Rosácea


La rosácea es una dermatosis facial muy frecuente en la población. No es una enfermedad grave  pero puede repercutir en la salud del paciente a nivel psicológico. Hoy profundizamos un poco más en esta patología y te damos algunos consejos prácticos que puedes aplicar.

¿QUÉ ES LA ROSÁCEA?
Es una enfermedad de la piel, superficial, crónica y recurrente en la que interviene un hongo tipo levadura llamado Malassezia y cierta labilidad vasomotora.
¿POR QUÉ SE PRODUCE?
La causa es desconocida pero parece que influyen en su patogenia: alteraciones de la microvascularización facial, factores climáticos y microorganismos.
¿A QUIÉN AFECTA?
Afecta sobre todo a personas de mediana edad (30-50 años) y piel clara, con cierta predominancia en las mujeres.
¿CÓMO SE MANIFIESTA?
Se caracteriza por manifestarse en brotes con enrojecimiento (que puede durar horas o días), rubor, telangiectasias, crisis vasomotoras, con o sin pápulas o pústulas. Las lesiones afectan habitualmente al área centro­facial (nariz, mejillas, mentón, frente y entrecejo), suele ser simétrica, pero a veces es más in­tensa en un lado de la cara e incluso unilateral.
También suelen asociar otras alteraciones: ardor y quemazón, inflamación, lesiones oculares (conjuntivitis, queratitis), lesiones en otras partes del cuerpo (escote, espalda, extremidades), aumento del volumen y grosor de la piel (sobre todo en la nariz, llamado rinofima).
 ¿CUÁL ES SU DIAGNÓSTICO?
Su diagnóstico es clínico, puede combinar varios ti­pos de alteraciones crónicas en la piel que evolucio­nan con el tiempo.
 ¿Y SU TRATAMIENTO?
No hay curación definitiva, pero los tratamientos actuales sirven para controlar los brotes y detener la evolución de la enfermedad. Según el tipo que presente tie­ne un manejo distinto, pero se basa fundamentalmente en el cuidado de la piel, cremas específicas, antibióticos y, en determinados casos, terapia lá­ser y cirugía.

No lo dude: acuda a su médico para que valore su piel y la necesidad de tratamiento específico.

 
CONSEJOS PRÁCTICOS PARA PACIENTES CON ROSÁCEA  (Click  para descargar versión imprimible)
Medidas preventivas

  • Aseo con agua templada, limpiador líquido suave o jabones naturales (avena). Lavado con las yemas de los dedos. Usar una toalla de algodón secando a pequeños toques, SIN FROTAR. Esperar 30 minutos de secado, pues el escozor surge frecuentemente con la piel húmeda. Después aplicar el tratamiento específico de rosácea. Esperar 5-10 minutos para continuar aplicando crema hidratante o cosméticos.
  • Usar factor de protección solar todos los días.
  • Evitar la manipulación de las lesiones así como tratamientos de limpieza y peelings.

Consejos sobre maquillaje

  • Utilizar brochas de maquillaje para aplicar cosméticos. Procurar utilizar la menor cantidad posible de productos.
  • El enrojecimiento y las telangiectasias pueden camuflarse con productos cosméticos en tono verde.
  • Usar sombras de ojos para ojos sensibles, rímel y delineador que se retire fácilmente. Los colores neutros de sombras de ojos pueden ser menos irritantes al llevar menos pigmento.
  • Optar por tonos de barras de labios neutros. Evitar los tonos rojos ya que puede exacerbar la apariencia de enrojecimiento en la piel.

Consejos para el afeitado

  • Es preferible el afeitado con maquinilla eléctrica porque irrita menos que la cuchilla pero es un criterio individual, elegir el que menos irritación produzca.
  • Evitar las lociones o cremas de afeitado con alcohol, que quemen o irriten la piel. Se aconseja un aftershave para ayudar a calmar la piel.

Factores agravantes
Los siguientes factores deben ser evitados, en la medida de lo posible, para disminuir el riesgo de recaídas:

  • El uso de cremas o pomadas con corticoides Si es necesario utilizarlas, serán cremas con corticoides de baja potencia y durante periodos cortos para evitar el fenómeno de rebote.
  • Algunos medicamentos que se toman por la boca también pueden empeorarla, consúltelo con su médico.
  • Exposición solar: el sol le perjudica. Si no le resulta posible evitarlo, debe usar cremas con factor de protección solar total.
  • El calor, el frío y el viento excesivo también deben evitarse.
  • La estancia en lugares muy caldeados y los cambios bruscos de temperatura desencadenan brotes.
  • Comidas y bebidas muy calientes, comidas con muchas especias y quesos fermentados. Evite el alcohol y las bebidas estimulantes.
  • Los cosméticos son generalmente mal tolerados.  Debe usar aquellos más apropiados.
  • Estados de nerviosismo como la ansiedad y el estrés pueden ser perjudiciales.
  • Evitar jabones agresivos que contengan alcoholes o fragancias puesto que la piel se irrita con facilidad.

Sara Leticia de la Fuente Ballesteros
Médico residente, MFyC, Centro de Salud Arturo Eyries, Valladolid

REFERENCIAS:

  • MÁS CONSEJOS PARA PACIENTES CON ROSÁCEA: https://www.rosacea.org/patients/index.php
  • Ballesteros Torrens MM. Rosácea y rinofima. AMF 2013; 9(7) 397-401
  • Fonseca Capdevila E. “Rosácea”. Fisterra. Actualización mayo 2010.
  • Olazábal Ulacia JC, Enríquez Gutiérrez EV, García Paniagua R, del Río Pérez P. Averroes. Manual de terapia en atención primaria. 2º ed. EviSciencie Publications; 2016: capítulo 15.

 
Revisado: febrero 2019

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