doses - for severe and resistant forms
- Laser and IPL are the only way to remove already formed spider veins; the drugs don't work on them
- For rhinophyma - laser or surgical correction
- For ocular manifestations - joint management with an ophthalmologist, eyelid hygiene
Гормональные мази на лицо при розацеа противопоказаны: они дают краткое улучшение, а затем вызывают тяжёлое обострение и стойкое расширение сосудов.
Care
- Wash with warm (not hot) water, a gentle cleanser without soap, alcohol or fragrance
- Dry your face with a towel, do not rub
- Daily sunscreen SPF 30–50, preferably with physical filters
- Moisturizers for sensitive skin - restore the barrier
- Refusal of scrubs, alcohol tonics, steaming, manual cleansing
- Mineral green base masks redness and does not irritate the skin