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Rosazea

 Rosazea

Definition
Rosazea ist eine häufige chronische Hauterkrankung, die Rötungen im Gesicht verursacht. Die Rötung wird oft von kleinen, roten, eitergefüllten Papeln begleitet und ist durch Schübe und Remissionen gekennzeichnet. Sie beginnt meist nach dem 30. Lebensjahr mit Rötungen an Wangen, Nase, Kinn oder Stirn, die schwanken. In einigen Fällen kann Rosazea auch am Hals, Brust, Kopfhaut oder an den Ohren auftreten. Mit der Zeit wird die Rötung beständiger und röter. Sichtbare Blutgefäße können erscheinen. Unbehandelt entwickeln sich oft Knötchen und Pickel. In schweren Fällen kann die Nase durch überschüssiges Gewebe geschwollen und knollig werden. Dieser Zustand wird Rhinophym genannt. Bei vielen Patienten sind auch die Augen betroffen, die sich gereizt anfühlen und wässrig oder gerötet erscheinen.

Rosazea kann jeden betreffen, aber Menschen mit heller Haut, die leicht erröten und sich schnell röten, sind am stärksten gefährdet. Frauen sind häufiger betroffen als Männer, aber die schwersten Anzeichen und Symptome treten bei Männern auf, möglicherweise weil sie die Behandlung bis zu einem fortgeschrittenen Stadium verzögern.

Es gibt keine Heilung für Rosazea und die Ursache ist unbekannt, aber eine medizinische Behandlung kann die Anzeichen und Symptome kontrollieren oder rückgängig machen. Personen, die vermuten, Rosazea zu haben, sollten einen Dermatologen oder einen anderen erfahrenen Arzt zur Diagnose und geeigneten Behandlung aufsuchen.

 Anzeichen und Symptome

Anzeichen und Symptome der Rosazea können sein:

  • Rötung im Gesicht: Rosazea verursacht meist eine anhaltende Rötung im zentralen Bereich des Gesichts. Kleine Blutgefäße an Nase und Wangen schwellen oft an und werden sichtbar.
  • Geschwollene rote Knötchen: Viele Menschen mit Rosazea entwickeln auf ihrem Gesicht Knötchen, die Akne ähneln. Diese enthalten manchmal Eiter. Die Haut kann sich empfindlich und heiß anfühlen. 
  • Augenprobleme: Etwa die Hälfte der Menschen mit Rosazea leidet auch unter trockenen, gereizten und geschwollenen, geröteten Augenlidern. Bei manchen Menschen treten die Augensymptome vor den Hautsymptomen auf.
  • Vergrößerte Nase: Selten kann Rosazea die Haut an der Nase verdicken, wodurch die Nase knollig erscheint (Rhinophym). Dies tritt häufiger bei Männern als bei Frauen auf.

Ursachen und Auslöser

 

Die Ursache der Rosazea ist unbekannt, es wird jedoch angenommen, dass sie eine Kombination aus erblichen und Umweltfaktoren ist.

Es gibt einige Faktoren, die Rosazea auslösen oder verschlimmern können, indem sie die Durchblutung der Hautoberfläche erhöhen. Zu diesen Faktoren gehören: 

  • Heiße Speisen oder Getränke
  • Scharfe Speisen
  • Alkohol
  • Temperaturextreme
  • Sonnenlicht
  • Stress, Ärger oder Verlegenheit
  • Anstrengende körperliche Betätigung
  • Heiße Bäder oder Saunen
  • Kortikosteroide, wie Prednison
  • Medikamente, die Blutgefäße erweitern, einschließlich einiger Blutdruckmedikamente

Diagnose
Die Diagnose erfolgt durch Untersuchung der Haut unter Berücksichtigung der Symptome und der Schwankungen der Anzeichen und Symptome im Zeitverlauf. Es gibt keinen spezifischen Test für Rosazea.

Behandlung

Obwohl es keine Heilung für Rosazea gibt, können Behandlungen die Anzeichen und Symptome kontrollieren und reduzieren. Das bestmögliche Ergebnis erfordert meist eine Kombination aus verschreibungspflichtigen Behandlungen und Änderungen des Lebensstils. Chirurgische und andere Verfahren sowie verschreibungspflichtige Medikamente, die bei Rosazea eingesetzt werden, können umfassen:

  • Antibiotika. Die bei Rosazea eingesetzten Antibiotika wirken entzündungshemmend. Es gibt verschiedene Anwendungsformen, darunter Cremes, Gele oder Lotionen zur topischen Anwendung sowie orale Tabletten. Antibiotika-Tabletten sind in der Regel bei kurzfristiger Einnahme wirksamer, können aber mehr Nebenwirkungen haben.
  • Akne-Medikamente. Wenn Antibiotika nicht wirken, kann Isotretinoin (Accutane, Claravis, andere) bessere Ergebnisse liefern. Es ist ein starkes Medikament, das normalerweise bei schwerer zystischer Akne eingesetzt wird. Es ist streng reguliert, besonders bei der Behandlung von Frauen im gebärfähigen Alter. Es ist bekannt dafür, schwere Geburtsfehler zu verursachen. Diese Medikamente können erhebliche Risiken bergen; sprechen Sie unbedingt mit Ihrem Arzt über mögliche Gefahren und Nebenwirkungen.
  • Laserchirurgie und Elektrochirurgie. Diese können die Sichtbarkeit von Blutgefäßen verringern und Gewebeansammlungen um die Nase entfernen, was das Erscheinungsbild verbessert.

Der beste Schritt zu gesünderer Haut beginnt damit, potenziell schädliche Chemikalien zu vermeiden und stattdessen 100 % reine Inhaltsstoffe zu verwenden. 

Alternative und natürliche Behandlung

Dies sind die am häufigsten verwendeten alternativen Behandlungen:

  • Chrysanthellum Indicum Creme: verwendet einen Extrakt aus dem gleichnamigen Kraut. Die Forschungsergebnisse sind begrenzt, aber Nebenwirkungen werden als mild beschrieben und nicht stärker als bei Placebos. Eine Studie zeigte, dass das Mittel deutlich wirksamer als Placebos ist.
  • Niacinamid-Creme, eine Form von Vitamin B3, hat sich als wirksame Feuchtigkeitscreme erwiesen, aber die Datenlage ist begrenzt.
  • Azelainsäure-Creme, gewonnen aus Weizen, Roggen und Gerste, soll Rötungen lindern und Papeln sowie Pusteln reduzieren.

Vorbeugung und Lebensstilmanagement

Rosazea-Hautbehandlung

Rosazea-Hautbehandlung

Sobald die Behandlung eine Remission erreicht hat, kann diese durch das Erkennen und Vermeiden von Lebensstil- und Umweltfaktoren, die Schübe auslösen oder den Zustand verschlimmern, aufrechterhalten werden. Siehe den Abschnitt mit den Auslösern, um zu erfahren, was Sie möglicherweise vermeiden sollten. Vorschläge zur Vermeidung von Schüben umfassen:

  • Tragen Sie einen Breitbandschutz-Sonnenschutz mit einem LSF von 30 oder höher.
  • Schützen Sie Ihr Gesicht bei kaltem Wetter – verwenden Sie einen Schal oder eine Skimaske.
  • Vermeiden Sie es, Ihre Gesichtshaut zu stark zu reiben oder zu berühren.
  • Waschen Sie betroffene Stellen mit einem sanften Reiniger (Dove, Cetaphil).
  • Vermeiden Sie Gesichtsprodukte, die Alkohol oder andere Hautreizstoffe enthalten. Außerdem enthalten viele Hautpflegeprodukte potenziell schädliche Inhaltsstoffe.
  • Verwenden Sie täglich saubere und einfache Inhaltsstoffe, um Ihre Haut zu befeuchten und zu revitalisieren.

Ihre Fragen beantwortet

  1. Kann ich Make-up tragen?  
    Es ist sicher, Make-up zu tragen, wenn Sie Rosazea haben. Erwägen Sie die Verwendung von grün getönten Foundations und Pudern, da diese entwickelt wurden, um Rötungen entgegenzuwirken.
  2. Werden Vitamine helfen?
    Die Vitamine K und A, oral eingenommen, sollen die Symptome verbessern. Es gibt keine schlüssigen Beweise dafür, und die Einnahme übermäßiger Dosen von Vitaminen kann gefährlich sein.
  3. Gibt es Nahrungsergänzungsmittel, die helfen?  
    Besprechen Sie mögliche Nahrungsergänzungsmittel mit Ihrem Arzt, bevor Sie sie verwenden. Viele Hersteller machen falsche Versprechen.
  4. Kann ich an den Strand gehen?  
    Ja, mit Vorsichtsmaßnahmen. Verwenden Sie großzügig einen natürlichen Sonnenschutz (ohne Parabene oder Petrochemikalien) und tragen Sie ihn mindestens alle 2 Stunden erneut auf. Tragen Sie einen breitkrempigen Hut und benutzen Sie einen Sonnenschirm.
  5. Meine Rosazea macht mich depressiv. Was kann ich tun?  
    Sprechen Sie mit Ihrem Arzt über die Depression. Es gibt Behandlungsmöglichkeiten für Depressionen.
  6. Ich fühle mich so allein damit. Was kann ich tun?  
    Eine Rosazea-Selbsthilfegruppe kann Sie mit anderen verbinden, die dieselben Probleme haben. Sie können die National Rosacea Society kontaktieren, um Gruppen in Ihrer Nähe zu finden, oder online nach Gruppen suchen. (Kontaktinformationen unten.)
  7. Ich hatte als Teenager schlimme Akne. Bedeutet das, dass ich Rosazea entwickeln werde?  
    Es gibt keine Belege dafür, dass Akne im Teenageralter auf zukünftige Rosazea hinweist.
  8. Beeinflussen Lebensmittel Rosazea?
    Scharfe Speisen können einen Schub auslösen. Finden Sie heraus, welche Lebensmittel bei Ihnen einen Schub verursachen, und vermeiden Sie diese. Da Rosazea ein entzündlicher Prozess ist, können entzündungshemmende Lebensmittel von Vorteil sein. Kontaktieren Sie die National Rosacea Society oder Ihren Arzt für Informationen zu Lebensmitteln, die Ihnen helfen könnten.
  9. Ich schäme mich und möchte das Haus nicht verlassen. Was soll ich tun?
    Bitten Sie Ihren Arzt um eine Überweisung zu einem Berater, der Ihnen hilft, mit Rosazea zu leben. Sie können ein erfülltes Leben führen.

Artikel geschrieben von Sheila M. Krishna M.D., FAAD

Dr. Krishna ist eine zertifizierte Dermatologin. Sie erhielt ihren Bachelor-Abschluss am Massachusetts Institute of Technology, wo sie Biologie und Fremdsprachen als Doppelmajor studierte und mit Phi Beta Kappa-Auszeichnung graduierte. Sie spricht fließend Englisch und Spanisch. Dr. Krishna erhielt ihren medizinischen Abschluss an der David Geffen School of Medicine der University of California, Los Angeles, wo sie Mitglied der Alpha Omega Alpha Medical Honor Society war. Sie absolvierte ihre Dermatologie-Assistenzzeit an der Virginia Commonwealth University in Richmond, Virginia, und war dort leitende Assistenzärztin der Dermatologie-Abteilung. Sie absolvierte ein zusätzliches Forschungsjahr an der UCLA bei Dr. Lloyd Miller, wo sie Expertise in Forschungsmethoden sowie Protokolldesign und -durchführung erwarb. Dr. Krishna ist Fellow der American Academy of Dermatology (AAD) und der American Society for Mohs Surgery (ASMS). Dr. Krishna praktiziert in San Diego, Kalifornien, wo sie Erwachsene und Kinder mit Hauterkrankungen behandelt. Dr. Krishna wurde 2017 von ihren Kollegen in San Diego als Top-Ärztin ausgewählt. Webseite - https://www.sheilakrishnamd.com/

Artikel geprüft von Natalia Kerr, lizenzierte Kosmetikerin/Gesichtsspezialistin

Natalia Kerr ist eine lizenzierte Kosmetikerin/Gesichtsspezialistin. Sie absolvierte 2019 das Orange Technical College mit ihrem Diplom in Gesichtsspezialität. Sie ist leidenschaftlich an Hautpflege und Hautgesundheit interessiert und hat ihre Ausbildung seit dem Abschluss durch die Teilnahme an verschiedenen Seminaren, Schulungen und Fachmessen fortgesetzt. Sie hatte viele Jahre lang während ihrer Mittel- und Oberschulzeit mit Akne zu kämpfen und kennt die Auswirkungen auf das Selbstvertrauen. Dies inspirierte sie zu ihrem Weg in die Welt der Hautpflege, und sie besitzt und praktiziert derzeit bei Skin by Natalia in Orlando, Florida. Webseite - https://skin-by-natalia.square.site/

Weitere Informationen

National Rosacea Society, 196 James Street, Barrington, IL 60010, rosaceas@aol.com, 888-NO-BLUSH

Quellen

  1. American Academy of Family Physicians: http://familydoctor.org/familydoctor/en/diseases-conditions/rosacea.html
  2. National Rosacea Society: http://www.rosacea.org
  3. U.S. Department of Health and Human Services, Office on Women’s Health: http://www.womenshealth.gov/news/healthday/en/2013/jul/17/677977.html
  4. Mayo Clinic: http://www.mayoclinic.org/diseases-conditions/rosacea/basics
  5. National Library of Medicine: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0004971
  6. National Institutes of Health: http://www.nlm.nih.gov/medlineplus/rosacea.html

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