Long-term skin conditions can be particularly irritating (get it?!) as they can be painful and/or itchy as well as making the sufferer lose confidence in themselves. The one that I’m asked about most frequently, outside of acne, is rosacea. Rosacea is incredibly common – it is estimated that around 45 million people across the globe are plagued by the symptomatic flushing, blushing and itching.
This article is purely for informative purposes and self-diagnosis is a definite skin sin, so please leave the diagnosing to your GP!
What is rosacea?
Rosacea is an auto-inflammatory skin condition, meaning that there is a malfunction in the body’s defense mechanisms which leads to the inflammation associated with rosacea. There are four main types of rosacea:
- Subtype 1: Erythematotelangiectatic rosacea
- This is the type of rosacea I see the most of by far. In appearance, it is the typical flushing and redness as well as small blood vessels becoming visible through the skin. From a symptom perspective, the affected area may sting, burn or become rough.
- Subtype 2: Papulopustular rosacea
- Some refer to papulopustular rosacea as acne rosacea as it features papules and pustules, just like in acne. In this subtype of rosacea, there will also be redness, swelling of the skin and plaques (risen, red patches on the skin when the surrounding skin is not affected).
- Subtype 3: Phymatous rosacea
- The skin will become thicker and the texture may be irregular and have nodules or bumps. Phymatous rosacea can often be found on the nose, possibly leading to rhinophyma AKA a bulbousness of the tip of the nose.
- Subtype 4: Ocular rosacea
- This is rosacea of the eyes. The eyes may become red and irritated and may develop sty-like lumps.
Rosacea affects the centre of the face, the column coming from your eyes down, ie. your nose, chin and the centre of your forehead.
Who gets rosacea?
The exact cause of rosacea is still unknown – you may have noticed this a common theme when it comes to the causation of skin disorders and conditions.
Basically, when it comes to knowing who is most likely to get rosacea, we have to work off of observation. It’s been observed that those of Celtic heritage are prone to rosacea… no surprise there, what aren’t we prone to?! Interestingly, rosacea is more common in women; however, men are more likely to have severe rosacea. Rosacea is also linked to your genes but often doesn’t appear fully until middle-age. Menopause can trigger rosacea in women too – as if they don’t have enough to deal with!!
Recent research has discovered a link between rosacea and a little creature called the Demodex mite. It may sound like a creepy-crawly but it is most certainly not and is actually a normal and important inhabitant of the human skin. The Demodex is a type of microbe that gobbles up dead skin cells to reduce waste on the face – the mite is a bit like one of those robot hoovers except for your face, in this sense.
How many Demodex are found on the skin of those with rosacea? Sometimes up to 15 to 18 times as many as on non-rosacea sufferers. Dr. Fabienne Forton, a Belgian dermatologist, believes the mites may provide the answer to understanding subtype 2 rosacea, as when the amount of mites was normalised during a study, the sufferers no longer complained of skin sensitivity!
What are the symptoms?
One of the reasons that rosacea is so hard to diagnose and treat is because the symptoms of it are easily mistaken for other conditions and there are just so many of them.
The symptoms include, but are not limited to:
- Flushing of the skin
- Redness that does not go away
- Pustules and papules
- Thickening of the skin
- Visible blood vessels
- Irritation of the eyes
- Burning or stinging sensation
- Rough, dry appearance to the skin
The nerdie summary
The skin flushing associated with rosacea can last a few minutes, a few hours or a few days. As it can come and go as it pleases in rapid visits, rosacea goes undiagnosed in many with the condition. Flare-ups can occur very infrequently, so it is easy to presume it is a reaction to food, products or even the weather.
Although rosacea usually begins as the light, mild, waxing and waning flushing of subtype 1 rosacea, without treatment, it can worsen over time. Long-term rosacea sufferers may notice that the redness will not go away completely and that the visible blood vessels will not fade between flare-ups.
This is why it is a skin sin to self-diagnose. Persistent congestion of the papular and pustular form could turn out to be acne rosacea, what you think to be on-going sensitivity could turn out to be subtype 1 and so on and so forth. If you are having incessant skin problems, book in with your GP and get to the bottom of it rather than just fighting from the top – the skin needs a 360˚approach, after all: inside, outside and on top.