Couperose represents the first stages of a dermatologic condition called rosacea.
Couperosic skin looses the healthy, elastic and resistant quality, and the blood capillaries become visible. The specific changes are predominantly localized on cheeks, nose and beard. The onset manifests through episodes of face redness caused by heat, hot food, emotions, which disappear when the aggressive factor ceases.
Then permanent redness of the face and visible blood vessels (telangiectases) appears, as small, delicate spider-web like lines.
The causes are multiple, vascular, endocrine, digestive and infectious factors are involved.
The evolution of the condition is slow, long duration and cannot be healed spontaneously.
Examination, evaluation and treatment by a dermatologist is necessary.
Rosacea is a cutaneous disease characterized by face redness (erythema), appearance of blood vessels (telangiectasias) and pimples (papulo-pustules). Early diagnosis is very important as rosacea is a progresive disease, which left untreated can aggravate. Rosacea is a disease that must be diagnosed by a dermatologist.
The disease begins with episodes of severe reddening of the face (flushes). The reaction appears suddenly and is triggered by certain factors, such as: sun exposure, emotions, spicy foods, alcohol. Face redness, similar with the redness caused by sunburn, is accompanied by skin temperature changes and „burning cheeks” sensation.
As symptoms become worse, vascular rosacea or cuperose can appear. In this case, the small blood vessels around the nose and cheek area expand and become visible (telangiectasias).
Little red skin outgrowths can appear (papules), which sometimes turn into pus-filled vesicles (pustules), which is inflammatory rosacea. In severe and rare cases, the sebaceous glands from the nose and sometimes cheek area enlarge, causing tissue to grow on and around the nose (rhinophyma). Over 50% of people with rosacea present ophthalmic rosacea. They can have a burning or „sand in the eye” sensation, with the eyelids becoming inflamed or scaled.
Rosacea can be aggravated by spicy foods, alcohol, extreme temperature exposure, stress, administration of medicines which dilate the blood vessels or the use of certain skin care products which contain ingredients such as acids, alcohol and other irritant substances.
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OILY & COMBINATION SKIN
Oily or seborrheic skin, with its typical shiny appearance, is frequently associated with dilated pores and imperfections (whiteheads, blackheads, microcysts) when the number and activity of sebaceous glands is increased. The combination skin type is different from the oily skin type due to the specific localization of the shiny areas in the T zone level (forehead, nose, beard).
Seborrheic skin – predisposed to pimples and acne is caused by both internal and external factors. Among the internal factors the most important is the hormonal influence (at puberty, during menstruation, use and cessation of contraceptives, pregnancy etc). There is a genetic predisposition for oily skin. Stress is also known to cause an acne break out.
Both oily and combination skins are caused by sebum hypersecretion (hyperseborrea) Hyperseborrea occurs as a result of multiple factors. Some external factors (pollution, temperature, stress) or internal ones (hormonal changes) are considered to be the cause due to their stimulative influences over the activity of the sebaceous glands.
The density of sebaceous glands is increased (400-900/cm2) and up to 5-10 times more numerous on the face than elsewhere on the body. They are well supplied with blood which makes them a target for androgen hormones (testosterone and dihydrotestosterone).
Hyperseborrhea may also be considered the skin reactive defense mechanism as a result of previous dehydration, in order to limit transepidermic water losses. The dense layer of sebum is a favorable medium for the development of microorganisms, being the substrate of inflammatory processes under the action of infectious factors. Along with the association of the inflammatory phenomena on a hyperseborrheic background oily and combination skin suffers acne type lesions.
Acne vulgaris is linked with an increased sensibility of the skin and particularly with malfunction of the sebaceous glands. Acne vulgaris is an inflammatory condition of the hair follicle. Each follicle is anatomically constituted of a hair shaft and a number of sebaceous glands. Physiologically the sebum is drained along the hair follicle towards the surface of the skin.
The acne is characterized by the occurrence of successive pathological processes.
Hyper-seborrhea, the excessive secretion of sebum, which gives the shiny aspect to the skin, is the first step to acne. There is an accumulation of sebum in the hair follicle which cannot be drained.
The dense layer of sebum represents a favorable medium for the multiplication of the bacteria considered to be the cause of acne (Propionibacterium acnes, Staphylococcus pp). The exacerbated process of bacterial multiplication represents the triggering infectious factor of the inflammatory mechanisms associated with acne.
The inflammatory lesions vary from small papules (accentuated elevation accompanied by redness), pustules (purulent vesicles) and cystic nodules. In addition to these lesions patients with acne may have scars of different sizes.
Acne is a condition that requires the examination and evaluation of a dermatologist.
Dry skin lacks elasticity and tonicity, it is rough and desquamated. It may appear at any age, due to the loss or decrease of superficial hydrolipidic film, dehydration of corneous layer or disorders in the keratinisation process.
Skin may be genetically dry or caused by certain factors – substances (soaps), alkaline/alcoholic solutions, medicines, climate, hot showers and diet.
This type of skin is fragile, with marks of premature aging (fine wrinkles) and is easily irritated.
At a closer look the desquamation (shedding of the dead and dried cells from the outer layer of the skin) can be noticed.
The sensation of discomfort appears which often turns into pruritus (itchiness).
The hydration is extremely important throughout the cold season, when the hydrolipidic film no longer offers the same protection and the skin becomes more sensitive to the action of aggressive factors (indoor heating, hot baths, cold, humidity, wind, stress, UV radiations, various chemical compounds).
UV radiations are one of the most damaging: photo-aging is the cause of precocious aging of the skin.
The atopic dermatitis is a chronic inflammatory disease of the skin, with familial predisposition. In children, it is the most common cutaneous disease and it has become increasingly prevalent during recent years. The onset is early, usually under 6 months, with periods of exacerbation and remission. 50% of patients develop atopic dermatitis during the first year of life, and 80% of these patients may develop allergic rhinitis or bronchial asthma during childhood.
Dry skin (xerosis), redness (erythema) and itchiness (pruritus) are the clinical manifestations of atopic dermatitis and the most frequent symptoms for which newborns and children go see a dermatologist.
Atopic dermatitis is often treated aggressively with cortisone derivatives which have numerous side effects. Each patient should benefit from an individually tailored treatment plan.
In the care of children with atopic dermatitis specialists recommend two main procedures: the first is washing with non-aggressive, emollient, non-detergent bath products and the second is hydration with emollient, hydrating and anti-inflammatory creams. Thus the cutaneous barrier becomes rebalanced and the tightness of the epidermis is strengthened, limiting the effects of allergens and exogenous factors.
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SENSITIVE, INTOLERANT SKIN
The term „sensitive skin” is frequently used and can refer to genetically hyper-reactive skin, normal skin which has become hypersensitive due to external factors or skin that reacts abnormally without an apparent cause.
The sensitive skin type is a delicate and easily irritable skin. It reacts quickly to different aggressive factors such as ultraviolet radiations, heat, cold, rapid variations in temperature, pollution, stress, etc. Temperature changes, certain detergents, cosmetics, alcohol (applied on the skin) may cause irritations, blemishes, the sensation of „stretched skin”, itchiness and discomfort or turn the skin red.
Over time sensitive skin may become allergic and eczematous.
The sensitive skin type is frequently associated with dry skin, generally involving a genetic predisposition.
Some people are born with cutaneous sensitivity – fair skin, predisposed to redness, not resistant to cold, wind, sun; dry, delicate, fragile skin, atopic skin.
Baby and young children`s skin is very sensitive as the corneous layer is more permeable, the activity of the sebaceous glands is low and the hydrolipidic protection layer is less developed.
Seborrheic dermatitis is a papulosquamous disorder. It is thought to be due to a combination of an over production of skin oil and irritation from a yeast called Malassezia. It can occur on many different body areas. Typically it forms where the skin is oily or greasy. Commonly affected areas include the scalp, eyebrows, eyelids, creases of the nose, lips, behind the ears, in the external ear, and along skin folds on the middle of the body. Cradle cap is the term used when seborrheic dermatitis affects the scalp of infants. It is commonly aggravated by changes in humidity, changes in seasons, trauma, or emotional stress. Seborrheic dermatitis is a common, inflammatory skin condition that causes flaky, white to yellowish scales to form on oily areas such as the scalp or inside the ear. It can occur with or without reddened skin.
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