[Rosacea]

Rosacea is a frequent disease which occurs mostly in women with dry skin and much more rarely in men with greasy skin. In women, rosacea is heralded, around the age of 20 years, by intermittent facial erythema, and this is followed by the gradual development of permanent erythema (erythrosis) with telangiectasia (couperose) and later on, around the age of 40, very unsightly papulo-pustules (papular rosacea, improperly called acne rosacea). In men, these successive stages are less frequent, but progressive dilatation of the nose due to sebaceous gland overgrowth may occur (rhinophyma). Rosacea is caused by vascular abnormalities not completely determined, and also, at the papulo-pustural stage, by a small parasite called Demodex folliculorum. Treatment rests on hygienic and dietary rules and vasoconstrictor drugs at the erythema stage, then on fine electrocoagulation or pulsed dye laser to suppress couperose and on the prescription of long-term low-dose tetracycline, sometimes preceded by a 2-month course of metronidazole to remove the papulo-pustules. Rhinophyma is treated by surgery. The results obtained are remarkable, at least on couperose, papulo-pustules and rhinophyma.