Pyoderma Faciale

Pyoderma faciale (rosacea fulminans) is a rare but extremely serious skin condition that only afflicts women. It is characterized by severe, sudden onset acne-like cysts, nodules, and pustules, which are painful and disfiguring.

Skin conditions such as acne and rosacea can be devastating, both physically and mentally; the stigma, physical pain, and scarring is traumatic for those with severe cases. Sufferers of pyoderma faciale (rosacea fulminans) have what is often described as one of the worst skin conditions known to man—and its cause is still unknown. It can, however, be treated.

What is Pyoderma Faciale (Rosacea Fulminans)?

  • Pyoderma faciale (roseacea fulminans) is a severe skin condition that has symptoms resembling both acne and rosacea, but it is not truly either one. There are no comedones (blocked pores, such as blackheads and whiteheads), although pyoderma faciale sufferers may also have acne vulgaris at the same time.
  • This uncommon condition appears to only afflict women, usually between the ages of 20-40 years.
  • It appears suddenly, with lesions popping up in the space of hours, and the condition worsens rapidly, usually over the course of a week. Symptoms persist for several weeks or even months without medical attention; if you get care from a medical professional, the duration is typically much shorter.
  • There is currently no known cause of pyoderma faciale (rosacea fulminans). Extensive testing can prove no relationship between bacterial or viral infection and pyoderma faciale. There have been suggestions that it could result from female hormonal fluctuations or even too much B12 vitamin consumption, but these theories have not been validated.

Symptoms of Pyoderma Faciale (Rosacea Fulminans)

Pyoderma faciale (rosacea fulminans) is characterized by symptoms such as:

  • Erythema. This localized redness is common in rosacea. Erythema in pyoderma faciale (rosacea fulminans) shows up mainly on the cheeks, chin, and forehead. It can range from a bright pink to deep red, and some sufferers flush so deeply that it resembles a purplish-blue.
  • Lesions. Pyoderma faciale (rosacea fulminans) lesions are similar to acne vulgaris lesions, but they are much more severe. Nodules, pustules, and cysts develop, especially on the cheeks and along the chin and jawline. These lesions tunnel, spread, and connect. Cystic lesions can fill with and seep pus.
  • Hemorrhaging. Once the lesions form, they typically ulcerate (become crater-like) and spontaneously begin to bleed.
  • Scabbing. After the hemorrhaging, pyoderma faciale (rosacea fulminans) lesions can form crusty scabs that stick to clothing and bedding, and which continue to seep.
  • Fever. Some pyoderma faciale (rosacea fulminans) patients experience fever and aching joints, although it is unclear whether those symptoms are due to the effects of an infection resulting from the open lesions or from the proderma faciale (rosacea fulminans) itself.
  • Scarring. The lesions will eventually heal, but they will almost certainly scar, typically thick, plaque-like or keloid-type scars that either protrude or recess.

Treatment of Pyoderma Faciale (Rosacea Fulminans)

Since the cause of this severe skin condition is unknown, it is difficult to formulate a treatment plan. Antibiotics, whether topical or oral, do not seem to have an effect. Topical treatments with benzoyl peroxide also do not appear effective.

Treatment for this disorder lasts anywhere from three to seven months.

These pyoderma faciale (rosacea fulminans) treatments have shown success in healing lesions and ending the condition:

Steroids. Whether systemic, injected, or topical, steroid treatment appears to calm the inflammation and promote lesion healing. The most effective steroid treatments seem to be when a dermatologist performs cortisone injections directly into lesions.
Isotretinoin (Accutane). This common acne treatment reduces the skin’s oil production and improves skin renewal functions, and has proven very beneficial in cases of pyoderma faciale (rosacea fulminans). It is given orally.

Pyoderma faciale (rosacea fulminans) is a severe skin condition that causes pain, inflammation, disfiguring lesions, and emotional damage. Although its cause is unknown, it can be treated with certain medications, such as steroid injections and isotretinoin. Prognosis is good for pyoderma faciale sufferers, as long as they get prompt medical attention.

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