Red cheeks and nose may be a triggering factor and suspicious symptom of rosacea

Red cheeks and nose with obvious raised particles are not necessarily acne. There is a chronic skin condition called rosacea that has some symptoms similar to acne.

Red cheeks and nose may be rosacea

Rosacea, also known as rosacea, is a chronic inflammatory skin disease characterized by erythema and dilated capillaries that occur primarily in the central part of the face. It is more common in middle-aged people aged 30 to 50, especially in women. The cause is not yet fully understood. It may be due to the action of various harmful factors inside and outside the body on the basis of sebum secretion, which causes the vasomotor nerve dysfunction and long-term dilation of capillaries in the affected area. Trichocystis and repeated local infection are important factors for the onset of the disease. Alcoholism, smoking, spicy diet, gastrointestinal dysfunction, endocrine dysfunction (especially during menopause), mental factors, lesion infection, and long-term exposure to hot and cold factors on the skin such as high-temperature work, sun exposure, cold, wind, etc. can all induce and aggravate this disease.

Clinical manifestations

The disease is prone to occur in the middle part of the face, mainly on the tip of the nose and the wings of the nose, followed by the cheeks, chin, and forehead. It is often distributed symmetrically and is more common in middle-aged people, especially women. Patients often have seborrhea, and their faces look like they are covered with fat. Skin lesions manifest as erythema, telangiectasia, and inflamed follicular papules and pustules. The disease progresses slowly and can be divided into three stages without clear boundaries. It is divided into 3 stages: erythema stage, papule stage, and hypertrophic stage.

1. Erythema and telangiectasia stage

Erythema appears in the middle of the face, especially the nose, cheeks, between the eyebrows and chin, and is symmetrically distributed. The erythema is temporary at first. The face becomes flushed and congested, and there is a sense of burning sensation when eating spicy food or hot drinks, when the ambient temperature rises, or when emotional impulses occur. After repeated attacks, superficial dendritic capillary dilation occurs on the nose wings, nose tip and cheeks, and localized persistent redness occurs, often accompanied by enlarged nasal hair follicles and sebum secretion.

2. Papular stage

On the basis of erythema and capillary dilation, acne-like follicular papules and pustules appear repeatedly. When the lesions are deep and large, they form boils, cysts, and deep inflammatory nodules. The openings of the hair follicles on the nose and cheeks may enlarge, and may come and go over the course of several years, sometimes mild and sometimes severe. In middle-aged women, the rash often worsens before menstruation.

3. Hypertrophy stage

Also known as the rhinoplasty stage. It is only seen in a small number of patients, mostly in men over 40 years old due to long-term congestion, repeated infections, hyperplasia of nasal connective tissue, abnormal enlargement of sebaceous glands, hypertrophy of the nose tip, and dark red or purple-red color. There are enlarged nodules on the nose, which are uneven on the surface and form a tumor-like shape called nasal polyps.

In addition to skin manifestations, the eyes are often affected. The clinical manifestations are blepharitis, conjunctivitis, and occasionally keratitis and scleritis. Patients may experience dry eyes, foreign body sensation, tearing, photophobia, blurred vision, etc. There is no parallel relationship between the symptoms of eye involvement and the severity of rosacea symptoms.

In addition to the above symptoms, there are some special types of rosacea, such as steroid rosacea, which is caused by long-term local use of corticosteroids, which leads to thinning of the skin, aggravated capillary dilation, and the surface is inlaid with cystic, round, deep-located papules or pustules, and nodules. The skin is dark red and the patient feels uncomfortable and painful. Granulomatous rosacea is a special type of rosacea that often occurs on the face and around the mouth, forming butterfly-shaped nodules that appear as yellow-brown or jam-colored nodules when pressed on a slide.

How can people distinguish rosacea from these two common skin problems?

Often occurs in people with fair skin

The symptoms of rosacea in the early stages are very similar to common skin problems such as acne and eczema, but it is less common in Asian groups. This tends to happen more often in people with fair skin and prone to facial redness. Dr. Ranner also said that women are more often diagnosed, but more severe symptoms occur in men.

In addition, since the initial symptoms are very similar to those of acne and eczema, many times the disease is discovered only when the condition does not improve or becomes more severe after patients have received corresponding treatments for these two more common skin problems, such as persistent burning and itching, and obvious microvessels appearing on the surface of the skin. However, the disease progresses very slowly and is often mistaken for other common skin problems such as acne and eczema, and most patients are therefore not diagnosed until after the age of 30.

Differentiating between rosacea, acne and eczema

Rosacea

Common Locations: Can occur in the cheeks and nose area, where blood circulation is best.

Common symptoms: Generally, there will be persistent redness and raised pimple-like particles, but no blackheads. In severe cases, there may be persistent burning, stinging or itching, and micro-vessels may appear on the surface of the skin.

acne

Common Locations: It can occur anywhere on the body including the chest and back, but is more common on the oily areas of the face.

Common symptoms: Usually red, raised pimples that often have blackheads and pus.

eczema

Common Locations: Can occur anywhere on the face and body, especially in skin folds such as the elbows and knees.

Common symptoms: Small red spots appear on the skin, often causing itching, but generally not raised. In severe cases, inflammation may occur.

Predisposing factors and suspected symptoms

Rosacea triggers may include the following:

Sun exposure

Pressure

Hot weather

●Exercise a lot

Alcohol intake

●Take a hot shower and drink hot beverages

He advises patients to avoid these common causes as much as possible, pay attention to sun protection, and avoid irritating and spicy foods.

Can it be cured?

It is worth noting that in addition to the fact that the exact cause of rosacea is unknown, there is no cure for it. But Dr. Ranna says current treatments can help manage the disease and relieve common symptoms.

In addition, rosacea is not contagious, has no strong genetic factors, and has not yet spread to other parts of the body. General treatment includes topical antibiotics, but in more serious cases, oral antibiotics may be prescribed under the doctor's advice to achieve anti-inflammatory effects and help control symptoms. These oral medications usually need to be taken for several months.

Laser therapy can help reduce persistent facial redness and the appearance of visible capillaries. If the condition is severe enough that the nose becomes deformed and swollen, carbon dioxide laser can be used to reduce the thickening of the skin.