Acne or rosacea?(differences between skin conditions)

Mark Greener describes the differences between these two common skin conditions

 
Objectives 
 
* To be aware how symptoms of acne differ from rosacea 
* To be aware of possible causes of acne or rosacea 
* To be able to distinguish rosacea from similar skin conditions 
* To revise treatments for acne and rosacea 
* To know what lifestyle advice to give to sufferers 

THE COLLEGE OF PHARMACY PRACTICE

This course (module 1254), in association with multiple choice questions being published in C&D December 7, provides one hour's continuing education

Rembrandt's 1659 self-portrait was, at least, honest. He painted his papules and pustules, the spidery blotch under his right eye and his bulbous nose with coarse skin. We would now recognise these as hallmarks of rosacea.1 Its old name - acne rosacea - suggests a link to the pimples most of us suffered as teenagers. However, acne and rosacea differ markedly in pathogenesis, symptoms and treatment.

How common?

Estimating acne's prevalence is surprisingly difficult. There's no universally accepted acne classification and increasingly effective OTC treatments reduce the number of sufferers that present to doctors.

Nevertheless, a recent UK study2 found that half the children aged between 14 and 16 years suffered from acne. Eleven per cent endured moderate to severe acne. And while acne tends to be a disease of adolescence, it often persists into adulthood.

Similarly, rosacea is relatively common, accounting for around 1.6 per cent of cases presenting to a UK dermatology clinic.3 An American study4 found that 96 per cent of rosacea patients are Caucasian. Women accounted for 69 per cent of consultations and their average age was 50 years. Further community-based studies are needed to assess rosacea's current prevalence in the UK.

What causes acne and rosacea?

Acne arises in pilosebaceous units, driven by hormonal changes and bacterial infection. Blackheads and whiteheads (open and closed comedones respectively) occur when androgens, during adolescence, stimulate sebum overproduction and epithelial cell proliferation. The sebum and desquamated cells in comedones offer an ideal habitat for the proliferation of Propionibacterium acnes, one of a number of bacteria…