Acne Rosacea

Acne rosacea is a disease with dermal and ophthalmic manifestations that combines the symptoms specific to rosacea with the pustules of acne.

So far, the cause that triggers acne rosacea is not fully explained although it is generally admitted that the disease is favored by sun exposure. The pustules and the flushing of the skin usually affect the face and the chest with a deterioration of the condition after the consumption of alcohol, spicy foods or hot drinks.

It seems that acne rosacea affects more women than men, with a higher occurrence of the disease in the middle-aged group. Thus, the majority of patients are people between 30 and 60, with the mention that in the case of black complexions the identification is more difficult and often delayed. Although many assumptions have been made on the preponderance of acne rosacea with fair-skinned people, the theory is not supported by clinical evidence.

The acne lesions characteristic to the disease usually appear on the chin and cheeks, or in the nose area, but the central part of the forehead is also commonly affected. The skin is usually very oily too, yet there are some major differences between acne rosacea and acne vulgaris. In traditional acne forms, comedones have no limitation of extent, whereas with rosacea they only appear in the flush areas. Moreover, acne rosacea is characterized by hypertrophy which is not found with acne vulgaris.

Unlike regular acne forms, acne rosacea is a chronic disease that evolves in time, sometimes extending over years. Most often, topical corticosteroids are applied to reduce the intensity of the symptoms and to improve the overall condition, but they are not suitable for long-term therapy due to the tissue atrophy risk or the danger to cause permanent vaso-dilation. Most doctors will therefore choose to recommend the systemic treatment instead of the topical one.

Depending on the skin changes caused by acne rosacea, surgical intervention could become necessary but only after running medical tests and at the special recommendation of a dermatologist. The tunable dye laser procedure and electrocautery represent the two main solutions under the circumstances, but skin grafting, dermabrasion and other forms of excision are also possible. The treatment of acne rosacea should not be ignored or postponed even if the condition shows an improvement over some periods of time.