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Rosacea on Television

Thursday, January 28, 2010

Rosacea is the featured topic of a recent segment on ABC-TV’s Good Morning America Health. Dr. Doris Day, clinical assistant professor of dermatology at New York University, discusses signs and symptoms of the disorder as well as treatment options and avoidance of triggers.

To watch the entire interview, click here.

Effects of Heat in Winter

Thursday, January 21, 2010

Heat often brings on the signs and symptoms of rosacea, and this can be a problem even in the frosty winter months, according to a recent National Rosacea Society survey of 424 rosacea patients.

Overly warm rooms, common in winter, often induce rosacea flare-ups, as 56 percent of survey respondents said indoor heat had caused an outbreak. Hot baths, another frequent antidote for chilly winter days, were a temperature-related trigger for 53 percent, while the heat generated by heavy exercise caused a flare-up in 55 percent. Other heat-related triggers included the hot beverages favored by many after a foray into the cold, cited by 42 percent of the respondents, as well as the ubiquitous heavy clothing of winter, named by 31 percent.

“While medical therapy is fundamental in managing rosacea, avoidance of lifestyle or environmental factors that trigger flare-ups in individual cases is also crucial,” said Dr. Lisa Maier, associate professor of dermatology at the University of Michigan. “Patients who both comply with medical therapy and avoid their individual triggers are much more likely to maintain remission of their rosacea symptoms.”

Respondents indicated they make an effort to avoid temperature-related flare-ups as much as possible. The biggest behavioral change reported was in the way people bathe: Seventy-three percent of the respondents said they always or sometimes bathe or shower in cooler water since their rosacea diagnosis. Sixty-seven percent said they frequently or sometimes leave a heated room in an effort to avoid a flare-up.

The sun and warm weather were nearly universal heat-related rosacea triggers identified by the survey, both cited by 81 percent of the respondents. Menopausal hot flashes were another common source of heat-related flare-ups for 26 percent.

Rosacea.org offers an extensive list of common rosacea triggers, as well as tools for identifying and avoiding them.

Flushing Cause Uncovered

Monday, January 11, 2010

Researchers have now identified the molecular pathway for flushing caused by niacin -- also known as vitamin B3 or nicotinic acid, and found in many foods -- according to a study recently completed by Dr. Robert Walters and colleagues at Duke University and funded by the National Rosacea Society (NRS). The new findings may lead to future improvements in the treatment or prevention of rosacea, which is commonly associated with flushing.

"So little is known about the flushing responses in rosacea, and the first step toward their control is to understand the nature of their causes," Dr. Walters said. "Since niacin is often a trigger factor for flushing, it was important to investigate this response at the molecular level."

He noted that this substance is an essential vitamin found in an extensive range of foods, including foods reported to trigger rosacea flare-ups in some individuals, such as beef liver, yeast, avocadoes and spinach. While niacin deficiency leads to pellagra -- a disease associated with skin problems, weakness and dementia -- he noted that it has also been associated with severe flushing in individuals taking large amounts as a supplement.

The researchers studied this process in microscopic cultures of cells and found that when one of the body’s niacin receptors -- cell surface protein GPR109A -- is stimulated, both G-proteins and beta-arrestin proteins are activated. A receptor is a cellular structure that accepts the molecular structure of a specific chemical agent, and then acts on nervous tissue to produce a physiological response.

In the new study, the investigators found that niacin-like drugs stimulating only G-proteins do not induce flushing, suggesting that it is instead the beta-arrestins that cause the flushing. The beta-arrestins were further implicated when it was observed that they are required for activation of the enzyme cPLA₂, which produces molecules that act directly on blood vessels in the skin to increase blood flow. As final proof, beta-arrestin activated by niacin was demonstrated to be a requirement for the flushing to occur.

"By defining the molecular pathway for flushing that begins with niacin, new therapies might be developed to block this process," Dr. Walters said. He noted that other causes of flushing may utilize the same pathway, suggesting it could also be an important mechanism for flushing in general.

More information on the NRS research grants program may be found in the Research Grants section.