Like a mosaic slowly gaining definition and becoming clear, so too is the scientific understanding of the potential causes of rosacea. April has been designated as Rosacea Awareness Month by the National Rosacea Society (NRS) to educate the public on the warning signs of this chronic but treatable facial disorder now estimated to affect more than 16 million Americans.
The NRS has long supported medical research on rosacea through its patient-funded research grants program, awarding $1.4 million to date for 56 studies that may lead to advances in its treatment and potential prevention or cure. Ongoing research has suggested that rosacea may be caused by various possible factors, including defects of the immune system, nervous system, facial blood vessels and genetics, as well as the presence of microbes and Demodex mites on the skin. Meanwhile, there is now an expanding range of treatment options for its many potential signs and symptoms.
“Researchers are now making steady progress in defining potential causes of the disorder, which may provide a foundation for significant improvements in its effective control,” said Dr. Richard Gallo, chief of dermatology at the University of California – San Diego and a member of the NRS medical advisory board. “Nevertheless, translating those scientific advances into effective therapy will be for naught if those who suffer from the disorder fail to realize they have a medical condition that can be treated.”
In a recent NRS survey of 1,459 rosacea patients, 47 percent said they had never heard of rosacea prior to their diagnosis, and 95 percent said they had known little or nothing about its signs and symptoms. In other NRS surveys, 90 percent of rosacea patients said rosacea’s effect on personal appearance had lowered their self-esteem and self-confidence, and 41 percent said it had caused them to avoid public contact or cancel social engagements.
“Promoting early recognition of rosacea’s warning signs is a primary goal of the NRS because early diagnosis and treatment can keep the disorder from progressing to the point where it becomes an emotional and social burden,” Dr. Gallo said.
Rosacea typically first strikes anytime after age 30, and may initially resemble a simple sunburn or an inexplicable blush. Suddenly, without warning, a flush comes to their cheeks, nose, chin or forehead. Then just when they start to feel concerned, the redness disappears.
Unfortunately, it happens again and again, becoming ruddier and lasting longer each time, and eventually visible blood vessels may appear. Without treatment, bumps and pimples often develop, growing more extensive over time, and burning, itching and stinging are common.
In severe cases, especially in men, the nose may become enlarged from the development of excess tissue. This is the condition that gave comedian W.C. Fields his trademark red, bulbous nose. In some people the eyes are also affected, feeling irritated and appearing watery or bloodshot. Severe cases of this condition, known as ocular rosacea, can result in reduced visual acuity.
Among the most famous rosacea sufferers is former President Bill Clinton, whose doctors disclosed that he had this condition in The New York Times. Others reported to have suffered from the disorder include Princess Diana, singer Sam Smith, model Dita Von Teese and actress Lisa Faulkner.
Adding insult to injury is the common myth that rosacea sufferers who have an enlarged nose or ruddy complexion may be heavy drinkers. In fact, while alcohol may aggravate rosacea, these symptoms can be just as severe in a teetotaler. Another common misconception is that rosacea is caused by poor hygiene, when in reality it is unrelated to personal cleanliness.
Research is helping to dispel these common misconceptions by illuminating rosacea’s relationship to various internal and external factors that may be involved in its development. The role of the innate immune system in rosacea has been the focus of groundbreaking studies funded by the NRS, including the discovery of irregularities of key components known as cathelicidins that may lead to inflammation. Other scientific investigators have documented a possible genetic component, and that the nervous system may be intimately linked with the vascular system in producing the redness of the disorder.
Medical scientists are now examining the potential role of microscopic Demodex mites, which are normal inhabitants of human skin but often occur in far greater numbers in people with rosacea. It is also believed that an immune response to bacteria associated with the mites may lead to the inflammatory bumps and pimples of the condition.
Although the definitive cause of rosacea remains unknown, a vast array of lifestyle and environmental factors have been found to trigger flare-ups of signs and symptoms in various individuals. Common rosacea triggers include sun exposure, emotional stress, hot or cold weather, wind, heavy exercise, alcohol, spicy foods, heated beverages, humidity, certain skin-care products and potentially an overabundance of Demodex mites.
“The good news is that rosacea can now be effectively controlled with medical therapy and lifestyle changes,” Dr. Gallo said. “Through ongoing progress in medical research, a growing number of medical therapies are now available that can be tailored to each case and substantially reduce the impact of rosacea on people’s lives.”
Individuals with any of the following warning signs of rosacea are urged to see a dermatologist for diagnosis and appropriate treatment:
- Redness on the cheeks, nose, chin or forehead
- Small visible blood vessels on the face
- Bumps or pimples on the face
- Watery or irritated eyes
During April and throughout the year, people who suspect they may have rosacea can contact the NRS for more information.
Comprehensive information and materials on rosacea are available on the NRS website at rosacea.org. The NRS encourages those interested in spreading awareness during the month of April to visit the official Rosacea Awareness Month landing page and follow the online conversation using the hashtag #RosaceaAwareness. The NRS may also be followed on Facebook, Twitter or Pinterest for up-to-date information and tips on rosacea. Further information may be obtained by writing the National Rosacea Society, 196 James Street, Barrington, Illinois 60010; via email at firstname.lastname@example.org; or by calling its toll-free number at 1-888-NO-BLUSH.
Global Rosacea Awareness Month
Starting this year the National Rosacea Society has also joined forces with the Global Rosacea Coalition, an independent group of internationally renowned dermatologists, media medics, rosacea sufferers, bloggers, celebrities and professional organizations from around the world, all of whom share the common goal of improving the lives of people with rosacea. The Coalition is holding the first Global Rosacea Awareness Month in April, culminating in the world’s first ever Global Rosacea Tweetathon (#ChatRosacea) on Monday, April 27. Coalition experts including doctors, sufferers and bloggers will take part in a Twitter discussion over six time zones covering core rosacea topics from diagnosis and the impact of living with rosacea to managing symptoms. The conversation begins in Europe and Australia before moving to Latin America and then to the U.S. and Canada.