Acne erythematosa

Rosacea is a chronic dermatosis that belongs to the vasomotor nerve of the skin. It is a medical and aesthetic problem of about 10% of the population, aged 30 to 55, mainly people with I or II skin phototype, with light eyes and hair. In 80% of patients with this dermatitis, the main symptom is the occurrence of vascular lesions, such as erythema and telangiectasias. In 20% of the remaining cases there are clumps and pustules, as well as the development of soft tissue hypertrophy and the occurrence of so-called "PhyM."

The etiopathogenesis of the disease is complex. The most common reasons include:

1) vasomotor disorders - increased response of blood vessels to nerve stimuli triggered by external factors such as:
- UV radiation: being in the sun, solarium,

- high temperature: hot baths, sauna,

- weather conditions: wind, frost, high humidity, temperature fluctuations,

- received foods: hot drinks, spicy foods, alcohol,

- topical medications: corticosteroids,

- cosmetics containing alcohol, acetone, menthol,

- stress;

2) hormonal disorders:
- dependence in women on the phase of the menstrual cycle,

- exacerbation during climacteric period,

- intensification after gestagenic contraceptives;

3) gastrointestinal disorders:
- frequent occurrence of gastritis, chronic constipation, hypoacidity,

- exacerbation of skin lesions after dietary mistakes,

- Helicobacter pylori infection causes exacerbation of vascular lesions;

4) infection with demodex Demodex folliculorum intensifies inflammation on the skin;

Stages of disease:

1) prerosacea - so-called vascular skin: with a predominance of blush, no obvious telangiectasias,

2) vaso-erythematous phase:
- intensive, violent, periodic facial redness under the influence of physical or emotional stimuli - it takes about 10 minutes,
- permanent dilatation of blood vessels (telangiectasias),
- symptoms associated with redness: burning pruritus, excessive warming of the skin;

3) maculo-pustular (inflammatory) phase:
- papules and pimples on the erythematous base,
- chronic swelling of the skin,
- may be accompanied by chronic conjunctivitis, blepharitis and cornea;

4) hypertrophic phase:
- in men only,
- connective tissue hypertrophy of the soft parts of the face (phyma), most often the nose (rhinophyma);


The rosacea therapy is long-lasting and depends on the phase of the disease. The most commonly used are:

Local treatment:

1) antibiotics (erythromycin, clindamycin),

2) metronidazole (e.g., Rozex),

3) ichthyol (in 1-10% toothpastes) - reduces skin congestion, has anti-inflammatory properties,

4) sulfur (in suspensions 1-5%) - has bactericidal, fungicidal, anti-seborrhoeic and keratoplastic properties,

5) resorcinol (in solutions of 1-3%) - disinfecting, keratoplastic, anti-seborrhoea,

6) azelaic acid - has antibacterial and keratolytic properties, inhibits melanogenesis by brightening post-inflammatory discolorations,

7) retinoids - normalize the process of exfoliation in the ducts of the sebaceous glands, facilitate the evacuation of sebum, reduce the inflammatory reaction,

8) macrolides with immunomodulatory effects (Elidel, Protopic);

General treatment:

1) antibiotic therapy:
- used in the papulo-pustular phase,
- the main antibiotics are tetracyclines and macrolides,
- goal of treatment: anti-inflammatory effect, reduction of intestinal microbes that produce toxic metabolites,
- long-term treatment, often requiring repetition;

2) metronidazole:
- in the form of tablets or suppositories,
- there is no tide for erythema and capillaries,
- goal of treatment: anti-inflammatory, antibacterial and antiprotozoal effect, reduction of D. folliculorum population;

3) retinoids - isotretinoin:
- severe forms of rosacea;

4) supportive medicine:
- vitamin PP,
- beta-blockers - reduce episodic erythema depending on emotional factors,
- sulphones (e.g., Dapson, Disulone),
- H. pylori eradication

Treatment Facility:

1) laser / IPL treatments:
- especially recommended in the erythema-vascular phase (method of choice),
- they cause closing teleangiectasia, reduce erythema,
- prolong periods of remission;

2) CO2 laser therapy:
- removal of hypertrophic changes (phyma);

3) cosmetic treatments:
- ionophoresis with vit. C,
- peels from AHA - only low concentrations and short times, the possibility of deterioration of the skin condition in the initial period of treatment; goal: strengthening the walls of blood vessels by affecting the collagen building this wall,
- galvanization treatments, improving lymph outflow and eliminating edema,
- gel strengthening and stimulating masks with vitamin K and C for complexions with dilated capillaries,
- cosmetic masks with algae, with vitamins C and E; 

Skin care:

1) general recommendations:
- protection of the skin against UV - SPF preparations> 30 with a predominance of mineral filters,
- washing face with lukewarm water, using liquid cleaners (based on syndets, without alkaline soaps), not using washers, sponges; gentle drying without rubbing,
- individual selection of care products,
- dermocosmetics that improve the condition of capillaries,
- avoiding a strong massage enhancing vascular play;

2) ingredients of skin care preparations:
- allantoin - soothing properties, accelerates healing,
- D-panthenol - accelerates healing, regulates the water balance of the epidermis,
- mucopolysaccharides - moisturizing effect,
- vitamin C (ascorbic acid) - strengthens the capillary wall by affecting their collagen,
- vitamin PP (nicotinamide) - regulates the diastolic function of blood vessels,
- vitamin K (phylloquinone) - accelerates the resorption of haemorrhages,
- tannins - they seal blood vessels, have anti-inflammatory properties and stabilize vitamin C,
- silicon dioxide - it seals blood vessels, has a green color - use in camouflage make-up;

3) a series of dermocosmetics for vascular skin:
- Avene: Antirougeurs, Dirosea,
- Bioderma: Sensibio AR,
- Iwostin: cream for capillaries,
- La Roche-Posay: Rosaliac,
- SVR: Rubialine,
- Uriage: Roseliane;

The Laser-Medica Center offers:

- full pharmacological treatment,
- IPL (photorejuvenation): closing of blood vessels, reduction of erythema,
- procedurei jonoforezy z witaminą C,
- iontophoresis treatments with vitamin C,
- delicate AHA peels, cavitation peeling:
a) specific cosmetic treatment,
b) Xylogic anti-redness,
c) Rubo-derma,
- CO2 laser therapy - hypertrophic changes;