Diagnosis

Often the diagnosis can be made on the basis of the typical symptoms, which occur mainly on the forehead, nose and cheeks. In general, the skin of rosacea patients is thickened and large-pored, and skin biopsies (tissue samples) can be taken to exclude rarer diseases such as butterfly lichen.

I have rosacea, what can I do?

On the one hand, you should continue to follow the preventive measures already mentioned. You yourself can make a significant contribution to a mild course of the disease through proper skin care. When washing your facial skin, it is best to use lukewarm water, as rapid temperature changes irritate the skin.

Be careful with “refreshing” ingredients. Especially cosmetics for men often contain menthol or camphor! Even if the skin then feels fresh: These substances irritate the skin and should be avoided.

Use pH skin-neutral soaps. This means that the soap has the same (slightly acidic) pH value as your skin. This means that the natural acid mantle of the skin is not neutralized.

Besides chemical irritations, you should also protect your skin from physical irritations. This means, dry your face carefully. Peelings also damage the skin in rosacea.

Although it may seem sensible to use exfoliation for rough skin, it does more harm than good! If you use a skin care product after washing, you should rather use water-based products.Oily ointments tend to close the pores of the skin, which is rather unfavorable in rosacea. If in doubt, you should consult your pharmacy or your dermatologist to find out what is best used for your condition and skin type.

Here too, you should avoid products containing colorants and fragrances. Depending on the severity of rosacea, certain creams and ointments are advisable. At each stage, individual consultation with a dermatologist is recommended.

In principle, only mild, pH-neutral skin care and skin cleansing products should be used. The skin should be washed with lukewarm water and dried with a soft towel before applying a skin care cream. Skin care creams should always contain a high sun protection factor or a sunscreen should be combined for stays in the sunlight.

Greasy products and products with essential oils should be avoided. Men should avoid unnecessary skin irritation before applying creams and ointments. This means that wet shaving should be avoided if possible.

In the first stages of rosacea, a targeted, individual application of creams and ointments is often sufficient. Drugs are often not necessary in the preliminary and first stages. The aim of the treatment is to prevent and alleviate skin redness.

The dermatologist can find out the appropriate products with the affected persons. In the preliminary stage, the so-called rosacea diathesis, special intensive care is often sufficient. In stage 1, prescription anti-inflammatory creams and ointments are indicated.

The creams and ointments usually contain antibiotics. Their active ingredients are usually azelaic acid, metronidazole, tetracycline or clindamycin. Depending on age and other factors, the appropriate active ingredients are selected.

For example, tetracycline must not be used in children or during pregnancy. In stage 2 of rosacea, temporary use of medication in tablet form in addition to creams and ointments is often advisable. As a rule, neither cortisone ointments nor cortisone treatment with tablets are effective in rosacea.

The advanced stage of rosacea is stage 3 and often requires further treatment. In some cases, isotretionin therapy under the supervision of a physician may be effective. In the treatment of rosacea it is particularly important not to try out creams and ointments on your own, but rather under the guidance of a dermatologist.

It is also important to be patient. Sometimes it takes a few days or several weeks before the treatment is effective. Rosacea can and should also be treated with medication.

It is important that the treatment is carried out according to the stage of the disease. In this way one avoids letting the disease progress further without shooting at sparrows with cannons. In stage I and II of the disease it is sufficient to treat only the skin.

The physician speaks of “topical treatment”. The active ingredients metronidazole and azelaic acid are particularly effective in the topical treatment of rosacea. Azelaic acid is an antibacterial and anti-inflammatory substance similar to vitamin A.

It reduces nodules and pustule somewhat better than metronidazole. Azelaic acid is available as a gel or cream and is available only on prescription. Metronidazole is an antibiotic that works against oxygen-avoiding bacteria (anaerobes).

The effect of Metronidazole has also been proven beyond doubt in several studies. Metronidazole also has an anti-inflammatory effect. Research is currently investigating whether so-called retinoids are effective.

Retinoids are actually acne medication, but they also seem to help in rosacea. However, all these topical agents have no effect on redness of the skin. Only the lumps and blisters improve.

There is currently no drug approved in Germany to treat redness. In stage III of the disease, but also in cases of sudden severe courses (rosacea fulminans) and if the eyes are affected, antibiotics in tablet form (systemic) are used. These include in particular tetracyclines.

However, caution is advised in pregnant women, nursing mothers and small children! Tetracyclines are incorporated into growing bones and teeth and stain them yellow. In the case of severe inflammation, it is possible to use cortisone at short notice.

Normally, cortisone is prohibited in rosacea, but in severe cases it can successfully interrupt the initial inflammatory reaction. Recently, a new type of medication called tacrolimus has been increasingly used.Tacrolimus is actually an immunosuppressive agent, i.e. a drug which reduces the defence reactions of humans. Used as an ointment or cream it helps to reduce the inflammatory reaction of the skin.

Especially in men, rosacea causes a nasal bulb (rhinophyma). Although this is not dangerous, it is very unattractive. It can be reduced by Isotretinoin, a drug developed for acne and other skin diseases.

However, the most effective method is ablation. Depending on your experience, your dermatologist will advise you on different procedures: Firstly, the growths can easily be surgically removed with a scalpel. In addition, there is the possibility of using various types of laser to remove the excess tissue without a blade. Furthermore, the tissue can also be frozen.