Couperose (or rosacea) is a dermatological disease that mainly affects women from 30-40 years old. It causes redness on the face (nose, chin, cheeks). Laser, antibiotics, creams… Update on treatments and advice to prevent rosacea.
Couperose or rosacea is a dermatological condition mainly localized on the face at the level of the nose, cheeks and chin. It is manifested by redness which may be accompanied by other symptoms. Some factors such as consumption alcohol or exposure to sun aggravate the effects of rosacea. From most effective treatments, we can turn to the laser to reduce the signs of rosacea. What triggers couperose? Does couperose get cured? What are the treatments ? Causes, photo and tips to prevent it.
Definition: What is rosacea?
Rosacea is a vascular abnormality that is characterized by redness on the cheeks, nose, forehead and chin. When the disease progresses, this redness can become permanent and be accompanied by dilated vessels (rosacea) on the cheeks and sides of the nose, as well as red pimples. It more often affects women between 40 and 50 years oldindividuals are more likely to fair skin, eyes and hair. The physiological explanation of the phenomenon is not well known, but it would be a disorder in the blood vessels of the face. It’s about a active skin disease. The disease can progress through several stages in an inconsistent manner.
What are the causes of rosacea?
There is a predominant vascular phenomenon which involves the alterations of the small vessels probably partly genetically determined. “The alcohol, often implicated in the genesis of rosacea, is in fact not involved in its occurrence. It can just be a vessel vasodilation cofactor, making rosacea more visible” explains Dr. Marie Estelle Roux, dermatologist in Paris. “On the other hand, theSun exposure would be largely implicated in its aggravation.”
Photo of couperose on the face
What are the symptoms of rosacea?
Initially, rosacea can begin with phenomena of sudden successive outbreaks of redness of the face and neck with a hot flushes, we speak of skin flushes or vasomotor flushes. In a second time, a diffuse and permanent redness mainly affecting nose and cheeks settled. Sometimes the evolution is towards the presence of inflamed-looking skin elevations : this is the characteristic stage of rosacea. In its most intense form and which almost touches exclusively men, it can progress to rhinophyma, characterized by a red, enlarged nose with thickened skin. Rosacea can be accompanied by a associated ocular rosaceawith symptoms similar to those of conjunctivitis:
- Redness on the face
- Dry, sensitive skin, burning sensation
- Increased redness due to emotion or change in temperature
- Appearance of papules or pustules on the nose, cheeks, forehead and chin
- Dry, red and irritated eyes
Who is most affected by rosacea?
Children are very rarely affected by rosacea, which affects the vast majority of children. adults between 30 and 50 years old. Women are more often prone to it than men since there are two women with rosacea for every single man, and light phototypes (light skin, light eyes) are more sensitive to rosacea. Finally, the condition is hereditarypeople with affected parents are more likely to suffer from it too.
What are the risk factors for rosacea?
Certain factors increase the risk of the appearance of rosacea in predisposed people. This is particularly the case:
- From prolonged exposure under the sun ;
- Of temperature change ;
- From the consumption of hot drinks, spices or alcohol;
- Hormonal variations: pregnancy, menopause;
- Strong emotions: Stress, anger;
- From a grip of corticosteroids.
In the case of rosacea, the diagnosis is clinical. Just go to a doctor or dermatologist, which will establish a diagnosis through a skin examination and an interrogation. In case of doubt with other diseases, one can carry out a skin biopsy.
What are the treatments to cure rosacea?
In less advanced forms, certain anti-parasitic creams, can relieve the person of the symptoms felt, or sometimes reduce the redness. “In more advanced forms (with papules), a parasite called demodex follicularum is often incriminated, and the use of local antibiotics may be effective” explains Dr. Roux.
► At the stage of permanent rosacea, specific techniques such as electrocoagulation or laser sometimes have good results. Electrocoagulation acts on rosacea, requires several sessions and can lead to bleeding, redness and the formation of small crusts. This technique is gradually being abandoned and replaced by the laser. The laser, less painful than electrocoagulation, is today the reference treatment for rosacea. having only an aesthetic aim, laser sessions are not covered by health insurance. Rhinophyma can also be treated with laser.
► Drug treatments:
- Antibiotics : most often, a cream based on metronidazole or clindamycin is prescribed. When rosacea is extensive or causes inflammation of the eyes, the practitioner can prescribe an oral antibiotic (cyclins) for three months.
- Azelaic acid : in cream or gel to be applied locally, it helps to reduce the number of pustules and reduce redness.
- Oral isotretinoin : used as a second-line treatment for severe forms of rosacea, such as phymatous rosacea or appearance of papules, pustules or nodules resistant to other treatments.
- Topical ivermectin treatment in the form of a cream is available in pharmacies on prescription. This treatment is an anti-parasitic that helps reduce papules and pustules, as well as inflammatory redness.
You cannot really prevent rosacea, but you can avoid the aggravation or too frequent repetition of certain symptoms by adopting certain daily actions: avoiding drinks and dishes that are too hot or too spicy, alcohol, products that irritate the skin, and vasodilating drugs (high blood pressure).
► If you must be exposed to the sun, do it before 11am and after 4pmand protecting your skin with a high factor cream to prevent sunburn.
► Limit certain foods and drinks which contribute to the dilation of the vessels and the appearance of rosacea: coffee, hot drinks, alcohol, spices…
► In periods of extreme cold, wind or snow, protect your face with warm clothing.
► Learn to relax: stress and strong emotions can be aggravating factors rosacea.
► Avoid saunas and hot baths extended.
► Do not wash your face with hot water: prefer lukewarm water.
► Avoid washing products containing alcohol or acid: if in doubt, ask your pharmacist.
► Avoid creams that are too greasy, and if possible choose a cream suitable for skin prone to rosacea.
► Beware of vasodilator drugs (in treatment of arterial hypertension in particular) likely to aggravate the phenomenon.
Thanks to Dr Marie Estelle Roux, dermatologist in Paris,