Rosacea is a chronic inflammation of the central face characterized by flare-ups, flushing, erythema, telangiectasia, lesions with papules/pustules and possible remission and relapse conditions. It has been conventionally defined by a certain age (generally adult onset) or period for its occurrence but as we have seen in many cases there is no typical age for its occurrence. It also has been correlated with certain ethnic background and skin types particularly fair skinned people but now it is found affecting people of all different backgrounds and skin of color people. In fact, diagnosis of rosacea is very challenging and difficult in skin of color. The underlying cause of rosacea includes aberrant immune system, environmental factors, genetics and most importantly microbial flora of our skin. Sometimes only one factor predominantly plays its part and sometimes all the factors play together to cause an inflammatory response in rosacea. It mostly affects women but sometimes causes very severe form in men in cases of rhinophyma. Rosacea is a condition which in some cases co-exists with other skin conditions and ocular manifestations and may present comorbidities with other parts of the body especially correlating with intestinal inflammation. There are further theories with this condition and more yet to explore which needs further investigation into rosacea research.
According to the classification based on phenotypical characteristics, we will explore the characteristic patterns of each phenotype going deeper into skin.
Flushing in Rosacea [Phenotype 1] :
Flushing is usually but not always the earliest sign of rosacea which is marked by the redness of the skin with persistent episodes. Though the redness is caused by the dilation of the blood vessels beneath the skin, however, in its initial level, the early signs of flushing do not show the typical visible blood vessels appearing immediately. Flushing is characterized by a sudden feeling of warmth, tender, stinging, dry and itchiness of the skin. In this stage you can see your pores are very little enlarged contrasting to its natural state and are restored to its natural state when the flushing disappear. It depends on its frequency and comes and goes on its own but with physical responses such as stress and stress of their own flushing, anxiety, fear and other emotional states, it prolongs its time to disappear. Some people only show the flushing condition and never develop the other phenotypes of rosacea but for some people it is the onset and early sign of rosacea which furthers down to other phenotypes appearing at later stages. We will consider the other phenotypes later to delve into a deeper understanding of rosacea.
You can read earlier post on phenotypes to know about characteristics and other information.
Written and Illustrated by Apurva Tathe