The sun can be warm and invigorating, but for many rosacea sufferers, it's a reason to take special precautions. In fact, sun exposure was ranked as the leading rosacea trigger by 61 percent of rosacea patients in a National Rosacea Society survey.
Beyond triggering flare-ups, researchers have found that sun exposure may potentially cause blood vessel damage that is associated with rosacea.1 "The significance of sun-damaged skin in rosacea cannot be stressed enough," said Dr. Gerd Plewig, professor of dermatology at the Ludwig-Maximilians University in Munich, a noted rosacea researcher. He suggests that all rosacea patients should use sunscreens as part of their daily skin-care regimen.
Avoiding exposure to the sun, particularly from 10 a.m. to 2 p.m. when the sun's rays are hottest and most direct, is the most basic protective measure. During outdoor activities, find a shaded area under a tree or canopy. Remember that sun danger also may be posed by reflected light from sand or water, for example.
In addition, proper clothing can supply excellent protection against sun damage. A hat to shade the face may be especially useful for sun-sensitive rosacea patients. A broad-brimmed hat provides the fullest coverage of the face and also protects the ears.
Beyond these basic steps, the use of a sunscreen is a valuable tool in reducing the sun's harmful effects. However, while sunscreens can help prevent damage from the sun's rays, it is important to be protected against the full range of radiation.
"The SPF, or sun protection factor, refers only to protection against ultraviolet B (UVB) and not ultraviolet A (UVA) rays, which are also harmful," said Dr. Joseph Bikowski, clinical assistant professor of dermatology at the University of Pittsburgh.
The higher-energy, shorter-wavelength UVB rays are primarily responsible for sunburns, DNA damage and elastic tissue damage. On the other hand, UVA exposure is the culprit in accelerating the aging process -- causing photoaging, premature wrinkling, age spots and photosensitivity as well as elastic tissue damage -- and may be a contributor to skin cancer. Moreover, UVA rays can penetrate ordinary window glass, and are present all year.
"Patients often have a false sense of security if they have applied a sunscreen with a high SPF," Dr. Bikowski said. For complete protection, patients should use a sunscreen or sun block that has an SPF of at least 15 and also indicates on the label that it is effective against light throughout the UVA waveband.
If a sunscreen proves irritating to the sensitive skin of a rosacea sufferer, a pediatric formulation or a moisturizer combined with sunscreen may offer a solution.2
With proper precautions -- avoiding sun especially during the hottest part of the day, wearing protective clothing and using an appropriate sunscreen or sun block -- rosacea sufferers can minimize the effects of this all-too-common tripwire.
Neumann E, Frithz A: Capillaropathy and capillaroneogenesis in the pathogenesis of rosacea. International Journal of Dermatology. 1998;37:263-266.
Millikan L: Recognizing rosacea. Postgraduate Medicine. 1999;105:149-158