Rosacea (rosacea, couperose)

Rosacea is a chro­nic inflamm­a­to­ry skin dise­a­se that pri­ma­ri­ly affects the face. It typi­cal­ly occurs in midd­le age and affects women more often than men, with men often show­ing more seve­re cour­ses. Around two to five per­cent of the popu­la­ti­on are affec­ted, espe­ci­al­ly peo­p­le with fair skin. The exact cau­se is not ful­ly unders­tood, but seve­ral fac­tors play a role: gene­tic pre­dis­po­si­ti­on, dys­re­gu­la­ti­on of the immu­ne sys­tem, hyper­sen­si­ti­ve blood ves­sels in the face, increased num­bers of Demo­dex mites on the skin and a dis­tur­bed skin bar­ri­er. Various trig­ger fac­tors can trig­ger fla­re-ups: Heat and cold, sun expo­sure, hot drinks, spi­cy food, alco­hol, stress, cer­tain skin care pro­ducts and phy­si­cal exer­ti­on. A distinc­tion is made bet­ween dif­fe­rent sub­ty­pes: Ery­the­ma­tous-telean­giec­ta­tic rosacea shows par­oxys­mal or per­ma­nent facial red­ness and visi­ble dila­ted veins. Papul­opus­tu­lar rosacea is cha­rac­te­ri­zed by inflamm­a­to­ry papu­les and pus­tu­les, simi­lar to acne, but wit­hout black­heads. Glan­du­lar hyper­pla­s­tic rosacea leads to skin thi­c­ke­ning, the most well-known being rhi­no­phy­ma, a bul­bous thi­c­ke­ning of the nose that occurs almost exclu­si­ve­ly in men. Ocu­lar rosacea affects the eyes with red­ness, dry­ness and bur­ning. The dia­gno­sis is made cli­ni­cal­ly based on the cha­rac­te­ristic appearance and loca­liza­ti­on on the face. Tre­at­ment depends on the sub­ty­pe and seve­ri­ty: avo­id­ance of trig­ger fac­tors is essen­ti­al. Topi­cal pre­pa­ra­ti­ons such as metro­nid­azo­le, azelaic acid or iver­mec­tin are used for mild forms. Oral anti­bio­tics in low doses have an anti-inflamm­a­to­ry effect in papul­opus­tu­lar forms. Laser the­ra­py is effec­ti­ve for red­ness and dila­ted veins. It is important to use appro­pria­te, mild skin care with pH-neu­tral, fra­grance-free pro­ducts and con­sis­tent sun protection.