Although rosacea has been classified into four common patterns of signs and symptoms known as subtypes, most rosacea patients experience a progression in their disorder from one subtype to another, according to a new survey by the National Rosacea Society.
In the survey of 1,231 rosacea patients, 72 percent reported that their rosacea had evolved from one subtype to another, and 77 percent said they had experienced more than one subtype at the same time.
Eighty-three percent of respondents reported experiencing subtype 1 (erythematotelangiectatic) rosacea, characterized by facial redness and in some cases visible blood vessels. Sixty-two percent reported having subtype 2 (papulopustular) rosacea, which includes redness with bumps and pimples. Subtype 3 (phymatous) rosacea, characterized by skin thickening -- most commonly on the nose -- was reported by 15 percent, and 50 percent experienced subtype 4 (ocular) rosacea, in which the eyes are irritated.
Of those whose rosacea evolved from one subtype to another, 80 percent said they initially experienced subtype 1, and 56 percent said they experienced subtype 2 second. Subtype 3 was experienced third by 10 percent, while subtype 4 was experienced fourth by 6 percent, third by 26 percent, second by 27 percent and first by 6 percent.
"Although there were many exceptions, these survey results show a general tendency for rosacea to progress from subtype 1 to 2 and then in some cases to subtype 3," said Dr. Richard Odom, professor of dermatology at the University of California -- San Francisco. "On the other hand, the eye irritation of subtype 4 may develop at any time, sometimes even before rosacea affects the skin."
The overwhelming majority (88 percent) of all patients surveyed reported that their conditions had improved or somewhat improved with medical therapy. Of those with subtype 1 only, 49 percent said medical help improved their condition and 37 percent said it had improved their rosacea somewhat. Of those with subtype 2 only, 56 percent said their rosacea had improved and another 29 percent said it improved somewhat. Fifty-five percent of those with subtype 3 alone said medical help had improved their condition and 45 percent said it improved somewhat. Of those with subtype 4 only, 22 percent said medical therapy had improved their condition and 44 percent said it helped somewhat.