Rosacea: Unsightly skin disease with a pretty name

By Christiane Loell Sep 6, 2010, 4:06 GMT

Berlin - The name may be pretty but the condition is not. The skin disease rosacea can be very distressing to the people it affects, who have extremely red cheeks and acne-like pimples, pustules and papules.

'While acne usually appears in adolescents, rosacea typically occurs after 30 or 40 years of age,' noted Klaus Fritz, an executive board member of the Professional Association of German Dermatologists.

'The causes of this chronic, inflammatory, non-infectious and benign disease are still not fully known,' said Harald Gollnick, director of Magdeburg University's dermatology and venereology clinic. Dermatologists suspect a facial skin circulatory disorder aggravated by both internal and external irritants.

According to experts, microscopic mites found in hair follicles and known as Demodex folliculorum are involved in rosacea. Many people have these mites but they are particularly plentiful in rosacea sufferers.

Among the common triggers for rosacea are alcohol - both ingested and in skin care products - high blood pressure and blood pressure medicines, spices and spicy foods. Ultraviolet A (long-wave) and B (medium-wave) radiation as well as infrared radiation are also triggers, Gollnick said.

Although rosacea is a benign condition, people with persistently flushed cheeks should see a doctor. 'You must rule out other possible diseases,' he said.

Either topical or oral medications are used to treat rosacea, depending on how far the disease has progressed. 'The best tested medication is metronidazole, which can be applied as a cream, lotion or gel,' Gollnick remarked. Another popular medication is azelaic acid in gel form. To kill Demodex mites, permethrin cream can also be used, he added.

In severe cases of rosacea, low dosages of the oral antibiotic tetracycline are prescribed for a period of time. Cortisone, which is used to treat a number of skin diseases, should not be used for rosacea, however.

'It can bring about improvement initially, but the rosacea worsens, sometimes dramatically, when it is discontinued,' Fritz warned.

The only way to take direct action against the visible small blood vessels characteristic of rosacea is laser surgery. Some patients look for alternative therapies in addition to those offered by conventional medicine.

'You can judiciously try different things but there's little conclusive evidence that the therapies are effective,' noted Bernhard Uehleke, research coordinator for the department of natural medicine at Charite University Hospital in Berlin.

Uehleke said that a small-scale trial in which rosacea patients' cheeks were treated with healing earth had mixed results. 'Some couldn't tolerate the treatment, while others did, in fact, see improvement of their symptoms.'