Rosacea: what it is and why it belongs in the HOF history
Quick facts
- Definition
- Chronic inflammatory skin disease of the face, with persistent redness, visible vessels and, at times, acne-like lesions.
- Typical location
- Center of the face: cheeks, nose, chin and forehead.
- Common triggers
- Heat, sun, alcohol, spicy food, stress and irritating products.
- Relevance in facial harmonization
- Reactive skin may respond to procedures with more erythema and swelling; the diagnosis is medical and the medical history should ask.
Rosacea is a chronic inflammatory skin disease of the face that usually appears from adulthood on. Its typical picture involves persistent redness in the center of the face, easy flushing, telangiectasias (visible fine vessels) and, in some forms, lesions similar to acne. Diagnosis and treatment of the disease are medical.
What are the forms of presentation?
Rosacea does not look the same in everyone. The subtypes described in the literature range from predominantly vascular to inflammatory lesions:
| Form | Predominant signs |
|---|---|
| Erythematotelangiectatic | Persistent redness, flushing, visible vessels |
| Papulopustular | Papules and pustules in the center of the face |
| Phymatous | Thickening of the skin, most common on the nose |
| Ocular | Red eyes, gritty sensation, dryness |
Subtypes can coexist or evolve over time. The stage of the disease (controlled or flaring) is as important as the subtype for planning.
Why does this matter for the medical history?
Skin with rosacea tends to have an altered skin barrier and reactive vessels. It may respond to needle punctures, heat and manipulation with more erythema, swelling and sensitivity than skin without the disease. Some thermal procedures, such as intense pulsed light and fractional laser, have specific indications and precautions in this condition.
That is why the medical history should ask about rosacea, about treatments in use (such as topical and oral medications) and about recent flares. It is also useful to ask what triggers the redness. With skin in an active phase, the most prudent approach is to postpone elective procedures and coordinate with the physician who follows the patient.
How to handle a patient with rosacea?
The central point is expectation. The patient may be self-conscious about the look of their skin and expect the procedure to improve the redness. Fillers and toxins do not treat rosacea. The explanation should be clear, without discouraging what is feasible or promising what is not.
In patients with controlled rosacea, the plan usually prioritizes gentleness, short follow-up visits and guidance on avoiding triggers in the following days, such as excessive heat and sun exposure.
Also called: acne rosacea (an old and imprecise name), couperose (popular term for visible vessels).
Frequently asked questions
Can someone with rosacea get filler or toxin?
Rosacea alone does not rule it out, but it calls for an assessment. The skin is reactive and the stage of the disease matters. During an active phase, it is best to postpone and coordinate with the physician in charge of the treatment.