Affecting more than 415 million people globally, rosacea is a common skin condition, although a poorly understood one. The face and eyes are primarily affected, and the condition is often mistaken for being an 'adult acne'. According to a National Rosacea Society survey, close to 95% of patients know next to nothing about the signs just before being diagnosed. So, what are the types of rosacea and how different are they from acne? And, what's the role of your DNA in all of this?
Dating back to the 14th century, Rosacea was first called 'goutresse’, by a French doctor because of the facial redness it caused. The condition is now known to be chronic and inflammatory. There are different types of rosacea, most often accompanied by swollen red bumps and small visible blood vessels.
Since the condition mostly affects the face, they’re often mistaken for acne, eczema, or allergy. It predominantly known to affect females, especially when they are between 30 and 50 years of age. Those of European ancestry are also at a higher risk for the condition.
Rosacea is kind of an umbrella term that covers the four different subtypes:
|Erythematotelangiectatic rosacea (ETR)|
Symptoms: Facial redness, flushing, and visible blood vessels.
|Papulopustular (or acne) rosacea|
Symptoms: Acne-like breakouts, swelling, and redness.
Symptoms: Thickening and redness, mostly on the nose. Often co-exists with other types.
Symptoms: Redness in the eye, along with irritation and swollen eyelids.
Before taking up a certain course of treatment, dermatologists often look for common triggers that cause a rosacea flare-up. The common triggers are:
Genetic factors have been shown to play a role in increasing the risk of the condition. Since the most apparent symptoms are redness and inflammation of the skin, rosacea could be caused by genes associated with blood vessel abnormalities and immune reactions. Rosacea is caused by mutations in two gene families:
The HLA genes, primarily involved in immune function, help the body in distinguishing foreign proteins from the body’s own. Variations in these genes have also been linked to rosacea symptoms - when the immune system misdirects the response, causing inflammation of the blood vessels.
The proteins encoded by the GSL gene family help in protecting cells from oxidative damage - for example, the ones caused by exposure to sunlight and UV rays. Mutations in this gene complex could affect its efficiency in protecting skin cells, leading to rosacea.
A genome-wide study that analyzed over 20,000 individuals with European descent was able to set forth a genetic basis to Rosacea. In this preliminary study, volunteers who were in the ‘cases’ group having answered yes to rosacea symptoms, were tested for genetic variation. One variant was found to be associated with disease occurrence, and this is located between two genes - HLA-DRA and BTNL2. The variant was found to influence the inflammatory response associated with rosacea.
A coincidental finding of this study was that variations in the HLA gene were also related to symptoms of diabetes and celiac disease, giving a suggestive link that rosacea may act as a visual cue to another underlying disease.
It is easy to misdiagnose rosacea for acne, but there are several subtle differences:
|Trigger||Organs affected||Risk group||Treatment|
- Spicy food
|- 30+ years|
- Men (severe form)
|- Topical solutions|
- Laser therapy
|Ance||- Hormonal imbalances|
- Young adults
|- Topical solution|
- Chemical peels
There is no direct diagnosis for this condition. The main indicator of rosacea is that the redness is contained to the face or the presence of enlarged blood vessels on the face.
I. Preliminary diagnosis:
The preliminary diagnosis occurs with a physical examination of the face. If there is scarring elsewhere (like on the scalp), or if the doctor suspects another medical condition, like lupus, blood tests would be ordered.
II. Clinical tests:
Other clinical tests would also be performed to rule out other confounding conditions like psoriasis or eczema. If the symptoms include the eyes, consultation with an ophtlamologist may be required.
Several foods could trigger flare-ups. It is preferred that these are limited or avoided:
Foods that reduce inflammation, healthy fats, probiotics, and fiber-rich foods may be able to help or reduce the severity of some rosacea symptoms. These include:
People with rosacea may develop really sensitive skin, that could be easily irritated by the wrong choice of cleansers, creams, and makeup. Some common triggers:
Rosacea could become severe if left untreated. However, most treatment practices help in managing symptoms. The course of treatment usually differ based on the types of rosacea.
It is important to note that rosacea is a chronic condition and so these treatments only help in reducing the intensity of the symptoms.
There are a lot of DIY/home remedies to manage rosacea:
In all, the many types of rosacea are chronic and inflammatory that requires intensive care and a strict diet and skincare regime. The exact cause of this condition is unknown, and maybe there could be a link between rosacea and other underlying diseases, but that can only be determined through more studies. Currently, there is no treatment, however, symptoms can be managed.
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