CHICAGO (April 1, 2019) – Rosacea can be a vicious cycle. The more you worry about its dreaded appearance, the likelier the stress may cause it to come crashing in at the worst possible time, showing up in the most conspicuous and embarrassing place—the face—as a redness that won’t go away, often with unsightly bumps and pimples. Fortunately today, rosacea sufferers have more reason than ever to be optimistic. The good news is that although rosacea cannot be cured, important advances in medical therapy have made it increasingly possible to achieve the next best thing: clear skin.
The National Rosacea Society has designated April as Rosacea Awareness Month to educate the public on this often life-disruptive disorder estimated to affect more than 16 million Americans and 415 million individuals worldwide, urging those with warning signs to see a dermatologist for diagnosis and appropriate therapy.
“Recent studies on the burden of illness of rosacea have shown just how important it is to have clear skin, as the condition can profoundly damage quality of life because of its effect on personal appearance,” said Dr. Linda Stein Gold, director of dermatology clinical research at the Henry Ford Health System. “In so many cases, all it takes is a single blemish or a single comment about having a red face to ruin someone’s day.”
In an NRS survey of 1,675 rosacea patients, 90 percent said the disorder had lowered their self-esteem and self-confidence, and 52 percent said they had avoided face-to-face contact because of the disorder. In another survey, 51 percent of those with severe symptoms said they had even missed work because of their condition.
When the signs and symptoms of rosacea are virtually eliminated, however, the improvement in patients’ lives is often dramatic. In a new NRS survey of more than 800 rosacea patients, 83 percent of those who had achieved clear or almost clear skin said their psychological well-being had improved. Seventy-three percent said it had also improved their social lives, and 63 percent reported improvement in their occupational well-being.
In contrast, among those whose rosacea had only slightly or moderately improved, just 26 percent reported improvement in psychological well-being, 22 percent in social well-being and 21 percent in occupational well-being.
“Clear skin is not only desirable, but it is increasingly attainable with the advanced medical therapies that are available today. Though they may feel discouraged, the most important thing for those battling the signs and symptoms of rosacea is to visit a dermatologist to be correctly diagnosed and treated,” said Dr. Stein Gold. “Rosacea is a disorder of varying signs and symptoms, and finding the best therapy or combination of therapies for each individual’s case is key.”
Although it can develop in many ways, rosacea typically first appears after age 30 as a redness on the cheeks, nose, chin or forehead that grows ruddier and more persistent over time, and small blood vessels may become visible. Without treatment, bumps and pimples often develop, and burning and stinging are common. In severe cases, the nose may become enlarged from excess tissue, and in many rosacea patients the eyes are also affected, feeling irritated and appearing watery or bloodshot.
During Rosacea Awareness Month and throughout the year, the NRS will conduct public education activities to reach the many millions of rosacea sufferers who may not realize they have a medical condition that can be treated, emphasizing the warning signs and urging those who suspect they may have rosacea to see a dermatologist. Comprehensive information and materials are available on the NRS website at rosacea.org.
Those interested in spreading awareness during the month of April are encouraged to visit the official Rosacea Awareness Month landing page at rosacea.org/ram for ways in which they can participate, and to follow the conversation online using the hashtag #RosaceaAwareness. The NRS may also be followed on Facebook, Twitter and Pinterest for up-to-date information and tips on rosacea.
What Is Rosacea?
Rosacea is a chronic disorder of the facial skin that is often characterized by flare-ups and remissions. According to the recently updated standard classification of rosacea, the presence of persistent facial redness or, less commonly, phymatous changes where the facial skin thickens is considered diagnostic of the disorder. Additional major signs include bumps (papules) and pimples (pustules), flushing, visible blood vessels (telangiectasia) and certain ocular manifestations. The presence of two or more major features independent of the diagnostic signs is also considered diagnostic of rosacea, and secondary signs and symptoms include burning or stinging, swelling and dry appearance.
In around half of rosacea patients, the eyes are also affected, including visible blood vessels on the eyelid margin and a bloodshot appearance, as well as inflammation and growth of fibrous tissue. Burning, stinging, light sensitivity and the sensation of a foreign object may also occur, as well as conjunctivitis, inflammation of oil glands at the rim of the eyelids (blepharitis) and crusty accumulations at the base of the eyelashes. Severe cases of this condition, known as ocular rosacea, can result in loss of visual acuity.
In some patients, 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.
The red face of rosacea was described as early as the 1300s in Chaucer’s “Canterbury Tales,” and the less common swollen nose was shown in the 1540 Renaissance painting “The Old Man and his Grandson” by Ghirlandaio. Among the most famous modern rosacea sufferers is former President Bill Clinton, whose doctors disclosed that he has this condition in the New York Times. Others reported to have suffered from rosacea include Princess Diana, singer Sam Smith, model Dita Von Teese and comedian Amy Schumer.
Recent studies have shown that the initial redness of rosacea appears to be the start of an inflammatory continuum initiated by neurovascular dysregulation and the innate immune system. Research has further demonstrated that a marked increase in mast cells, located at the interface between the nervous system and vascular system, is a common link in all major presentations of the disorder. Other studies have documented a possible genetic component, as well as the potential role of the human microbiome, including Demodex mites and certain bacteria.
Although causal relationships have not been determined, recent research has also found associations between rosacea and increased risk of a growing number of potentially serious systemic disorders. These have included cardiovascular diseases, gastrointestinal disorders, neurological conditions, autoimmune diseases and certain types of cancer.
Although the ultimate cause of rosacea remains unknown, a vast array of lifestyle and environmental factors has 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.
“Fortunately, through ongoing progress in medical research, a growing number of therapies are now available that can be tailored to each individual case, bringing clear skin within reach and substantially reducing the impact of rosacea on people’s lives.” Dr. Stein Gold said. 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, or visit rosacea.org.
About the National Rosacea Society
The National Rosacea Society is the world's largest organization dedicated to improving the lives of the estimated 16 million Americans who suffer from this widespread but poorly understood disorder. Its mission is to raise awareness of rosacea, provide public health information on the disorder and support medical research that may lead to improvements in its management, prevention and potential cure.
In addition to the NRS website at rosacea.org, 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.