Cuperosis: etiology, differential diagnosis and treatment

Kristina Filevich , editor of Pro Cosmetology BHUB

What is rosacea?

Cuperosis is a pathological condition that is associated with persistent dilation of skin vessels and is manifested by local hyperemia and telangiectasia . Couperosis is not isolated as a separate disease; it is often a symptom of other skin pathologies, for example, rosacea or dermatitis.

Etiology

Redness of the face under the influence of temperatures, with activation of the sympathetic nervous system, the use of various drugs and substances that affect vascular tone are normal reactions of the body. However, in some people, due to physiological characteristics, the elasticity of the vascular wall is reduced, resulting in persistent vasodilation.

Patients with light, sensitive skin of phototype I according to the Fitzpatrick classification, genetic predisposition, residents of countries with cold climates, and representatives of professions with unfavorable temperature working conditions are prone to the development of rosacea. In women, due to hormonal characteristics, rosacea occurs more often than in men.

Key risk factors for the development of rosacea:

• Sharp fluctuations in ambient temperature;
• Exposure to direct sunlight and wind on the skin without the use of protective equipment;
• Genetic predisposition;
• Excessive consumption of spicy foods and too hot drinks;
• Alcohol, smoking;
• High blood pressure;
• Menopause;
• Long-term therapy with corticosteroids.

Main symptoms

The most common localization of rosacea is the cheek area and the T-zone of the face. Couperosis on the nose, hands and feet is also possible. The main symptoms are: hyperemia, local increase in temperature, dryness, hyperesthesia of the affected skin area. Later, visible expansion of the skin capillaries appears - “spider veins”, inflammatory and structural changes in the epithelium.

Visual symptoms of rosacea. Source

Diagnostics

Diagnosis of rosacea involves a general examination of the patient and a detailed history taking.

Cuperosis in most cases is a diagnosis of exclusion. Such patients should be carefully examined, anamnestic data collected, additional laboratory diagnostic tests prescribed and, if necessary, referred for consultation to related specialists.

Based on the examination results , differential diagnosis of rosacea is carried out with :

• Acne;
• Allergic dermatitis;
• Photodermatitis;
• Burns and post-burn changes;
• Systemic vasculitis;
• Seborrhea;
• Rosacea;
• Systemic lupus erythematosus, sarcoidosis and other autoimmune diseases.

Complications

The most common problem for people with rosacea is aesthetic discomfort, which causes self-doubt, interferes with leading a normal lifestyle, and reduces performance.

In the absence of adequate treatment and care, persistent erythema develops and inflammatory and structural changes in the skin are expressed.

Cuperosis and rosacea: the difference

Rosacea is a chronic inflammatory skin disease. The pathology is often complicated by suppuration, and in later stages by rhinophyma, hyperplasia of the tissues of the cheeks and nose.

Persistent erythema and vasodilation often precede the development of rosacea, so sometimes rosacea is the initial stage of this pathology, also known as prerosacea.

How to treat rosacea on the face

Correction of lifestyle and nutrition

Patients with rosacea or a tendency to develop it should minimize the effect of triggers. It is recommended to exclude allergenic foods (nuts, cheese, spicy foods) and hot drinks from the daily diet. Smoking, alcohol and excessive exercise are also not recommended.

Skin care selection

An individual care plan for skin prone to rosacea is developed by a qualified dermatocosmetologist. Patients should be reminded to use moisturizers and sun protection with SPF 30 or higher daily. Proper care can even completely correct mild rosacea on the face.

Treatment with low temperatures

Facial cryotherapy is an innovative procedure for reducing hyperemia due to rosacea. Skin areas are exposed to low temperatures, which have anti-edematous, anti-inflammatory and vasoconstrictor effects.

Laser therapy

Laser correction of rosacea involves the use of a yellow laser. The yellow spectrum laser wavelength penetrates deep into the skin vessels without damaging the surface layers. Hemoglobin in red blood cells absorbs the energy of laser light, resulting in thermocoagulation of vascular defects, which makes it possible to remove rosacea on the face.

IPL therapy

IPL therapy (intense pulse light) is a procedure for removing vascular and skin defects using intense pulse light. An IPL device, unlike laser devices, emits light of different wavelengths. The flash penetrates into the deep layers of the skin, where thermal coagulation of dilated capillaries occurs.

Botulinum therapy

Injections of botulinum toxin type A are an alternative method for the treatment of erythema and telangiectasia in rosacea. BTA blocks the transmission of impulses in the sympathetic ganglia in the facial area. As a result, persistent vasodilation of blood vessels disappears, erythema and the severity of spider veins decrease.

An integrated approach to the diagnosis and treatment of rosacea prevents the occurrence of cosmetic defects and long-term complications, which can significantly worsen the patient’s quality of life.

Bibliography:

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