Who does rosacea affect?

The disease usually begins in middle age, between 40 and 50 years. Slightly more women than men are affected, but the growths of the sebaceous glands are much more frequent in men, which is why the men affected suffer more. About 10% of the population in Central Europe is affected. Since the disease occurs almost only in advanced age, the proportion of those affected is much higher in old age. Almost exclusively fair-skinned people are affected.

Symptoms of rosacea

The symptoms of rosacea include redness and the formation of veins. In more severe cases, inflammatory papules and pustules may also occur. More about papules and pustules can be found under our topic Skin changes and rashes with pustules.

In contrast to acne, there are no blackheads next to pus-filled pustules in rosacea. However, mixed forms are conceivable. The middle third of the face (forehead, nose, cheeks) is particularly affected by these symptoms.

Apart from these symptoms, those affected feel healthy. There are therefore no general symptoms such as fever. However, some patients experience considerable psychological stress due to the obvious “disfiguration”.

As different as the individual person may be, the effects of the disease can vary as well. From slight redness of the cheeks to accompanying acne of the entire face. It can also happen that rosacea remains in one of the stages described above.

Rosacea can also manifest itself additionally in the eyes. About 25% of patients are affected. In these cases one speaks of ocular rosacea.

The symptoms include In rare cases ocular rosacea can lead to blindness. Treatment depends on the stage and symptoms. From stage 2 onwards, oral medications can also relieve ocular rosacea.Thus, from this stage on, the eye involvement in rosacea can be positively influenced by certain antibiotics in tablet form.

For example, the treatment with tetracyclines 2 x 250 mg per day shows success. The duration of the intake depends on the active substance. Taking Doxycycline in the above-mentioned dosage for 4 weeks is generally recommended.

The duration of taking Minocycline, in this context, may be advisable for 2 – 6 weeks. Every patient suffering from rosacea should have their eyes examined regularly by an ophthalmologist. Ocular rosacea is not curable, but it can be well controlled by adequate treatment.

Permanently reddened eyes
Foreign body sensation
Burning and itching
Swelling
Photosensitivity
Visual impairment
Drought
Eyelid margin, corneal and conjunctivitis.

Rosacea usually progresses in several stages. In a preliminary stage of the disease, redness (erythema) of the facial skin occurs only occasionally at first, then more frequently. These “flushes” are usually sudden, attack-like and very unpleasant for the sufferer.

In this preliminary stage, the facial skin becomes increasingly irritable and reacts more and more quickly with redness until it finally becomes permanent. In stage I of the disease the skin is already permanently reddened and the irritability of the facial skin increases significantly. For the first time, fine, superficial vascular infiltrations (telangiectasia) appear in the two-dimensional redness.

Increased itching, tightening, stinging or pain must also be expected. The physician calls this stage “rosacea erythematosa-teleangiectatica” because both redness (“erythema”) and vascular ingrowths (“telangiectasia”) occur. In stage II, nodules and pustule appear on the reddened areas.

The changes usually affect the central part of the face and usually occur symmetrically. The longer the disease persists, the more likely it is that the chin, forehead and peripheral areas of the face will also be affected. The physician calls this stage “rosacea papulopustulosa” because lumps (“papules”) and pus blisters (“pustules”) appear.

In stage III, more extensive benign growths of the skin, especially on the nose, occur. The skin appears rough and uneven. The sebaceous glands are enlarged.

This leads to a nasal bulb (“rhinophyma”). The most severe form of rosacea is rosacea fulminans. This is an acute form of rosacea in which severe skin changes develop within a few days, especially nodules and purulent pimples.

The skin is very oily and can be massively inflamed. Almost only younger women are affected by rosacea fulminans. Although the skin changes are very severe, the affected women often do not feel ill, and the unattractive sight is psychologically very stressful. Fortunately, this form of rosacea can be treated quite well and the changes usually disappear when treated without scars. There is also no risk of relapses in rosacea fulminans.