Facts on File Encyclopedia of Health and Medicine

surgery are likely to require multiple procedures
over time. It is important to discuss these factors
with the plastic surgeon.
See also AGING, INTEGUMENTARY CHANGES THAT
OCCUR WITH; BLEPHAROPLASTY; RHINOPLASTY; SURGERY
BENEFIT AND RISK ASSESSMENT.

ringworm See TINEA INFECTIONS.

rosacea An inflammatory condition that pro-
duces acnelike outbreaks and erythema (redness)
on the face. Rosacea, sometimes incorrectly called
adult ACNE, occurs primarily in people over age 40
and becomes more common with advancing age.
Dermatologists do not know what causes rosacea,
though believe it is an interaction between genetic
and environmental factors. About 14 million
Americans have rosacea. Though more women
than men have rosacea, men tend to have more
severe symptoms.

Symptoms and Diagnostic Path

The symptoms of rosacea are mild and general at
first, often starting with increasingly frequent
blushing. Dermatologists believe this early stage of
rosacea may persist for years, though not many
people seek medical care for it alone. Eventually
the condition progresses to outbreaks of pimple-
like pustules and other lesions that appear to be
acne but resist conventional acne treatments.
Most people seek a doctor’s evaluation at this
stage.
The typical symptoms that bring people to the
dermatologist include

• extended flushing of the face and neck that
  may persist for hours after onset


• papules that erupt in clusters across the cheeks,
  on the chin and forehead, around the base of
  the NOSE, and sometimes around the eyelids


• itching and burning of the face, particularly in
  areas where papules have erupted


• patches of dry flaky skin when the papules
  retreat


• TELANGIECTASIS(fine BLOODvessels that appear as
  red lines beneath the surface of the skin)


• CONJUNCTIVITISand itchy, dry eyes
  
  
  • rhinophyma (enlarged and bulbous nose) in
    advanced or severe rosacea
  
  
  
  

The dermatologist generally can make the diag-

nosis on the basis of the appearance and history of

the symptoms and the person’s age. Other factors

that support a rosacea diagnosis include a personal

or family health history of AUTOIMMUNE DISORDERS

or rosacea symptoms.

Treatment Options and Outlook

Effective treatment for rosacea varies widely; what

works for some people may have no effect for oth-

ers. Dermatologists generally offer a combination

approach of topical products and oral ANTIBIOTIC

MEDICATIONSthat are effective in controlling skin

conditions. Most people who have rosacea try a

number of treatments to find those that are the

most effective.

COMMON TREATMENTS FOR ROSACEA

Topical

azelaic acid benzoyl peroxide

clindamycin topical erythromycin topical

glycolic acid metronidazole

sulfacetamide sulfuric solutions

Oral

doxycycline erythromycin

minocycline tetracycline

Laser therapy becomes a treatment option for

rhinophyma and can reduce the size and shape of

the nose to normal. Laser therapy is also useful for

controlling telangiectasis. Treatment for EYEsymp-

toms may include ophthalmic moisturizing solu-

tions and CORTICOSTEROID MEDICATIONS to reduce

INFLAMMATIONand irritation. As rosacea is a chronic

condition with no known cure, treatment is ongo-

ing.

Risk Factors and Preventive Measures

People who are fair-skinned, blond, and blue-eyed

seem most likely to develop rosacea. Because der-

matologists do not know the precise mechanisms

of rosacea, there are no known preventive meas-

ures. Factors that can sometimes trigger outbreaks

of rosacea, though do not cause rosacea, include

• spicy foods

192 The Integumentary System