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Stage I
Stage II
Stage III
Persistent edema of rosacea
Rosacea conglobata and rosacea fulminans
Lupoid or granulomatous rosacea
Steroid rosacea
Eye involvement
Rhinophyma
Non-approved therapies


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Treatment- General

Rosacea usually responds satisfactorily to treatment, but improvement is gradual and requires patience as well as perseverance. Patient education plays an important role in managing this disease.

Skin cleansing

Rosacea patients should wash their face with lukewarm water, avoiding hot or cold temperatures, and apply a gentle liquid cleanser with their fingertips. For wiping the face dry, a soft towel is recommended. Special rosacea cleansers, e.g. containing sodium sulfacetamide and sulfur, may be used.

Avoid certain cosmetic products

Products containing alcohol, menthol, peppermint, eucalyptus oil and fragrances should be avoided in order to minimize irritation of the skin, as well as greasy products.

Use sunscreen

Sunscreens with a protective factor of 15 or higher should be applied regularly. If patients complain of skin irritation after the use of sunscreens, chemical-free sunscreens containing titanium and iron particles may be tried.

Facial massage

Massaging the nose, cheeks and forehead each evening using a lubricant may be of benefit in persisting edemas (Sobye massage). Controlled studies are lacking, though. The proposed mechanism of this procedure is acceleration of lymphatic drainage with consequent reduction of erythema.

Shaving

Male patients should use an electric shaver rather than blades. If blades are used, they should be sharp ones.

Diet

There is no rosacea-specific diet, but avoidance of factors which cause facial vasodilatation such as alcohol, hot beverages and spiced food is recommended. Tobacco products should be avoided as well.

Ice chips

If flushing is to be prevented in a hot environment, ice chips held in the mouth may help for up to half an hour.

Corrective cosmetics

Covering facial redness and telangiectases with cosmetic concealers does not ameliorate the condition, but it leads to an improved appearance. There are several cosmetic products available for rosacea, all of them characterized by a green tint.



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