April is Rosacea Awareness Month and we feel that it is important to keep you informed about this commonly misunderstood condition that affects approximately 14 million Americans every year.
Understanding rosacea is a continuous process. Only within the last several years has rosacea been classified into four subtypes, and research brings us more information all the time. Only a physician can make a diagnosis, but it is important for the skin care clinician to be able to recognize these various presentations in order to educate the patient and make an appropriate recommendation to a physician.
Rosacea cannot be cured, only controlled, so it is important for the rosacea patient to understand what triggers this condition. Heat, spicy foods, hot showers or hot tubs, certain types of cosmetics or extremes in temperature are some of the triggers that should be avoided.
- Subtype 1 – erythematotelangiectatic rosacea is characterized by persistent redness within the central portion of the face, with possible telangiectasias (visible capillaries). The patient will become red or flushed easier and stay red longer.
- Subtype 2 – papulopustular rosacea is characterized by persistent redness in the same area as Subtype 1, with lesions that resemble papules and pustules. This subtype is commonly referred to as “acne rosacea” because of its presentation, but absolutely cannot be treated in the same manner. Only a physician can make a proper diagnosis, but it is important for the clinician to be able to differentiate between this subtype and acne in order to treat it properly. Acne will typically present on all areas of the face and is commonly accompanied by comedones or cysts. In the case of Subtype 2 rosacea, the breakouts will present within the inflamed areas. Also, the papules and pustules present with Subtype 2 rosacea tend to be dry and scaly; extractions will not produce anything and should be avoided altogether.
- Subtype 3 – phymatous rosacea is characterized by a thickening of the skin, most commonly seen on the nose (rhinophyma), but can affect other areas of the face, such as the glabella and chin. This type of rosacea presents mostly in men and may be treated surgically.
- Subtype 4 – ocular rosacea affects the eye area, and includes symptoms such as eye irritation, conjunctivitis (pink eye), blepharitis (inflammation of the eyelids), frequent styes, itching, burning and stinging of the eyes. This type of rosacea is often misdiagnosed and, if left untreated, can lead to blindness. For this reason, it is very important to educate all rosacea patients about this type of rosacea so that they can keep their physician informed should they begin to experience these types of symptoms.
While rosacea can worsen if left untreated, it does not necessarily progress from one subtype to the next. Many patients can have Subtypes 2 and 3, or Subtypes 1 and 4. What’s more is that many people have rosacea and don’t even know it. For more information, go to www.rosacea.org.