Rosacea is a chronic disease which develops gradually in middle and advanced age. It is limited to the face affecting the flush areas of the central part of the face, especially the lower part of the forehead, the nose, the cheeks and the chin. As the name indicates, it is characterized by a special redness.

In the beginning, flushing appears under certain circumstances such as emotional stress, exposure to intensive cold, heat, the sun’s rays or after alcoholic drinks; this flushing lasts longer than usual. In due course, the hyperemic state tends to persist and eventually becomes permanent. It varies in the intensity, with individuals and different times, from pinkish to dull-red.

Simultaneously or later, the blood vessels become dilated. The telangiectasia presents an important feature of the disease, and often dominates the clinical picture. Acne lesions develop frequently on seborrhoeic soil. The follicular openings are prominent, but acne lesions of the popular, indurated pr pastular type may appear without originating from comedones.

In acne rosacea, infiltration and hypertrophy may increase considerably, particularly on the nose. In men, a clinical picture develops which is called rhinophyma. The nose is enormously enlarged and often lobulated. The pores are widened and oily masses can be readily expressed. Ocular involvement is not rare; it is seen as blephartitis, conjunctivitis or keratitis.

Rosacea is an example of multi-causal dermatitis. Many factors precipitate the disease, such as atmospheric influences, exposure to cold, heat, strong sunlight, gastro-intestinal troubles, dietetic errors, excessive consumption of hot and strong tea, coffee, alcoholic drinks, pelvic and menstrual disturbances in women and emotional stresses.

The psychogenic factor plays a significant role not only in aggravating but also in causing the disease. Women are more frequently affected than men. Patients complain of sense of heat, quick temper and easy excitability.

Diagnosis: It is generally not difficult, and is based upon the following features: (A) Age- middle age, usually after 30 years of age, (B) Distribution- central part of the face, (C) Seborrhoeic skin, (D) Redness, telangiectasia and acneinform lesions without blackheads.

It is distinguished from acne vulagaris by the age of the patient, the lack of comedones, the presence of telangiectasis and the limitation of the disease to the central part of the face. Some patchy lesions may resemble lupus erythematosus, but the absence of infiltration; hyperkeratosis and atrophy help to eliminate lupus in the differential diagnosis. It is a chronic disease with a tendency to progressive aggravation.

Treatment: It should be treated both internally and locally. The systematic treatment aims at correcting the causes. The diet should be light and simple. Foods like hot tea, coffee etc. which causes flushing of the face should be strictly avoided. Vegetarian food is encouraged.

Exposure to sudden alterations in temperature should be minimized. Every effort should be made to relieve nervous tension. In local treatment, dilated vessel can be successfully obliterated by superficial electrodessication or injection of 25 p.c. saline into the vessels with a very thin needle.

Patches with closely aggregated talangiectases can be favorably treated by freezing with CO2 snow for 10 seconds under moderate pressure. Massage of skin with astringent lotion is also beneficial.