The National Rosacea Society (NRS) has published new standard patient care options for rosacea, developed by a consensus committee and review panel of 26 rosacea experts, and articles on the various options for controlling the many potential aspects of this widespread disorder will appear in the coming issues of Rosacea Review.1
"Because the full effects of rosacea tend to vary significantly from one patient to another, medical therapy and other elements of care must be tailored by physicians for each individual case for optimal results," said Dr. Richard Odom, professor of dermatology at the University of California-San Francisco, who chaired the expert committee. "The new standard options should serve as a significant tool in helping doctors provide the best possible outcomes for their rosacea patients."
The new system for managing the disorder builds off of the standard classification and grading systems, previously developed and published by the NRS consensus committee, which identified the four subtypes of rosacea. These include subtype 1 (erythematotelangiectatic) rosacea, characterized by flushing, redness and often visible blood vessels; subtype 2 (papulopustular) rosacea, including bumps and pimples; subtype 3 (phymatous) rosacea, including skin thickening, commonly of the nose; and subtype 4 (ocular) rosacea, involving irritation of the eyes.
"Patients often experience more than one subtype at the same time, and that's one of the reasons good patient-doctor communication can be so important," Dr. Odom said. He noted that the new system begins by advising health professionals to ask patients about possible features of the disorder that might not be visibly evident at the time of their visit.
For example, anyone who has significant flushing should be sure they inform their dermatologist, including how and when it occurs. Patients should also tell their doctor if they have had extensive sun exposure in their job or lifestyle, as this may lead to redness and visible blood vessels from sun damage.
Beyond its facial symptoms, rosacea can also affect the eyes in some patients, and it may be especially important to note any eye discomfort, such as irritation, burning or stinging, or if the eyes tend to be watery or bloodshot. Although eye symptoms are often mild, in more severe cases they may require treatment by an eye specialist.
Also let your doctor know about any facial burning, stinging or itching, as these factors may then be addressed for your individual case. In addition, because of its effect on personal appearance, remember to be open about the impact rosacea has on your professional or social life in order to help determine the appropriate level of care.
"A wide range of measures are available for managing this potentially complex disorder," Dr. Odom said. "Along with appropriate use of oral or topical therapy, these can include lifestyle changes, surgical procedures such as laser therapy if needed, eye care when called for, proper skin care and effective use of cosmetics."
- Odom R, Dahl M, Dover J, Draelos Z, Drake L, Macsai M, Powell F, Thiboutot D, Webster GF, Wilkin J. Standard management options for rosacea, part 1: Overview and broad spectrum of care. Cutis 2009;84:43-47.