What is rosacea? How is it diagnosed?

  Rosacea, also known as rosacea, is a chronic inflammatory skin disease that occurs in the midface. Rosacea occurs in middle-aged adults and is more common in women than in men, but the condition is milder than in men. The exact cause of rosacea is unknown, but it is associated with increased vascular reactivity. Alcohol and spicy stimulating foods can cause capillary dilation, certain cosmetics can also cause aggravation of symptoms, and facial creeping mite infection is also an important factor.  Clinically, the disease can be divided into 3 phases: the erythematous phase, the papulopustular phase, and the nasal flaccid phase.  During the erythematous phase, symmetrical erythema and capillary dilation may appear in the middle of the face, including the nose, cheeks, forehead, and jaw. It can be aggravated by the stimulation of the above factors and the patient may have a local burning sensation. In the papulopustular phase, papules and pustules appear on the basis of erythema, and capillary dilation is more obvious. In the nasal flaccid stage, hyperplasia of the sebaceous glands and connective tissue of the nose leads to enlargement of the nasal tip. Often, rosacea can be associated with acne and seborrheic dermatitis, and the eyes can also be red and itchy.  The diagnosis of rosacea needs to be differentiated from acne, seborrheic dermatitis and hormone-dependent dermatitis, especially hormone-dependent dermatitis caused by the long-term topical application of glucocorticoid-containing creams or cosmetics on the face, which has symptoms very similar to rosacea.  Patients with rosacea should pay attention to avoid spicy and stimulating food, tobacco and alcohol, emotional abnormalities, and proper rest. The disease can be treated with oral antibiotics such as minocycline, doxycycline and azithromycin, and topical metronidazole, benzoyl peroxide and retinoic acid. For capillary dilatation and erythema, laser treatment can be used, and severe nasal redundancy requires surgery, electrodesiccation, and other treatments. In recent years, with the understanding of skin barrier function, the addition of moisturizing emollients to patient treatment can effectively reduce symptoms.