Author: Dr Anahit Vali, Dermatologist
Introduction:The two skin diseases acne and rosacea have many similarities, which is why rosacea is also called acne rosacea. Acne and rosacea have many differences also and completely different pathogenesis. Surprisingly, although they have different pathogenesis, from the perspective of treatment are partially similar.
This article is a review and discusses the similarities and differences between these two common diseases.
Methods: Meta-analysis and review of articles and books in dermatology from the last 15 years.
Results:
One of the similarities of both diseases is that the most severe types are more prevalent in men. Both severe nodulocystic acne and phymatous rosacea are more common in men.
In both diseases, the face appears red, and pustules, nodules granulomas are seen in both diseases. There are similarities in response to topical and oral treatments or lasers in both diseases. Both respond to treatment with vascular lasers.
The female-to-male ratio in Rosacea is 3 and Rosacea has an underlying erythema and telangiectasia component, and ocular involvement that is not seen in acne, which is why it seems that the pathogenesis of the two diseases is different. Acne is a multifactorial inflammatory disease of the pilosebaceous units with the characteristic lesion named comedon, while rosacea is a vascular disease so blushing and flushing are the main signs. It appears that in Rosacea, the nervous control of the skin vessels is impaired. This is why avoiding aggravating factors such as emotional and nervous stress, wind, and spicy and hot foods and drinks,.. effective in rosacea management.
Beta-blockers such as carvidolol, alpha-2 sympathetic receptor blockers such as clonidin, and serotonin reuptake inhibitors such as paroxetine are effective in rosacea. Some medications, such as tetracycline, doxycycline, and isotretinoin, are effective in both diseases. However, in patients with ocular rosacea, isotretinoin should be used in low doses and with great caution
.
Conclusion: In both diseases, treatment is like a roof that rests on four pillars: abstinence from aggravating factors, topical treatment, oral treatment, and medical devices such as vascular lasers. Emphasize to the patient that all four measures must be taken simultaneously and over a long period.
Keywords: Acne, Rosacea, Management Aggravating factors, Vascular lasers, Isotretinoin, tetracycline
