Guest blog by VeganAcneSufferers
Rosacea is a common inflammatory skin disease that can cause facial flushing. It usually affects people with fair skin, generally women, and usually does not manifest until adulthood, 30-50 years old. Usually, people with a weak immune system are affected. Rosacea is a chronic condition that worsens over time and is generally cyclical, flaring up over a period of weeks or months, and then subsiding for some time. It affects nearly 14 million Americans, or about 3% of the population.
Anyone who has rosacea knows that this is frustrating, painful and mentally debilitating. Not to mention the fact that current therapies are often ineffective because the true cause of rosacea is unknown.
It can manifest itself in different ways and look slightly different from person to person.
However, rosacea is generally characterized and diagnosed by the following features:
What causes rosacea?
Although we know that things like spicy food, heat, and alcohol can make rosacea worse, we never really knew why rosacea occurred in the first place.
In 2007, a team of researchers determined that it was not a contributing factor, but a combination of two abnormal factors that actually lead to rosacea.
It appears to be the overproduction of two inflammatory proteins that leads to excessive concentrations of a third protein that causes symptoms of rosacea.
Researchers found for the first time in the laboratory that antimicrobial peptides caused exactly the same symptoms in the skin as rosacea, such as reddening, increased visible blood vessels, bumps or pimples. The peptides also responded to the same triggers (spicy food, heat, alcohol, etc.).
When looking at patients with the disease, each of them had far more peptides than normal.
To find out why these patients have abnormal peptides, the researchers investigated the source of these molecules. The precursor form of these peptides, called cathelicidin, is usually known for its function of protecting the skin from infections. In other skin conditions, a lack of cathelicidin correlates with an increased infection. In rosacea patients, researchers found the opposite; There was too much cathelicidin in her skin. They also found that it was a different form of cathelicidin than people without skin disease.
Patients with rosacea also had greatly increased levels of enzymes called stratum corneum tryptic enzymes (SCTE). These enzymes converted the precursor into the disease-causing peptide.
By injecting the cathelicidin peptides found in rosacea or by adding SCTE, they were able to intensify the inflammation and demonstrate that these abnormalities can cause the disease.
So it is too much SCTE and too much cathelicidin that leads to the abnormal peptides that cause the symptoms of this disease.
But wait, a study conducted in 2012 showed that rosacea can actually be triggered by bacteria that live in tiny mites that are in the skin.
The mite species Demodex folliculorum usually lives harmlessly in the pilosebaceous unit that surrounds the hair follicles of the face. They are normal residents of the face and tend to increase with age and skin damage (after sun exposure or damage from products). The mites eat sebum or facial oil and colonize your face during puberty.
The number of Demodex mites that live in the skin of rosacea patients is higher than in normal people, which previously suggested a possible role of the mites in triggering the disease. More recently, the Bacillus oleronius bacterium has been isolated from a Demodex mite and has been found to produce molecules that induce an immune response in rosacea patients. Other studies have shown that patients with different types of rosacea react to the molecules produced by this bacterium and expose it as a likely trigger for the disease. This bacterium is also sensitive to the antibiotics used to treat rosacea.
The bacteria actually live in the digestive tract of Demodex mites on the face, in a mutually beneficial relationship. When the mites die, the bacteria are released and penetrate into the surrounding skin tissue – which leads to tissue breakdown and inflammation. As the number of mites increases, so does the number of bacteria, making rosacea more likely to occur. Combating these bacteria can be a useful way to treat and prevent this condition.
Healthy adults have approximately one or two mites per square centimeter of facial skin. However, people with rosacea can have ten times as many
However, it is possible that the presence of many mites is due to the underlying problem and not the cause of rosacea.
Treatment of rosacea
What does this mean for the treatment? Obviously, rosacea is an uncanny little disease. Well, antibiotics are most commonly prescribed and temporarily relieve the symptoms of rosacea in patients because some of the antibiotics inhibit these enzymes. However, this is not a sufficient option for long-term treatment (and can lead to more serious diseases such as bacterial resistance to antibiotics as well as autoimmune diseases and gastrointestinal diseases). After all, bacteria are not the right target.
Unfortunately, these results are still very preliminary. I am sorry to report that no better treatment option has yet been developed. only symptomatic control . No exact treatment has become the standard of care; Treatment remains empirical. It seems that the best options at this point are topical azelaic acid or metronidazole. This, along with avoiding aggravating "triggers" like spicy food, heat and alcohol, can help prevent flare-ups.
I got acne for the first time in high school and it came back in my early adulthood. I have mastered these difficult times and have strengthened, become smarter and healthier as a result. I am here to help you do the same!
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