Rosacea is a chronic skin inflammation mainly affecting the the Centro facial region (cheeks, nose, chin, forehead) and in rear cases eyes. It’s a common, acne-like benign inflammatory skin disease of adults, with a worldwide distribution.

Rosacea is characterized by recurrent episodes of flushing or transient erythema, persistent erythema, phymatid’s changes, papules, pustules, and telangiectasia. Rosacea, although distinct from acne, does have some similarities. Unlike common acne, rosacea occurs most often in adults (30-50 years of age). Unlike acne vulgaris, rosacea is devoid of blackheads and characteristically does not resolve after puberty. Rosacea strikes both sexes and potentially all ages. It tends to be more frequent in women but more severe in men. It is very uncommon in children, and is less frequent in people with dark skin.

More than half of patients with rosacea have ocular features including dryness, foreign-body sensation, photophobia, conjunctivitis, blepharitis, and in rare cases, keratitis that may compromise eyesight.

The exact cause of rosacea is still unknown. The basic process seems to involve the dilation of the small blood vessels of the face. Currently, health researchers believe that rosacea patients have a genetically mediated reduction in the ability to dampen facial inflammation that is incited by environmental factors such as:

• Sunburn
• Demodicosis (Demodex folliculorum in the hair follicles)
• Flushing
• Allopathic medications.

Rosacea tends to affect the “blush” areas of the face and is more common in people who flush easily. Additionally, a variety of triggers is known to cause rosacea to flare, including:

• Emotional factors (stress, fear, anxiety, embarrassment, etc.) may trigger blushing and aggravate rosacea
• Changes in the weather, like strong winds or a difference in the humidity can cause a flare-up
• Sun exposure and sun-damaged skin are associated with rosacea
• Exercise, alcohol consumption, smoking, emotional upsets, and spicy food are other well-known triggers that may aggravate rosacea
• Many patients may also notice flares around the holidays.

Read also : Acne and Acne Scars 

Typical signs and symptoms of rosacea include:

• Facial flushing
• Blushing
• Skin redness (erythema)
• Burning
• Red bumps and pustules
• Small cysts
• Thickening of the facial tissue, especially the nose

The symptoms and signs of rosacea tend to come and go. The skin may be clear for weeks, months, or years and then erupt again. Rosacea tends to evolve in stages and typically causes inflammation of the skin of the face, particularly the forehead, cheeks, nose, and chin.

When rosacea first develops, it may appear, then disappear, and then reappear. However, the skin may fail to return to its normal color, and the enlarged blood vessels and pimples arrive in time. Rosacea rarely resolves spontaneously.

Rosacea generally lasts for years, and if untreated, it gradually tends to worsen.

The nose is typically one of the first facial areas affected by rosacea. It can become red and bumpy and develop noticeable dilated small blood vessels. Left untreated, advanced stages of rosacea can cause a disfiguring nose condition called rhinophyma (ryno-fy-ma), literally, growth of the nose, characterized by a bulbous, enlarged red nose and puffy cheeks (like the classic comedian W.C. Fields). There may also be thick bumps on the lower half of the nose and the nearby cheek areas. Rhinophyma occurs mainly in men. Severe rhinophyma can require surgical correction and repair.

Some people falsely attribute the prominent red nose to excessive alcohol intake, and this stigma can cause embarrassment to those with rosacea.

Rosacea may affect the eyes. Not everyone with rosacea has eye problems. A complication of advanced rosacea, known as ocular rosacea, affects the eyes. About half of all people with rosacea report feeling burning, dryness, and irritation of the tissue lining of the eyes (conjunctivitis). These individuals may also experience redness of the eyelids and light sensitivity. Often the eye symptoms may go completely unnoticed and not be a major concern for the individual. Many times, the physician or ophthalmologist may be the first one to notice the eye symptoms. Untreated, ocular rosacea may cause a serious complication that can damage the cornea permanently damaging vision, called rosacea keratitis. An ophthalmologist can assist in a proper eye evaluation and prescribe rosacea eye drops. Oral antibiotics may be useful to treat skin and eye rosacea.

Doctors usually diagnose rosacea based on the typical red or blushed facial skin appearance and symptoms of easy facial blushing and flushing. Rosacea is underdiagnosed, and most people with rosacea do not know they have the skin condition. Many people may not associate their intermittent flushing symptoms with a medical condition. The facial redness in rosacea may be transient and come and go very quickly.

Dermatologists are physicians who have special training in the diagnosis of rosacea. Generally, no specific tests are required for the diagnosis of rosacea.

In unusual cases, a skin biopsy may be required to help confirm the diagnosis of rosacea. Occasionally, a dermatologist may perform a noninvasive test called a skin scraping in the office to help exclude a skin mite infestation by Demodex, which can look just like rosacea (and maybe a triggering factor). A skin culture can help exclude other causes of facial skin bumps like staphylococcus infections or herpes infections. Blood tests are not generally required but may help exclude less common causes of facial blushing and flushing, including systemic lupus, other autoimmune conditions, carcinoids, and dermatomyositis.

While most cases of rosacea are straightforward, some atypical cases are not as easy to diagnose. Other skin diseases and rosacea look-alikes include:

• acne vulgaris,
• Demodex folliculitis,
• staphylococcus infection,
• systemic lupus erythematosus,
• allopathic medication reaction,
• seborrheic dermatitis,
• allergic or contact dermatitis,
• eczema,
• seasonal allergies,
• allergic conjunctivitis,
• perioral dermatitis,
• carcinoid syndrome,
• dermatomyositis,
• impetigo, and
• herpes simplex.

Recently, there has been an association noted between rosacea and certain auto-inflammatory diseases, including diabetes, inflammatory bowel disease, and cardiovascular disease.

Allopathic treatment for rosacea

In my experience combination therapy is best option in homeopathy practice among dermatologists and widely recommended. Homeopathy is waast field, there are too many best medicines for rosacea curing not only the symptoms but cause of the disease too.

My (Dr. Qaisar Ahmed) experienced Homeopathic medicines for Treatment of Rosacea are :

China Officinalis (Hydroxychloroquine) :

Sallow complexion. Face inflamed; red. Extreme sensitiveness to touch, but hard pressure relieves. Coldness; much sweat. Anasarca (Ars; Apis). Dermatitis; erysipelas. Indurated glands; scrofulous ulcers and caries. Blue color (skin) around eyes. Hollow eyes. Yellowish sclerotic. Black specks, bright dazzling illusions; night blindness. Spots before eyes. Photophobia. Distortion of eyeballs. Intermittent ciliary neuralgia. Pressure in eyes. Amaurosis; scalding lachrymation.

Agaricus muscarius :

Tearing in the face, twitching in the cheek. On waking, pain so violent, Itching, redness, and burning in the cheeks (like chilblains). Palpitations and pulsations in the cheeks.-Bluish lips, Burning fissures in the upper lip.-Herpetic eruption, principally on upper lip.

Spasmodic drawing in the chin and in the lower jaw. Needle-like prickings in chin; chin covered with minute blisters. Itching and titillation, which force the sufferer to scratch himself. Miliary eruption, whitish and close-grained with excessive itching.