Rosacea: The Stages of Rosacea and Its Progression

The stages of Rosacea are a chronic and progressive dermatosis which is triggered by trauma that is cold injury, prolonged sun exposure or exposure to irritants for example soaps, benzoyl peroxide is often sufficient to initiate symptoms. At first symptoms are mild but cumulative damage results in more severe symptoms overtime in people in high risk groups or who are otherwise predisposed.

Target areas for the stages of rosacea include cheeks, nose, chin and forehead. Women are more likely to show symptoms on cheeks and chin. In men, symptoms occur more often on nose and rhinophyma is more common in men than women. Symptoms at forehead occur at similar rates in both sexes.

The stages of rosacea are characterized by periods of remission and relapses and occurs in three stages.

A pre rosacea stage can be identified in susceptible individuals before first stage symptoms become evident. These are frequent flushing, erythema or irritation in response to topical medications especially antiacne therapies.

Stage 1
– the first stage is vascular. Transient facial erythema appears over central areas of the face and fine telangiectasia may develop. Ocular lesions may also occur.

Stage 2
– the disorder then progresses to second stage within a year. Erythema persists and spreads and papules and pustules often develop. The presence of enlarged pores signals fibroplasias an early sign of third stage rosacea [105(2)].

Stage 3
– this last stage in addition to including an exacerbation of existing symptoms is characterized by tissue hyperplasia as inflammatory nodules bridge across progressively larger areas of the face. A proliferation of tissue may result in rhinophyma.

Rosacea is common cause of a red eye and ocular findings have been reported in 58% patient, Blepharitis, conjunctival injection, tearing, burning recurrent chalazia, corneal vascularization and scarring, episcleritis and iritis have all been reported in minor manifestations. In severe forms of rosacea progressive vision loss is possible and requires aggressive therapy [31(3)].

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