Couperosis is a genetically determined connective tissue weakness, which manifests itself from the age of 30 onwards by means of visible vascular dilatations (telangiectasias) on the face. Especially people of Celtic type (reddish blond hair, fair skin) or people with easily irritated and sensitive skin are affected by couperosis, which is not considered a classical disease but rather a cosmetic problem. Couperosis is considered an early form of rosacea (rosacea) or copper fin.
What is couperosis?
Couperosis is the term used to describe a dilation of the blood vessels (telangiectasias) in the face, which usually manifests itself after the age of 30 and is caused by a genetically determined weakness of the connective tissue. In the initial stage of couperosis, temporary redness in the area of the cheeks and nose can be noticed. In the further course, permanent vasodilatation develops as a result of blood stasis, as well as the formation of new vessels, which are characterized by reduced elasticity and increased permeability. This causes the symptoms characteristic of couperosis, such as a visible network of vessels shimmering through the skin on the face, as well as a pronounced redness as a result of blood leaking into surrounding tissue structures. In addition, couperosis is differentiated according to whether arterial vessels or venous vessels (veinctasias) are affected, although mixed forms can also be observed.
Causes
The exact causes of couperosis have not yet been fully elucidated. It is assumed that couperosis is due to a genetically determined weakness of the connective tissue, which with increasing age results in blood congestion in the finest veins (capillaries) of the skin, especially of the face. A genetic predisposition (disposition) is also supported by the fact that mainly fair-skinned people with reddish-blond hair (Celtic type) as well as people with sensitive skin are affected by couperosis. As a result of excessive blood circulation, the capillaries are permanently exposed to increased pressure, which leads to dilatation or widening of the vessels as well as increased permeability of the vessel walls. As a result of this process, redness develops, which may become permanent as the condition progresses. Excessive sunbathing, severe temperature fluctuations, and excessive nicotine and alcohol consumption are external environmental factors that promote the manifestation of couperosis.
Symptoms, complaints, and signs
Due to couperosis, affected individuals suffer from a number of different skin conditions. These can have a very negative effect on the aesthetics of the affected person and thereby also significantly reduce the quality of life of the patient. Often this also leads to depression and other psychological upsets, as the affected person does not feel comfortable and beautiful. In children, the skin conditions can also lead to teasing or bullying. Those affected suffer from reddening of the skin, especially on the face. A clear widening of the vessels is also visible, so that bleeding can also occur on the skin. In general, therefore, there is then a weakness of the connective tissue, which has a negative impact on the health of the affected person. In many cases, couperosis does not require early treatment because the symptoms are not particularly characteristic and do not directly indicate the disease. If the skin bleeding is not treated, couperosis can also cause inflammation under the skin, which is usually associated with pain. In most cases, the patient’s life expectancy is not negatively affected by couperosis.
Diagnosis
Couperosis can be diagnosed by the characteristic skin changes on the face. However, conditions that lead to a similar skin appearance such as rosacea, actinic changes of the skin, or erythrosis should be excluded for differential diagnosis. In particular, the differentiation from rosacea is difficult in many cases, as it is so similar to couperosis etiologically and in its early stages also symptomatically that some experts assume the same disease. Couperosis is not considered a disease in the classical sense, but rather a cosmetic problem, especially since telangiectasias are considered to be particularly persistent. However, these can be eliminated or reduced with modern procedures.
Complications
A number of complications can occur in the course of couperosis.The pathological vascular changes initially cause reddening of the skin, which occurs particularly on the cheeks, forehead and nose and is associated with severe itching. Skin bleeding can develop from this; subsequently, inflammatory abscesses develop in the affected areas. The vasodilatation of the facial veins also leads to the rapid formation of wrinkles, and the risk of skin diseases is increased. Despite these complications, couperosis is mainly a cosmetic problem that rarely leads to major discomfort. When treating couperosis, complications can arise, for example, if the skin care products used cause an allergy or further irritate the redness of the skin that has already developed. With IPL2 light technology, in which the affected areas of skin are closed with the help of a light pulse, the development of a life-threatening thrombus can rarely occur. Surgical procedures are associated with similar risks, although serious complications are rare. Couperosis can also proceed entirely without complications. Problems usually occur due to secondary diseases and accompanying symptoms of the vascular changes and can almost always be avoided by an early visit to the doctor.
When should you see a doctor?
Couperosis is a genetically caused vasodilatation in the facial area. From a medical point of view, couperosis is not considered a disease, but only a cosmetic problem. However, since couperosis can develop into very disfiguring rosacea, which is also classified as a skin disease, the disorder should be treated. Typical for an incipient couperosis are skin redness on the cheeks and nose, which are accompanied by clearly visible facial veins as well as skin bleeding and very often also a weakness of the connective tissue. Affected are mostly people, predominantly women, from the age of 30. A doctor should be consulted at the latest when vascular dilatations become apparent. The general practitioner can act as the first point of contact, but treatment should be carried out by a dermatologist who specializes in the treatment of couperose and rosacea. Other physicians usually have neither sufficient expertise nor special equipment for the treatment of couperosis. Since very good results are achieved with laser treatments, the treating physician should have this technique at his disposal. This also applies if other forms of treatment initially seem to be indicated. Qualified physicians and specialized clinics can be researched on the Internet or requested through the medical associations. Couperose treatments offered by cosmeticians should at best be used as a supplement and after consultation with the treating dermatologist.
Treatment and therapy
Low-irritant skin care products without perfume or preservatives are recommended for couperosis. For a soothing, skin-stabilizing as well as anti-inflammatory and antimicrobial effect, active ingredients such as vitamin K1, D-panthenol, boswellia sacra (frankincense), chamomile, aloe vera, echinacea (coneflower), linseed oil or evening primrose oil are recommended, which in combination with liposome concentrates can develop an increased skin penetration and effect. Make-up or powder with green pigments applied locally to the affected skin area neutralizes the reddish coloration of the skin. There are also cosmetic procedures for the removal of telangiectasias. For example, the affected vessels in the face can be sclerosed as part of a laser therapy. With the help of the so-called IPL2 light technology (Intense Pulsed Light), for example, a controlled light pulse is emitted onto the affected skin area, which is absorbed by the hemoglobin in the blood and subsequently converted into heat. This induces heating in the blood vessels, which leads to coagulation (clotting). As a result, the treated vessels stick together, die, and are metabolized or cleared by the human organism through the lymphatic system. However, visible vasodilatation may recur even after this treatment, as couperosis is a chronic disease for which no causative therapy exists to date.
Outlook and prognosis
Couperosis is a permanent alteration of the normal, healthy skin appearance and will persist throughout life. However, the expression of the disease can be favored by proper skin care, so that affected persons do not have to suffer from the visual effects on the face and skin.After the medical examination and diagnosis, it is often sufficient to consult an experienced cosmetician who can design a care program with special products for the affected person that is tailored to the couperosis. If this is followed consistently and the patient does not experiment with other products and methods on his or her own, the severity of couperosis will gradually settle down to a tolerable level for the patient. In most cases, there are no further complaints once the skin care regimen has become established. Although this is time-consuming and often not entirely inexpensive, it does result in a visually more beautiful skin appearance over time than without the care. Couperose can of course improve or worsen in phases due to influences such as environmental pollution, unhealthy diet, stress, lack of skin care or hormonal causes. However, these are usually only changes of a few days to weeks. After that, the skin returns to its normal appearance while maintaining the previous skin care regimen, and couperosis returns to its usual state.
Prevention
Since the exact causes of couperosis are not yet fully understood, it cannot be prevented. However, it is known that extreme temperature fluctuations (e.g. sauna, unprotected parts of the face in winter), increased sun exposure, alcohol and nicotine consumption as well as caffeine and spicy food strain the sensitive connective tissue in the area of the nose and cheeks and can favor and intensify couperosis.
Aftercare
Affected persons have in most cases only very few measures of an aftercare available for couperosis. In the first place, the disease must be detected early by a doctor, so that further complications and discomfort can be avoided. It cannot heal on its own, so affected individuals should ideally see a doctor at the first symptoms and signs of this disease. In the case of those wishing to have children, genetic counseling and testing may also be useful to prevent the recurrence of couperosis. The disease itself can be treated by taking various medications. The affected person should pay attention to a regular intake and also to a correct dosage in order to alleviate the symptoms permanently. If there are any uncertainties or questions, a doctor should be consulted first. Regular examinations of the entire body are also necessary to check the internal organs. Furthermore, the support and care of family and friends also has a very positive effect on the further course of the disease. In many cases, contact with other sufferers of couperosis can also be useful, as this leads to an exchange of valuable information.
What you can do yourself
Since couperosis usually occurs as an early form of rosacea, a dermatologist should definitely be consulted. However, those affected can also help themselves to keep the condition under control. Triggers for acute episodes of couperosis are usually emotional agitation and stress, heavy sweating, for example during sports or in the sauna, as well as the consumption of alcohol and certain foods. Not all of these triggers can be consistently avoided. However, sufferers should refrain from regular sauna visits and steam baths. Extreme exertion should be avoided during sports. Water sports are usually more tolerable than sports that involve heavy sweating. Affected persons should also observe whether and to which foods they react sensitively. Hot spices are generally considered critical, but couperose attacks can also be triggered by other foods. When caring for the skin, only mild, pH-neutral cleansers and skin care creams that are low in irritants should be used. Washing with too hot water or hot-cold alternating baths, which strongly stimulate the blood circulation, should also be avoided. Visually, couperosis can be concealed with special camouflage make-up from pharmacies or cosmetic retailers. The correct application of these products can be explained to those affected who have no experience in the use of make-up by a cosmetician.
