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WHAT CAUSES ACNE ROSACEA?
There are numerous theories covering a wide scope of what causes acne rosacea, thus, making acne rosacea treatment a difficult selection. Some of these theories point to gastrointestinal, infectious, psychological, immunological and even climatic as the culprits for acne rosacea, however, there are no scientifically controlled studies that prove any of these to be the primary cause. Gastrointestinal symptoms have not been consistent in patients with rosacea symptoms. When it comes to infectious causes, demodex folliculorum, a parasitic mite that lives in or near hair follicles, has been considered a causative agent of rosacea. The microscopic arthropod feeds on skin cells, hormones and sebum that accumulates in the hair follicles, and in some cases the treatment of demodex infestation has proven beneficial to patients with ocular rosacea and acne rosacea. However, in one particular study of 80 biopsies, demodex folliculorum were found in only 20% of the specimens. Similarly, no consistent findings of one bacteria in patients with rosacea symptoms have been demonstrated. A psychological anomaly has never been identified in any case, neither has a pharmacological mechanism. The same scarce evidence fails to build a case for auto-immune processes. Finally, excessive exposure to the sun and cold weather may have a contributing effect on the disease, but there is no clear evidence of climate exposure being the common denominator for most cases.
The pathogenesis of rosacea is unknown, it is presumed to be a genetic predisposition to an abnormal vascular response that usually develops in fair-skinned individuals between the ages of 30 to 60. However, rosacea acne and ocular rosacea have been documented in people with dark skin, it may also be found in children, although rarely. The fact that the disease appears to be mostly found in places were exposure to cold weather is frequent, and in persons with fair skin in whom flushing is common, gives base to the theory that rosacea is a flushing disorder. Another strong argument for this theory is that the recurring flushing over the face and upper chest, known as carcinoid syndrome, has resulted in full-blown rosacea. The hypertrophy or the enlargement of sebaceous glands typical in rhinophyma, a descriptive term for a reddish, bulbous nose, has led to believe that rosacea is a sebaceous gland disease. However, sebaceous gland hypertrophy is not a usual feature of early rosacea lesions.
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