{"id":105818,"date":"2025-01-30T11:26:23","date_gmt":"2025-01-30T10:26:23","guid":{"rendered":"https:\/\/bdr-beauty.de\/?p=105818"},"modified":"2025-07-16T17:17:20","modified_gmt":"2025-07-16T15:17:20","slug":"rosacea-understand-treat-help-2-2","status":"publish","type":"post","link":"https:\/\/bdr-beauty.de\/en\/skinknowledge-2\/rosacea-understand-treat-help-2-2\/","title":{"rendered":"Rosacea &#8211; understanding, treating, helping"},"content":{"rendered":"<div class=\"wpb-content-wrapper\"><p>[vc_row row_height_percent=&#8221;80&#8243; override_padding=&#8221;yes&#8221; h_padding=&#8221;2&#8243; top_padding=&#8221;5&#8243; bottom_padding=&#8221;4&#8243; back_color=&#8221;accent&#8221; back_image=&#8221;104736&#8243; overlay_color=&#8221;color-208547&#8243; overlay_alpha=&#8221;22&#8243; equal_height=&#8221;yes&#8221; gutter_size=&#8221;3&#8243; column_width_percent=&#8221;100&#8243; shift_y=&#8221;0&#8243; z_index=&#8221;0&#8243; top_divider=&#8221;gradient&#8221; bottom_divider=&#8221;gradient&#8221; content_parallax=&#8221;0&#8243; uncode_shortcode_id=&#8221;103312&#8243; back_color_type=&#8221;uncode-palette&#8221; overlay_color_type=&#8221;uncode-palette&#8221;][vc_column column_width_percent=&#8221;100&#8243; position_vertical=&#8221;bottom&#8221; gutter_size=&#8221;3&#8243; style=&#8221;dark&#8221; overlay_alpha=&#8221;50&#8243; shift_x=&#8221;0&#8243; shift_y=&#8221;0&#8243; shift_y_down=&#8221;0&#8243; z_index=&#8221;0&#8243; medium_width=&#8221;0&#8243; mobile_width=&#8221;0&#8243; width=&#8221;1\/1&#8243;][vc_row_inner row_inner_height_percent=&#8221;0&#8243; overlay_alpha=&#8221;50&#8243; gutter_size=&#8221;3&#8243; shift_y=&#8221;0&#8243; limit_content=&#8221;&#8221;][vc_column_inner column_width_percent=&#8221;100&#8243; gutter_size=&#8221;3&#8243; style=&#8221;dark&#8221; overlay_alpha=&#8221;50&#8243; shift_x=&#8221;0&#8243; shift_y=&#8221;0&#8243; shift_y_down=&#8221;0&#8243; z_index=&#8221;0&#8243; medium_width=&#8221;0&#8243; mobile_width=&#8221;0&#8243; css_animation=&#8221;alpha-anim&#8221; animation_delay=&#8221;200&#8243; width=&#8221;9\/12&#8243;][vc_custom_heading heading_semantic=&#8221;h6&#8243; text_size=&#8221;fontsize-160000&#8243; text_transform=&#8221;uppercase&#8221; text_space=&#8221;fontspace-135905&#8243; uncode_shortcode_id=&#8221;104081&#8243;][\/vc_custom_heading][vc_custom_heading heading_semantic=&#8221;h1&#8243; text_size=&#8221;fontsize-338686&#8243; css_animation=&#8221;single-slide&#8221; animation_delay=&#8221;400&#8243; interval_animation=&#8221;20&#8243; uncode_shortcode_id=&#8221;850411&#8243;]<em>Rosacea in focus: what you need to know<\/em>[\/vc_custom_heading][\/vc_column_inner][vc_column_inner width=&#8221;3\/12&#8243;][\/vc_column_inner][\/vc_row_inner][\/vc_column][\/vc_row][vc_row row_height_percent=&#8221;0&#8243; override_padding=&#8221;yes&#8221; h_padding=&#8221;2&#8243; top_padding=&#8221;3&#8243; bottom_padding=&#8221;3&#8243; overlay_alpha=&#8221;50&#8243; gutter_size=&#8221;4&#8243; column_width_percent=&#8221;100&#8243; shift_y=&#8221;0&#8243; z_index=&#8221;0&#8243; content_parallax=&#8221;0&#8243; uncode_shortcode_id=&#8221;738783&#8243;][vc_column width=&#8221;1\/1&#8243;][vc_custom_heading text_size=&#8221;fontsize-338686&#8243; text_weight=&#8221;300&#8243; sub_reduced=&#8221;yes&#8221; css_animation=&#8221;typewriter&#8221; animation_delay=&#8221;300&#8243; uncode_shortcode_id=&#8221;153011&#8243;]<strong>Rosacea<\/strong>[\/vc_custom_heading][vc_row_inner limit_content=&#8221;&#8221;][vc_column_inner width=&#8221;1\/2&#8243;][vc_column_text uncode_shortcode_id=&#8221;111044&#8243;]A term that inevitably conjures up images of <strong>chronic redness<\/strong>, <strong>visible veins<\/strong> and <strong>sensitive<\/strong>,<strong> inflamed skin<\/strong>. But this disease goes far beyond the superficial appearance. It affects <strong>millions of people<\/strong> who are confronted with limitations on a daily basis, be it through physical discomfort or the impact on their <strong>self-confidence<\/strong><strong>.<\/strong>[\/vc_column_text][\/vc_column_inner][vc_column_inner width=&#8221;1\/2&#8243;][vc_column_text uncode_shortcode_id=&#8221;352962&#8243;]Rosacea is a <strong>chronic skin disease<\/strong> whose causes lie deep within the skin and which can be exacerbated by external stimuli. The symptoms range from redness to inflammation. Treatment requires a<strong> targeted understanding<\/strong> of the underlying mechanisms in order to sustainably soothe the skin and improve its appearance.[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_column_text uncode_shortcode_id=&#8221;213394&#8243;]In this article, we take a detailed look at the complex world of rosacea to provide a sound understanding of this challenging skin condition. <strong>We explore its underlying causes and common triggers<\/strong>. It explains how rosacea affects the skin and what effective approaches can help to break the vicious cycle of redness and inflammation by strengthening the<strong> skin barrier <\/strong>and <strong>reducing sensitivity<\/strong> to restore the <strong>skin balance<\/strong>.[\/vc_column_text][\/vc_column][\/vc_row][vc_row row_height_percent=&#8221;0&#8243; override_padding=&#8221;yes&#8221; h_padding=&#8221;2&#8243; top_padding=&#8221;3&#8243; bottom_padding=&#8221;3&#8243; back_color=&#8221;color-gyho&#8221; overlay_color=&#8221;color-lxmt&#8221; overlay_alpha=&#8221;50&#8243; gutter_size=&#8221;3&#8243; column_width_percent=&#8221;100&#8243; shift_y=&#8221;0&#8243; z_index=&#8221;0&#8243; content_parallax=&#8221;0&#8243; uncode_shortcode_id=&#8221;817447&#8243; back_color_type=&#8221;uncode-palette&#8221; overlay_color_type=&#8221;uncode-palette&#8221;][vc_column width=&#8221;1\/1&#8243;][vc_custom_heading heading_semantic=&#8221;h3&#8243; uncode_shortcode_id=&#8221;170885&#8243;]The typical symptoms of rosacea[\/vc_custom_heading][vc_row_inner row_inner_height_percent=&#8221;0&#8243; back_color=&#8221;color-gyho&#8221; overlay_color=&#8221;color-lxmt&#8221; overlay_alpha=&#8221;50&#8243; gutter_size=&#8221;4&#8243; shift_y=&#8221;0&#8243; z_index=&#8221;0&#8243; uncode_shortcode_id=&#8221;363565&#8243; back_color_type=&#8221;uncode-palette&#8221; limit_content=&#8221;&#8221; overlay_color_type=&#8221;uncode-palette&#8221;][vc_column_inner column_width_percent=&#8221;100&#8243; align_horizontal=&#8221;align_center&#8221; gutter_size=&#8221;3&#8243; overlay_alpha=&#8221;100&#8243; shift_x=&#8221;0&#8243; shift_y=&#8221;0&#8243; shift_y_down=&#8221;0&#8243; z_index=&#8221;0&#8243; medium_width=&#8221;3&#8243; mobile_width=&#8221;7&#8243; zoom_width=&#8221;0&#8243; zoom_height=&#8221;0&#8243; width=&#8221;1\/4&#8243;][vc_icon icon=&#8221;fa fa-tick&#8221; icon_color=&#8221;accent&#8221; size=&#8221;fa-3x&#8221; text_size=&#8221;h4&#8243; linked_title=&#8221;yes&#8221; text_reduced=&#8221;yes&#8221; css_animation=&#8221;left-t-right&#8221; align=&#8221;left&#8221; title=&#8221;Redness&#8221; uncode_shortcode_id=&#8221;912015&#8243; icon_color_type=&#8221;uncode-palette&#8221;]Redness often occurs in the cheek and nose area, which usually intensifies during flare-ups.[\/vc_icon][\/vc_column_inner][vc_column_inner column_width_percent=&#8221;100&#8243; align_horizontal=&#8221;align_center&#8221; gutter_size=&#8221;3&#8243; overlay_alpha=&#8221;100&#8243; shift_x=&#8221;0&#8243; shift_y=&#8221;0&#8243; shift_y_down=&#8221;0&#8243; z_index=&#8221;0&#8243; medium_width=&#8221;3&#8243; mobile_width=&#8221;7&#8243; zoom_width=&#8221;0&#8243; zoom_height=&#8221;0&#8243; width=&#8221;1\/4&#8243;][vc_icon icon=&#8221;fa fa-tick&#8221; icon_color=&#8221;accent&#8221; size=&#8221;fa-3x&#8221; text_size=&#8221;h4&#8243; text_reduced=&#8221;yes&#8221; css_animation=&#8221;left-t-right&#8221; align=&#8221;left&#8221; title=&#8221;Veins&#8221; uncode_shortcode_id=&#8221;147613&#8243; icon_color_type=&#8221;uncode-palette&#8221;]Red or bluish vessels are often clearly visible on the skin, especially on light-colored skin.[\/vc_icon][\/vc_column_inner][vc_column_inner column_width_percent=&#8221;100&#8243; align_horizontal=&#8221;align_center&#8221; gutter_size=&#8221;3&#8243; overlay_alpha=&#8221;100&#8243; shift_x=&#8221;0&#8243; shift_y=&#8221;0&#8243; shift_y_down=&#8221;0&#8243; z_index=&#8221;0&#8243; medium_width=&#8221;3&#8243; mobile_width=&#8221;7&#8243; zoom_width=&#8221;0&#8243; zoom_height=&#8221;0&#8243; width=&#8221;1\/4&#8243;][vc_icon icon=&#8221;fa fa-tick&#8221; icon_color=&#8221;accent&#8221; size=&#8221;fa-3x&#8221; text_size=&#8221;h4&#8243; linked_title=&#8221;yes&#8221; text_reduced=&#8221;yes&#8221; css_animation=&#8221;left-t-right&#8221; align=&#8221;left&#8221; title=&#8221;Burning&#8221; uncode_shortcode_id=&#8221;189379&#8243; icon_color_type=&#8221;uncode-palette&#8221;]The skin reacts sensitively, burning and feelings of tension are often accompanying symptoms.[\/vc_icon][\/vc_column_inner][vc_column_inner column_width_percent=&#8221;100&#8243; align_horizontal=&#8221;align_center&#8221; gutter_size=&#8221;3&#8243; overlay_alpha=&#8221;50&#8243; shift_x=&#8221;0&#8243; shift_y=&#8221;0&#8243; shift_y_down=&#8221;0&#8243; z_index=&#8221;0&#8243; medium_visibility=&#8221;yes&#8221; medium_width=&#8221;3&#8243; mobile_width=&#8221;7&#8243; width=&#8221;1\/4&#8243;][vc_icon icon=&#8221;fa fa-tick&#8221; icon_color=&#8221;accent&#8221; size=&#8221;fa-3x&#8221; text_size=&#8221;h4&#8243; text_reduced=&#8221;yes&#8221; css_animation=&#8221;left-t-right&#8221; align=&#8221;left&#8221; title=&#8221;Inflammations&#8221; uncode_shortcode_id=&#8221;107868&#8243; icon_color_type=&#8221;uncode-palette&#8221;]In some cases, acne-like inflammations such as pustules and nodules develop on the skin.[\/vc_icon][\/vc_column_inner][\/vc_row_inner][\/vc_column][\/vc_row][vc_row row_height_percent=&#8221;0&#8243; override_padding=&#8221;yes&#8221; h_padding=&#8221;2&#8243; top_padding=&#8221;3&#8243; bottom_padding=&#8221;3&#8243; overlay_alpha=&#8221;50&#8243; gutter_size=&#8221;3&#8243; column_width_percent=&#8221;100&#8243; shift_y=&#8221;0&#8243; z_index=&#8221;0&#8243; content_parallax=&#8221;0&#8243; uncode_shortcode_id=&#8221;170845&#8243;][vc_column width=&#8221;1\/1&#8243;][vc_custom_heading uncode_shortcode_id=&#8221;142890&#8243;]A look beneath the surface &#8211; causes[\/vc_custom_heading][vc_column_text uncode_shortcode_id=&#8221;210892&#8243;]Rosacea is a multifactorial disease whose exact causes are not yet fully understood. However, scientific studies point to several interrelated mechanisms:<\/p>\n<ul>\n<li><strong>Overactivation of the skin nerves (nociceptors)<\/strong>: The nerves in the skin react hypersensitively to external stimuli such as heat, cold or stress. This reaction releases signals that trigger inflammatory processes.<\/li>\n<li><strong>Mast cells and pro-inflammatory substances<\/strong>: Activated mast cells release histamine and other pro-inflammatory mediators. These cause the blood vessels to dilate and lead to the typical redness.<\/li>\n<li><strong>Vascular instability<\/strong>: The capillaries in the face are particularly susceptible to dilated and visible veins in rosacea patients. This leads to impaired skin circulation and increased sensitivity.<\/li>\n<li><strong>Microbiome imbalance<\/strong>: Studies show that the skin microbiome &#8211; the skin&#8217;s natural bacterial flora &#8211; is often out of balance in rosacea patients. This can promote inflammation and skin irritation.<\/li>\n<\/ul>\n<p>[\/vc_column_text][\/vc_column][\/vc_row][vc_row row_height_percent=&#8221;0&#8243; override_padding=&#8221;yes&#8221; h_padding=&#8221;2&#8243; top_padding=&#8221;3&#8243; bottom_padding=&#8221;2&#8243; back_color=&#8221;color-gyho&#8221; overlay_color=&#8221;color-lxmt&#8221; overlay_alpha=&#8221;50&#8243; gutter_size=&#8221;3&#8243; column_width_percent=&#8221;100&#8243; shift_y=&#8221;0&#8243; z_index=&#8221;0&#8243; content_parallax=&#8221;0&#8243; uncode_shortcode_id=&#8221;126450&#8243; back_color_type=&#8221;uncode-palette&#8221; overlay_color_type=&#8221;uncode-palette&#8221;][vc_column width=&#8221;1\/2&#8243;][vc_custom_heading text_size=&#8221;custom&#8221; uncode_shortcode_id=&#8221;213819&#8243; heading_custom_size=&#8221;42px&#8221;]What brings the skin out of balance[\/vc_custom_heading][\/vc_column][vc_column width=&#8221;1\/2&#8243;][vc_column_text uncode_shortcode_id=&#8221;957418&#8243;]<\/p>\n<h4>An important step in dealing with rosacea is recognizing triggers. These can vary from person to person, but some triggers are particularly common:<\/h4>\n<p>[\/vc_column_text][\/vc_column][\/vc_row][vc_row row_height_percent=&#8221;0&#8243; override_padding=&#8221;yes&#8221; h_padding=&#8221;2&#8243; top_padding=&#8221;2&#8243; bottom_padding=&#8221;3&#8243; back_color=&#8221;color-gyho&#8221; overlay_color=&#8221;color-lxmt&#8221; overlay_alpha=&#8221;50&#8243; gutter_size=&#8221;3&#8243; column_width_percent=&#8221;100&#8243; shift_y=&#8221;0&#8243; z_index=&#8221;0&#8243; content_parallax=&#8221;0&#8243; uncode_shortcode_id=&#8221;145101&#8243; back_color_type=&#8221;uncode-palette&#8221; overlay_color_type=&#8221;uncode-palette&#8221;][vc_column column_width_percent=&#8221;100&#8243; align_horizontal=&#8221;align_center&#8221; gutter_size=&#8221;2&#8243; overlay_alpha=&#8221;50&#8243; shift_x=&#8221;0&#8243; shift_y=&#8221;0&#8243; shift_y_down=&#8221;0&#8243; z_index=&#8221;0&#8243; medium_width=&#8221;0&#8243; mobile_width=&#8221;0&#8243; width=&#8221;1\/4&#8243;][uncode_counter value=&#8221;30&#8243; counter_color=&#8221;&#8221; size=&#8221;fontsize-338686&#8243; weight=&#8221;600&#8243; height=&#8221;fontheight-179065&#8243; suffix=&#8221;%&#8221; uncode_shortcode_id=&#8221;611510&#8243;][vc_column_text uncode_shortcode_id=&#8221;179550&#8243;]UV-rays[\/vc_column_text][\/vc_column][vc_column column_width_percent=&#8221;100&#8243; align_horizontal=&#8221;align_center&#8221; gutter_size=&#8221;2&#8243; overlay_alpha=&#8221;50&#8243; shift_x=&#8221;0&#8243; shift_y=&#8221;0&#8243; shift_y_down=&#8221;0&#8243; z_index=&#8221;0&#8243; medium_width=&#8221;0&#8243; mobile_width=&#8221;0&#8243; width=&#8221;1\/4&#8243;][uncode_counter value=&#8221;20&#8243; counter_color=&#8221;&#8221; size=&#8221;fontsize-338686&#8243; weight=&#8221;600&#8243; height=&#8221;fontheight-179065&#8243; suffix=&#8221;%&#8221; uncode_shortcode_id=&#8221;463932&#8243;][vc_column_text uncode_shortcode_id=&#8221;134749&#8243;]Stress[\/vc_column_text][\/vc_column][vc_column column_width_percent=&#8221;100&#8243; align_horizontal=&#8221;align_center&#8221; gutter_size=&#8221;2&#8243; overlay_alpha=&#8221;50&#8243; shift_x=&#8221;0&#8243; shift_y=&#8221;0&#8243; shift_y_down=&#8221;0&#8243; z_index=&#8221;0&#8243; medium_width=&#8221;0&#8243; mobile_width=&#8221;0&#8243; width=&#8221;1\/4&#8243;][uncode_counter value=&#8221;20&#8243; counter_color=&#8221;&#8221; size=&#8221;fontsize-338686&#8243; weight=&#8221;600&#8243; height=&#8221;fontheight-179065&#8243; uncode_shortcode_id=&#8221;140553&#8243; suffix=&#8221;%&#8221;][vc_column_text uncode_shortcode_id=&#8221;178270&#8243;]Nutrition[\/vc_column_text][\/vc_column][vc_column column_width_percent=&#8221;100&#8243; align_horizontal=&#8221;align_center&#8221; gutter_size=&#8221;2&#8243; overlay_alpha=&#8221;50&#8243; shift_x=&#8221;0&#8243; shift_y=&#8221;0&#8243; shift_y_down=&#8221;0&#8243; z_index=&#8221;0&#8243; medium_width=&#8221;0&#8243; mobile_width=&#8221;0&#8243; width=&#8221;1\/4&#8243;][uncode_counter value=&#8221;15&#8243; counter_color=&#8221;&#8221; size=&#8221;fontsize-338686&#8243; weight=&#8221;600&#8243; height=&#8221;fontheight-179065&#8243; uncode_shortcode_id=&#8221;102446&#8243; suffix=&#8221;%&#8221;][vc_column_text uncode_shortcode_id=&#8221;134603&#8243;]Cosmetics[\/vc_column_text][\/vc_column][\/vc_row][vc_row row_height_percent=&#8221;0&#8243; override_padding=&#8221;yes&#8221; h_padding=&#8221;2&#8243; top_padding=&#8221;3&#8243; bottom_padding=&#8221;2&#8243; overlay_alpha=&#8221;50&#8243; gutter_size=&#8221;3&#8243; column_width_percent=&#8221;100&#8243; shift_y=&#8221;0&#8243; z_index=&#8221;0&#8243; content_parallax=&#8221;0&#8243; uncode_shortcode_id=&#8221;206477&#8243;][vc_column width=&#8221;1\/1&#8243;][vc_custom_heading uncode_shortcode_id=&#8221;841366&#8243;]Breaking the vicious circle &#8211; our solution: Rosa Calm[\/vc_custom_heading][\/vc_column][\/vc_row][vc_row row_height_percent=&#8221;0&#8243; override_padding=&#8221;yes&#8221; h_padding=&#8221;0&#8243; top_padding=&#8221;1&#8243; bottom_padding=&#8221;3&#8243; overlay_alpha=&#8221;50&#8243; gutter_size=&#8221;3&#8243; column_width_percent=&#8221;100&#8243; shift_y=&#8221;0&#8243; z_index=&#8221;1&#8243; content_parallax=&#8221;0&#8243; uncode_shortcode_id=&#8221;101554&#8243; el_class=&#8221;pp-even&#8221;][vc_column column_width_percent=&#8221;80&#8243; gutter_size=&#8221;3&#8243; overlay_alpha=&#8221;50&#8243; radius=&#8221;lg&#8221; shadow=&#8221;std&#8221; shift_x=&#8221;0&#8243; shift_y=&#8221;0&#8243; shift_y_down=&#8221;0&#8243; z_index=&#8221;0&#8243; medium_width=&#8221;0&#8243; mobile_width=&#8221;0&#8243; width=&#8221;1\/1&#8243; uncode_shortcode_id=&#8221;441108&#8243; el_class=&#8221;overflow-hidden-uncell&#8221;][vc_row_inner row_inner_height_percent=&#8221;0&#8243; overlay_alpha=&#8221;50&#8243; equal_height=&#8221;yes&#8221; gutter_size=&#8221;0&#8243; shift_y=&#8221;0&#8243; z_index=&#8221;0&#8243; inverted_device_order=&#8221;yes&#8221; uncode_shortcode_id=&#8221;872807&#8243; limit_content=&#8221;&#8221;][vc_column_inner column_width_percent=&#8221;100&#8243; gutter_size=&#8221;2&#8243; override_padding=&#8221;yes&#8221; column_padding=&#8221;3&#8243; style=&#8221;dark&#8221; back_color=&#8221;accent&#8221; overlay_alpha=&#8221;50&#8243; shadow=&#8221;std&#8221; shadow_darker=&#8221;yes&#8221; shift_x=&#8221;0&#8243; shift_y=&#8221;0&#8243; shift_y_down=&#8221;0&#8243; z_index=&#8221;0&#8243; medium_width=&#8221;0&#8243; mobile_width=&#8221;0&#8243; width=&#8221;1\/2&#8243; uncode_shortcode_id=&#8221;186101&#8243; back_color_type=&#8221;uncode-palette&#8221;][vc_custom_heading text_size=&#8221;custom&#8221; text_height=&#8221;fontheight-179065&#8243; uncode_shortcode_id=&#8221;853721&#8243; subheading=&#8221;Rosa Calm &#8211; Capillary Relief has been specially developed to soothe sensitive, rosacea-prone skin. The innovative formula soothes irritation of the skin nerves, inhibits inflammatory processes and strengthens the capillaries. This reduces visible redness, increases the skin&#8217;s resistance and regenerates its natural protective function.&#8221; heading_custom_size=&#8221;50px&#8221;]bdr\u00ae Rosa Calm[\/vc_custom_heading][vc_button border_width=&#8221;0&#8243; uncode_shortcode_id=&#8221;160760&#8243; link=&#8221;url:https%3A%2F%2Fbdr-beauty.de%2Fen%2Fhautpflege%2Frosa-calm%2F|title:bdr%20Rosa%20Calm|target:_blank&#8221;]Learn more[\/vc_button][\/vc_column_inner][vc_column_inner column_width_percent=&#8221;100&#8243; position_vertical=&#8221;middle&#8221; gutter_size=&#8221;3&#8243; override_padding=&#8221;yes&#8221; column_padding=&#8221;2&#8243; back_color=&#8221;color-xsdn&#8221; overlay_alpha=&#8221;50&#8243; shift_x=&#8221;0&#8243; shift_y=&#8221;0&#8243; shift_y_down=&#8221;0&#8243; z_index=&#8221;0&#8243; medium_width=&#8221;0&#8243; mobile_width=&#8221;0&#8243; width=&#8221;1\/2&#8243; uncode_shortcode_id=&#8221;525778&#8243; back_color_type=&#8221;uncode-palette&#8221;][vc_single_image media=&#8221;104897&#8243; 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