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Millions of people know the problem. They look in the mirror and their faces are covered with larger and smaller red spots. The reasons for this are diverse. Sometimes the cause is clear, for example if you have sunburn or are aroused. Sometimes, however, it is also a skin inflammation.
What happens in the body
Red spots appear when the blood vessels expand. In the face we see this especially on the cheeks and nostrils. We blush. Even when we are aroused, the blood vessels widen, as well as when we exert ourselves physically or drink alcohol. But usually the vessels contract again when the special condition is over.
However, if our blood vessels react particularly sensitively, they will expand more and more and will always appear as red spots on the face.
Sometimes the skin reacts to foreign substances such as cosmetics or medication. Dry heaters can also cause blood vessels to expand, as can nicotine.
The so-called oral rose, in specialist jargon perioral dermatitis, is a rash that spreads "like a rose" around the nose and mouth. It can be easily treated with an ointment prescribed by the dermatologist. However, as long as the rash is rampant, you must not apply cosmetics.
Couperose is a vascular disease in which the veins on the face widen so that the blood does not flow back when it blushes. It can also be treated well by a dermatologist.
Red spots on the face due to rosacea
Rosacea is an inflammatory skin disease. If your facial skin not only turns reddish, but also the blood vessels are visible and the skin burns and stings, then rosacea may be present.
The inflammation is particularly evident on the forehead, nose, chin and cheeks. Approximately 4 million people in Germany suffer from it, but only a few know that this is the disease.
The inflammation manifests itself in a chronic reddening, but also in the form of nodules, blisters, visible veins and swelling on the face. The symptoms are reminiscent of an acne or allergy, with which the skin disease is often confused.
Light skin is a risk factor
Rosacea is known as the "Curse of the Celts". The inflammation is particularly prevalent in Northern Europe, Scandinavia and Great Britain. But it is not the wet and cold weather that is responsible, but the fair skin with reddish or blonde hair and blue, green or gray eyes and freckles.
How does rosacea develop?
To this day, science does not know the cause of the skin disease, also known as "facial rose". Since it is an inflammation, a nerve control disorder, congenital immune deficiency or a reaction to external stimuli are probably responsible. The skin produces an inadequate protein, which is part of our immune system.
Demodex mites colonize to a large extent on skin attacked by rosacea. To date, however, it is unclear whether the mites seek out the affected skin after the disease has broken out or whether they themselves cause the inflammation.
The skin of the patient becomes extremely red when exposed to the sun (UV radiation), hot spices, alcohol or a change in temperature. So she is hypersensitive. Here, too, the cause and effect have not been clarified: in any case, the skin of the sick is hypersensitive. But is the most sensitive
Skin maybe also a cause of the disease?
Symptoms and overreactions
Many symptoms of facial rose show up as an extreme reaction to stimuli, which also cause red spots on the face in healthy people.
Alcohol dilates the blood vessels. That's why everyone knows the red cheeks who likes to drink one over thirst. With rosacea, however, the redness does not go away and the alcohol can cause pustules and papules.
Excessive heat such as cold and sharp wind promote blood circulation. What is good for healthy people is a curse for people with facial rose. If the blood gets going after the alternating shower or the sauna with the following ice bath, this often triggers an episode of illness. Those affected do not go out of the sauna relaxed, but look like a boiled lobster.
Chili con carne
Those affected should avoid foods that contain a lot of chili, pepper or curry. Chili promotes blood circulation, and Asians and South Americans therefore see it not only as a spice, but also as a medicine. Again, however, what is good for people without facial flushing triggers a surge in those affected. Your face turns bright red and the skin does not recover at first.
If you suffer from rosacea, you do not have to do without make-up in general, but watch out for low-fat cosmetics that do not irritate the skin. You should undergo a test and / or consult your dermatologist.
Self help with rosacea
If you have a facial rose, you should definitely discuss therapy with your dermatologist. You can also relieve the symptoms yourself if you know the triggers. It is best to keep a diary in which you write down when and how violently the relapses come.
They themselves know best when their skin is burning, pustules are forming, and their faces look like they have just come from a trip to the Sahara without sunscreen.
Now, every day, write down what your skin looks like and what you have done and are doing. This does not only include the obvious triggers such as a sauna session or participation in the "toughest currywurst competition".
Have you been under stress and have red spots on your face? If so, what was the trigger for the stress and how can it be avoided?
Have you tried a new makeup and looked like a strawberry cake afterwards? Change the preparation.
Avoid competitive sports. The blood vessels dilate during exercise. Do you have red spots on your forehead after jogging? Does the blood rise in their faces during weight training? Even if it is difficult: Replace the full power with relaxed cycling or longer walks.
Avoid sun. Make sure you have good sun protection, wear a hat, stay in the shade. Put on wide shirts with long sleeves.
Almost every human being is affected by these mites at some point. We usually don't notice it. If the mites multiply uncontrollably, the skin becomes inflamed. The mite occurs in excess in rosacea sufferers.
Blushing is embarrassing to many people. When we are in love and our dream woman appears on the scene, we can not hide our feelings because the blood rises in the cheeks. When someone provokes us and we put on a poker face, the red spots on the face show that we are "cooking internally".
People with facial roses are often emotionally unsettled because they keep turning red.
It is not the reddening alone that is particularly uncomfortable, but pus blisters that develop in the rosacea papulopustulosa. In contrast to acne, large areas of the face are red. The pus vesicles of the facial rose also do not develop from inflamed sebum follicles.
As with acne, pus in the middle of the face is extremely uncomfortable for those affected.
Rosacea leads to thickened connective tissue and sebaceous glands, especially in men. These occur primarily on the nose. Affected people get a so-called bulbous nose, colloquially known as prong or potato nose.
However, such “phymes” can also appear on the chin, forehead, ears and eyelid. The thickening is even more uncomfortable for those affected than the reddening of the face itself, they feel disfigured, and some have an almost monstrous appearance.
Good chances of recovery
The individual forms of rosacea can be treated very well dermatologically. A regular visit to the dermatologist and the proper use of medication will quickly relieve the symptoms.
Other causes of red spots on the face
Women over 40 in particular often blush on the nose and cheeks. These flare-ups are probably a result of menopause. Those affected have hot flashes, the skin itches and burns. In contrast to a face rose, the "flush" quickly decreases again.
The red spots on the face only remain if the blood vessel control is disturbed. Then the veins do not close on their own.
Triggers here are spicy food, alcohol, heat or cold as well as psychological-emotional triggers (stress, anger, shame or arousal).
Couperose shows up in enlarged blood vessels. The blood shimmers through the skin in blue-red-violet colors. The skin can also become inflamed and speckled with blisters, pimples and knots.
The cause of this skin disease is unclear. In any case, it is associated with weakened connective tissue, and women over 50 are most commonly affected.
Self-help means avoiding the same triggers as with a facial rose: sauna, extreme temperatures, hot drinks, alcohol, chilli and pepper, sun and sunlamps.
If recognizable veins in the face are particularly disruptive, the dermatologist can clear them or "weld" the vessels with light treatment.
Couperose is considered the onset of rosacea, but doctors are arguing whether it is different forms of the same disease.
Sensitive skin is not a disease and cannot be "healed". Often it is a naturally dry skin whose protection from the outside world is weaker than that of damp skin.
People with sensitive skin react intensely to various external stimuli: they quickly suffer from fungal infections, they often have an allergic reaction to cosmetics and spicy food causes an itchy face.
For some people, the red spots on the skin even appear when they take a hot or cold shower. People with sensitive skin need special care, for example with skin creams after a dermatologist has determined the fat and moisture content of the skin.
In general, you should not be in the sun for long, avoiding the sauna and hot showers. (Dr. Utz Anhalt)
Author and source information
This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
Dr. phil. Utz Anhalt, Barbara Schindewolf-Lensch
- Markus Reinholz et al .: Rosacea, Guideline of the German Dermatological Society, (accessed September 6, 2019), AWMF
- Couperose guide: Couperose (erythrosis facialis): causes, symptoms & treatment, (available on September 6, 2019), couperose guide
- Jonette E. Keri: Rosacea (Acne rosacea), MSD Manual, (accessed September 6, 2019), MSD
- Dorothea Terhorst-Molawi: Dermatologie Basics, Elsevier / Urban Fischer Verlag, 4th edition, 2015