Rosacea and Dry Eyes Part 3 - Commonly Associated Skin Conditions

Telangiectasias are when tiny blood vessels called capillaries become dilated and occur 4 times more commonly in people with Rosacea. Spider veins are even larger dilated vessels and a hemangioma is a cluster of dilated vessels creating a small, red patch. Nevus Flammeus is another word for a “Port Wine Stain” - seen as a birthmark that looks like a “splash” of ruby red wine - and caused by a larger group of dilated blood vessels. In this study, men dominated the abnormal vessel frequency (except for the hemangiomas).

Rosacea is the genetic tendency for sensitive skin and irritable oil glands. I see these dilated blood vessels as a direct consequence of this sensitivity, though one could debate which came first, the dilated vessel or the sensitivity. Increasing blood flow will bring the immune system with it and thereby make skin more sensitive, even as the sensitivity can “call” more blood vessels up to the surface to bring the immune system to where it can act on whatever caused the sensitive reaction. (The old “which came first, the chicken or the egg.?” argument.)

Eczema is another word for sensitive skin and can come in as many as 7 different guises: https://nationaleczema.org/eczema/types-of-eczema/

Contact dermatitis is form of eczema causing a reaction of the skin to something that it comes into contact with (like the red, itchy blistery rash from poison ivy). Once skin is sensitized to something, anytime it comes in contact with “that thing,” it will react - typically more severely with subsequent contact.

https://www.mayoclinic.org/diseases-conditions/contact-dermatitis/symptoms-causes/syc-20352742#dialogId5001370

This is an excellent example from the Mayo Clinic, of patients I commonly see with contact dermatitis. They note:

Contact dermatitis on the face

Contact dermatitis often affects skin directly exposed to an offending substance. Here, the rash is likely caused by cosmetics.

https://www.medicalnewstoday.com/articles/seborrheic-dermatitis-vs-eczema

Seborrheic Dermatitis is another common form of eczema that is frequently seen in patients with rosacea. It tends to affect oily skin such as the face and scalp. This fellow’s lids are affected along with most of his face.

Each form of eczema requires its own type of treatment, and the area affected along with the degree of involvement will dictate the best treatment required. This will sometimes require the combined efforts of skin (Dermatologists) and eye specialists. In each case, if rosacea is an undercurrent, then that aspect should also be appropriately treated - along with any associated dry eye and related ocular surface diseases. More on this to come!

To schedule an appointment with Dr. Jaccoma, call Excellent Vision at either of these two dry eye offices:

(1) 155 Griffin Rd, Portsmouth, NH 03801 (603) 574-2020

(2) 3 Woodland Rd, STE 112 Stoneham, MA 02180 (near Boston) (781) 321-6463