• Clinical science

Rosacea

Summary

Rosacea is a chronic inflammatory skin disease that may be triggered by a number of factors (e.g., alcohol, stress). The etiology is unclear; however, the disease is more common in females and middle-aged individuals with fair skin. The disease presents with central facial erythema, telangiectasias, and papules/pustules. In severe cases, the nose develops a large, bulbous shape (rhinophyma). In contrast to acne, comedones are not present. Treatment options include the avoidance of triggers, topical agents (e.g., metronidazole, brimonidine) for mild disease and oral agents (e.g., metronidazole) for more severe disease.

Epidemiology

  • Sex: > [1]
  • Age range: 30–60 years [1][2]

Epidemiological data refers to the US, unless otherwise specified.

Etiology

The cause of rosacea is not entirely understood. It involves chronic inflammation of skin and is especially associated with triggers that increase body temperature.

  • Trigger factors
    • Hot weather, hot drinks, spicy food
    • Stress, alcohol, nicotine
    • Demodex mites

References:[3][1]

Clinical features

In contrast to acne, comedones are NOT present in patients with rosacea.

References:[4][5]

Treatment

References:[4][6][7][8]

  • 1. Rainer BM, Kang S, Chien AL. Rosacea: Epidemiology, pathogenesis, and treatment. Dermato-Endocrinology. 2017; 9(1): p. e1361574. doi: 10.1080/19381980.2017.1361574.
  • 2. Gether L, Overgaard LK, Egeberg A, Thyssen JP. Incidence and prevalence of rosacea: a systematic review and meta-analysis. Br J Dermatol. 2018. doi: 10.1111/bjd.16481.
  • 3. Alinia H, Tuchayi SM, Patel NU, et al. Rosacea triggers. Dermatol Clin. 2018; 36(2): pp. 123–126. doi: 10.1016/j.det.2017.11.007.
  • 4. Goldgar C, Keahey DJ, Houchins J. Treatment options for acne rosacea. Am Fam Physician. 2009; 80(5): pp. 461–468. url: http://www.aafp.org/afp/2009/0901/p461.html.
  • 5. Mikkelsen CS, Holmgren HR, Kjellman P, et al. Rosacea: a clinical review. Dermatol Reports. 2016; 8(1). doi: 10.4081/dr.2016.6387.
  • 6. Oge LK, Muncie HL, Phillips-Savoy AR. Rosacea: Diagnosis and treatment. Am Fam Physician. 2015; 92(3): pp. 187–196. url: http://www.aafp.org/afp/2015/0801/p187.html.
  • 7. Weinkle AP, Doktor V, Emer J. Update on the management of rosacea. Clin Cosmet Investig Dermatol. 2015; 8: pp. 159–177. doi: 10.2147/CCID.S58940.
  • 8. Abokwidir M, Feldman SR. Rosacea Management. Skin Appendage Disord. 2016; 2(1-2): pp. 26–34. doi: 10.1159/000446215.
last updated 10/09/2020
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