Rosacea is an often overlooked, but very serious condition, with uncertain etiology and dangerous possible complication if left untreated. Rosacea can lead to eye complications or facial disfigurement as it evolves in stages and its evolution time cannot be exactly known. The first stage is facial flushing then erythema, edema and ocular symptoms occur; in the third stage pustules and papules are likely to appear causing a hideous aspect of the face. In the last stage the permanent enlargement of the nose is present called rhinophyma.



The most blamed causes for triggering the apparition of Rosacea symptoms are sun exposure, alcohol, cold weather and hot or spicy beverages. A first condition for ameliorating the symptomatology is to avoid all of these factors. The most efficient therapy for Rosacea seems to be the use of topical antibiotics although for patients with advanced stages of the disease or for those with rhinophyma, the only possible escape seems to be the laser intervention.

All family physicians must be acquainted with identifying, diagnosing and treating usual forms of Rosacea and send the patients to specialists only in case of complications or rhinophyma.

Very little is known about the epidemiology of Rosacea; we know that it is likely to occur between the ages 30-50 especially in fair-skin persons of north European origin and that women patients are 2-3 times more susceptible to develop it than men. Many Rosacea cases remain undiagnosed until late stages due to the patients that do not see a doctor to explain their symptoms or due to doctors that are insufficiently trained and cannot recognize the condition. Mostly exposed to rhinophyma are usually men. In USA the incidence of the disease seems to increase rapidly.

The inflammatory process due to Rosacea is caused by a series of chemical, physical and emotional factors all contributing to the exacerbation of the condition in some point. Recent studies believe to have found a link between Rosacea and Helicobacter pylori, migraine headaches and even the face mite Demodex folliculorum.

The most dominant symptoms of first stages Rosacea are intermittent facial flushing, erythema and an occasional stinging pain. The embarrassing flushing episodes can occur in social environment with no possible explanation or linked to chemical, food or emotional causes. Many patients especially men, are looked at as potential Alcohol consumers as rhinophyma tends to be associated with high amounts of alcohol consumed.

The products known as high complicating factors of the Rosacea symptoms are sun exposure, emotional distress, hot/ cold weather, alcohol, spicy food, exercises, wind, hot baths, hot drinks and some skin care products.