INTRODUCTION

Acne Rosacea is a condition in which the skin becomes red, develops rashes and flushing i.e. the skin feels hot.

Most common area affected – Face

Other areas in the Scalp, Chest, Hands etc. can also be affected.

The symptoms of skin redness and itching usually intensify, when exposed to the sun.

SYMPTOMS

On the basis of symptoms, Acne Rosacea can be classified into 4 types:-

1. TYPE I {Telangiectactic rosacea}: Most common type. It is associated with telangiectasis i.e. appearance of large dilated veins on the skin.

2. TYPE II {Papulo–pustular rosacea}: It is associated with pus filled tiny white/red bumps over the skin. It can be commonly mistaken for acne.

3. TYPE III {Rhinophyma rosacea}: It affects the Nose of the individual. It is a chronic long standing condition, in which the skin of nose appears rough and swollen like a potato, and its structure gets distorted; a condition called ‘Bulbous nose’. It’s the most severe form of rosacea.

4. TYPE IV {Ocular rosacea}: The conjunctiva of the eye is affected. It’s associated with Red eyes, Gritty feeling in the eyes, pain and itching of the eyes. The patient may have difficulty seeing.

WHO CAN DEVELOP?

Rosacea normally appears after the age of 30, but rarely children are affected.

CAUSES

The exact mechanism behind this condition is not known yet.

However, there are multiple risk factors which are seen to be associated with this condition:-

• Genetic: It is seen in those persons, whose family members have been previously affected by it.
• UV Radiation: People who are exposed to the sunlight for long durations have been seen to be affected.
• Side effects of cosmetics OR use of strong steroid creams (clobetasol, halobetasol etc.)
• Skin infections such as Demodex follicularum (parasite), Staphylococcus epidermidis (bacteria)
• Alcohol
• Spicy foods

DIAGNOSIS

Acne rosacea can be diagnosed by clinical examination of the symptoms. And in some cases, Skin biopsy may be required.

One should look out for:-

• Red bumps
• Pustules (pus filled tiny bumps)
• Redness of skin
• Flushing (burning of skin)

Other diseases with similar looking symptoms are:-

1. Acne
2. Perioral dermatitis
3. Gram negative folliculitis

Therefore, for proper diagnosis & treatment one must consult a dermatologist.

TREATMENT

1. General measures
   1. Avoid heavy makeup, cosmetics.
   2. Avoid using strong steroid cream over the face.
   3. Use plenty of physical sunscreen, containing zinc oxide or titanium dioxide.
   4. Avoid hot and spicy food, alcohol.
2. Medicines used? Creams like:-
   1. Azeleic acid cream
   2. Pimecrolimus cream
   3. Tacrolimus cream
   4. Metronidazole cream
   5. Sulphur cream

• Oral medicines:-
  1. Doxycycline
  2. Minocyclin
  3. Isotretinoin
  4. Ivermectine – Used in parasite induced rosacea

1. Brimonidine gel; Xylometaxoline & Oxymetazoline cream can be used to treat skin redness.
2. Laser treatment is useful in treating Telangiectactic rosacea & Rhinophyma (CO₂ laser resurfacing)
3. Surgery can be done in cases of Rhinophyma

Rosacea is a chronic disease. Its duration of treatment can be long. And recurrence has been seen in some cases, but it gets better by treatment. It’s important to have patience and carefully follow the doctor’s advice.

INTRODUCTION

It is a condition where certain areas of the skin become dry and rough, with small bumps appearing in that area, resembling pimples.

Most common sites affected – Upper arms, thighs

Other sites affected – Forearms, legs, cheeks, or anywhere in the body having hair follicles

It is a non-contagious condition.

WHO CAN DEVELOP (EPIDEMIOLOGY)

Keratosis pilaris is most commonly seen in children and teenagers. And it appears to resolve on it’s own as one’s age progresses to mid 20s and 30.

SYMPTOMS

In Keratosis pilaris, no pain or itching is associated with the affected area.

However, the patient may face cosmetic problems :-

• Most notably skin pigmentation (change in skin color)
• The affected area may turn black, brown or red (in fair skinned people) depending on the skin color of the patient.
• Affected area has tiny bumps of the same color, resembling pimples.

CAUSE

In Keratosis Pilaris, keratin – a hair protein, accumulates over immature hair follicles and dead skin cells, which appears as tiny bumps over the skin.

The exact cause of accumulation of keratin is not known.

RISK FACTORS

1. Genetic – It is commonly seen in people whose family members were affected with the same condition.
2. Environmental – It appears more during dry seasons like winter, when the skin is prone to dry up.

• Age – children and teenagers are mostly affected

1. Obesity
2. It can be associated with other skin conditions such as Atopic dermatitis, Icthyosis etc. and other dry skin

DIAGNOSIS

Keratosis pilaris is a condition which can be diagnosed by any dermatologist by simple clinical examination.

It usually does not require any additional tests or investigations.

TREATMENT

There’s no permanent cure for this condition yet.

However many options for symptomatic cure are available, which restores the appearance of the skin :-

1. Home remedies
   1. Use warm water for bathing.
   2. Short time baths – Because bathing for longer duration can cause skin dryness.
   3. Use moisturizer after bath.
   4. Physical exfoliator, like scrub can be effective in removing the keratin plugs.
   5. Avoid tight fitting dress.
   6. Use humidifier at home – to keep your skin cool and moist.
2. Creams
   1. Keratinolytic agents (which breaks down keratin) such as
      • Urea
      • Lactic acid
      • Salicylic acid
      • Glycolic acid
      • Retinoic acid cream (Trentinoin) etc., containing creams may be used for treatment.

*Caution / Contraindications (Note to patients)

• Avoid rubbing these creams in excess, which may cause burning, itching & redness over the skin.
• Retinoid creams are strong keratinolytics, but they should be avoided in pregnant or lactating mothers and those who are planning for pregnancy, because retinol is a teratogenic. Hence it can affect the baby.

Consult a Dermatologist for personalized details of these below therapies

3. Chemical peeling

4. Microdermabrasion

5. Laser treatment

INTRODUCTION

It’s a hair follicle disorder, characterised by spiny black papules containing multiple fine hairs, greatly resembling blackheads/pimples.

Each blackhead like point, when observed under a magnifying glass or dermatoscope, contains 5-25 fine hairs.

This condition is most commonly presented in the Nose.

Other sites of appearance may include – Scalp, Hand, Chest etc.

It can be easily confused with Blackheads/pimples, and the patient may apply multiple creams for it’s resolution. However, Trichostasis spinulosa cannot be treated with any medicated cream.

WHO CAN DEVELOP (EPIDEMIOLOGY)

Any age group, and both males and females can be affected.

SYMPTOMS

Most notable symptom in Trichostasis spinulosa are the cosmetic concerns that the patient usually presents with.

Otherwise, it is asymptomatic.

CAUSE

Trichostasis spinulosa occurs due to growth of multiple telogen club hairs from a single hair follicle.

The exact mechanism behind this is not known.

RISK FACTORS

• Skin damage
• Other skin diseases
• Aging etc.

DIAGNOSIS

• It can be diagnosed by a dermatologist by simple clinical examination.
• Dermatoscopy (magnification) is useful in diagnosis.
• No other tests are required.

TREATMENT

1. The fine hairs/hair follicles can be removed by tweezers or comedon extractors.
2. Plucking, Waxing& Nose strips can also help in removing the hair follicles.

However, by the above methods of treatment, there are high chances of recurrence.

Therefore, other methods such as :-

• Advanced hair removal laser treatment, combined with
• Retinoid cream (Trentinoin) can be used for long lasting results.