rosacea
ROSACEA
Rosacea is a chronic cutaneous disease of the convexities of the central face (cheeks, chin, nose and central forehead) w/ periorbital and perioral skin sparing. This condition is attributed to chronic vasodilation.
Remissions and exacerbations are common.
It typically appears after 30 years of age but may occur at any age.  It commonly affects fair-skinned individuals.
The common presenting symptoms are facial flushing, stinging/burning erythema, telangiectasia, edema, papules, pustules, ocular lesions, and hypertrophy of the sebaceous glands of the nose with fibrosis.
A history of episodic flushing often heralds onset of rosacea.

Prevention

Aggravating Factors

  • Sun exposure
    • Use sunscreens w/ combined ultraviolet-A & ultraviolet-B w/ a sun-protection factor ≥15
    • Sunscreen formulations w/ Dimethicone & Cyclomethicone may be less irritative
    • Use wide-brimmed hats
  • Hot or cold weather, wind, humidity
    • Stay in air-conditioned room during hot & humid days
    • Cover face w/ scarf & use moisturizer on cold days 
  • Stress
    • Use stress reduction techniques & exercises
  • Exercise
    • Avoid high-intensity workouts that cause flushing & overheating
    • During warm weather, exercise early or late in the day in a cool environment
    • Exercise for shorter, more frequent intervals
    • Place ice chips in mouth immediately following exercise
  • Spicy foods, alcohol, hot beverages, caffeine
    • Identify & avoid foods & beverages that worsen facial redness
  • Hot baths, skin care products
    • Avoid hot water
    • Use hypoallergenic, non-irritating, noncomedogenic skin products & avoid heavy cosmetics
    • Apply soap-free cleansers, silicone facial foundations & film-forming moisturizers
    • Men may benefit from use of electric razor 
  • Medication
    • Avoid use of topical corticosteroids on the face: Fluorinated topical steroids produce rosacea-like syndrome while non-fluorinated low-potency steroids may worsen preexisting rosacea & delay the resolution of flare-ups from steroid use
    • Avoid medications that may aggravate flushing (eg vasodilators, Nicotinic acid, amyl nitrite, calcium antagonists, opiates)
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