Couperose

Couperose is a chronic and fairly common condition, consisting of diffuse, permanent erythema of the face. Couperose does not appear as an isolated condition but as part of a chain of events in the course of acne rosacea.

Rosacea begins insidiously, most often unnoticed by patients and only recognised by them during the conversation with the dermatologist. The first signs of the condition appear as flushes, warmth and temporary redness of the cheeks, set off by various stimuli: exposure to high temperatures, sun, shifts from cold to warm, drinking alcohol and so on. Over a period that varies from person to person, this initially fleeting erythema becomes permanent, with telangiectasias on its surface, which patients sometimes find very troubling.
The extent of the skin involvement can range from a form limited to the cheeks to forms spreading over the nose, forehead and chin.

Couperose can affect anyone, but those most often affected have phototype I or II (fair skin that does not tan easily, blond hair, blue eyes). The condition very often begins in people between 30 and 50 years old, and women are affected more often, but men with this condition have more severe forms.

Treating couperose is first of all a matter of the patient recognising and avoiding the factors that make the couperose redness worse: prolonged exposure to the sun or to low temperatures, alcohol, coffee, spicy or very hot food, the sauna, and corticosteroids applied locally or taken systemically.

It should be noted that couperose very often goes with skin that is highly sensitive to cosmetic products which would not normally cause any problem. This is why the way the skin is cared for matters a great deal: it can help calm the symptoms or, on the contrary, make them worse. The reason is that people with this skin type have a very fragile horny layer, so the skin is easily irritated by various cosmetics, and careful skincare can have favourable results:

– Wash the face gently using lukewarm, not hot, water; the soap used should be gentle and unperfumed, and rinsing should be thorough.
– Avoid rubbing or drying the rosacea-affected skin vigorously, as this can irritate it further

– After washing, leave the skin 20 to 30 minutes to dry completely before applying other skincare products

– Apply effective therapeutic products before applying sunscreen or make-up

– Applying a well-tolerated cream, moisturising and with a repairing effect, can do this extremely sensitive skin good and also help reduce the redness

– The make-up used should be light and water-based, containing silicone, and easy to remove so as not to irritate the skin further. Make-up removers should contain no alcohol, fragrance, menthol, olive oil or salicylic acid.

– Every day, before going out in the sun, it is important to use a high-factor sunscreen (SPF over 50). Sunscreens containing silicone (dimethicone or cyclomethicone) can be beneficial.

– People with sensitive skin are advised to remember the products they have used before and not tolerated, so as to avoid using them again.

Dermatocosmetic products containing retinaldehyde and dextran sulfate, which have a therapeutic calming effect on the redness, do couperose good. These creams may also have a slightly green tint, which helps to camouflage the redness immediately.
For the facial telangiectasias that accompany couperose, the Nd:YAG Cutera laser is used, with very good results that last.

For couperose and for facial telangiectasias, treatment with intense pulsed light (IPL) is a solution used with success.

Whether the treatment is with dermatocosmetic products, with the laser or with IPL, it has to be followed by avoiding the aggravating factors and by respecting the rules for caring for couperose-prone skin.