A sunny, bright spring day can be a warm and invigorating outdoor adventure, but for many rosacea sufferers it's a call to remember to take special precautions against sun exposure.
"The significance of sun-damaged skin in rosacea cannot be stressed enough," said Dr. Joseph Bikowski, clinical assistant professor of dermatology at the University of Pittsburgh. "Protection from the sun should be an integral part of any rosacea treatment regimen."
Beyond triggering rosacea flare-ups, research has suggested that sun exposure may potentially cause blood vessel damage that is associated with the disorder.1 Research funded by the National Rosacea Society is currently exploring whether exposure to ultraviolet light, found in sunlight, leads to skin that has increased receptors for vascular endothelial growth factor (VEGF).
VEGF has a potent effect on blood vessels and may be associated with rosacea by abnormally increasing facial blood supply. A previous study funded by the Society found that in rosacea-prone individuals, the effects of the sun on epidermal VEGF may lead to persistent redness and the development of telangiectasia, the visible dilated blood vessels that are a common sign of rosacea.
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 rosacea sufferers can take. During outdoor activities, find a shaded area under a tree or canopy.
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.
Beyond these basic steps, the use of sunscreen is a valuable tool in reducing the sun's harmful effects. However, 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. Bikowski.
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 also may be a contributor to skin cancer.
"People often have a false sense of security if they apply 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.
Neumann E, Frithz A: Capillaropathy and capillaroneogenesis in the pathogenesis of rosacea. International Journal of Dermatology. 1998;37:263-266.