Which came first, the chicken or the egg?
In rosacea, are visible dilated blood vessels -- called telangiectasia -- the result of damaged connective tissue, or is it the damaged blood vessels themselves that have a degrading effect on the connective tissue? Experts have discussed both possibilities.
One theory holds that dilated blood vessels appear on the faces of rosacea sufferers because the blood vessels have yielded to connective tissue that has lost its elasticity and does not provide adequate support. However, recent research appears to tip the balance toward damaged blood vessels themselves as the culprit, with the primary damage evoked by environmental influences.
In a study published in the International Journal of Dermatology by Drs. E. Neumann and A. Frithz of Stockholm, Sweden, the researchers took biopsies from rosacea lesions and examined them by light microscopy and immunochemistry to identify structural changes leading to the formation of these dilated blood vessels.1 They found that damage to blood vessels came before degradation of connective tissue, and noted that the primary cause may be environmental factors -- especially the sun.
In a National Rosacea Society survey of rosacea sufferers, sun exposure was the most widely reported trigger factor for flare-ups.
Neumann E, Frithz A: Capillaropathy and capillaroneogenesis in the pathogenesis of rosacea. International Journal of Dermatology. 1998;37:263-266.
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