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Handling Awkward Queries

Tuesday, February 22, 2011

Insensitive questions about facial appearance can be a double whammy for rosacea sufferers -- the questions may not only cause embarrassment, but can lead to stress that may make the symptoms even worse. Fortunately, however, rosacea patients can usually bring this potentially destructive cycle to a halt by reacting positively, according to psychologists familiar with dermatological disorders.

“While rosacea sufferers have earned the right to their feelings about the physical and emotional demands of their disorder, the more desirable option is to embrace and master techniques that can diminish these negative feelings,” said Dr. Richard Fried, a dermatologist and clinical psychologist who serves as director of Yardley Dermatology Associates near Philadelphia.

“Instead of considering such questions inappropriate, they can be viewed as a positive sign that others care enough to ask about your condition,” said Dr. Ted Grossbart, a clinical psychologist at Harvard Medical School and author on the psychological aspects of dermatological conditions. “Rosacea patients can maintain their self-confidence by using these situations constructively as opportunities to educate others about the disorder.”

Questions are best answered directly, Dr. Fried advised, letting people know that rosacea is a common but poorly understood disorder that may be related to the immune system. In addition, it may be useful to reassure friends, family, employers and co-workers that this condition is not contagious and will not affect them in any way.

“Rather than responding to questions with self-consciousness or anger, tell them you’re glad they asked because most people don’t know about this condition,” Dr. Grossbart said.

Rosacea patients can also help their fellow sufferers by dispelling some of the myths or false assumptions that may surround the signs and symptoms. Some people associate red faces and noses with heavy drinking, and acne-like symptoms with poor hygiene. In fact, rosacea is entirely unrelated to hygiene, and while alcohol can aggravate the condition, it can be just as severe in a non-drinker.

“Feeling vulnerable or fearful of other people’s thoughts gives them immense power over your emotions, when what they think is not really something that can harm you,” Dr. Fried said. “Rosacea patients can also take control of their psychological well-being through such techniques as yoga, tai chi, progressive muscle relaxation, guided imagery, hypnosis, cognitive behavioral psychotherapy, meditation, self-talk and square-box breathing.”

He emphasized that such measures, together with good and creative dermatologic treatment, can all lead to improved skin appearance and function, as well as emotional health.

“It’s important to remember that you are not your skin,” Dr. Grossbart said. “Your skin is a small percentage of the total package. People judge you by the kind of person you are -- and rosacea is not you.”

Awareness Month in April

Tuesday, February 8, 2011

The many potential signs and symptoms of rosacea may so closely mimic other skin conditions that it has often been called “The Great Impostor.” The National Rosacea Society (NRS) has designated April as Rosacea Awareness Month to alert the public to the warning signs of this chronic and conspicuous facial disorder now estimated to affect more than 16 million Americans.

“To many people, the flushing or redness of rosacea may unknowingly resemble a sunburn, and the papules and pustules may be mistaken for a typical case of acne,” said Dr. Richard Odom, professor of dermatology at the University of California-San Francisco. “Adding to the confusion, even fewer are likely to associate the eye problems of ocular rosacea with a skin disorder.”

He noted that this lack of understanding causes many rosacea sufferers to delay seeing a dermatologist because they assume they have a temporary condition that will go away by itself. Without medical help, however, the effects of rosacea usually persist and may grow increasingly severe.

The NRS awareness campaign is designed not only to raise public recognition of the many “faces of rosacea,” but also to emphasize the importance of seeking professional diagnosis and appropriate treatment -- before the disorder becomes increasingly intrusive in people’s emotional, social and professional lives. In surveys conducted by the NRS, more than 76 percent of rosacea patients said uncontrolled rosacea had lowered their self-confidence and self-esteem, and 41 percent reported that it had caused them to avoid public contact or cancel social engagements.

Unfortunately, even though more Americans than ever are now estimated to suffer from rosacea, only a small fraction are being treated. In an effort to reach the growing number of rosacea sufferers, the NRS will conduct public service announcements and other educational activities during Rosacea Awareness Month and throughout the year.

“People need to know rosacea is a chronic disorder that can be effectively controlled with medical therapy and lifestyle modifications,” Dr. Odom said. “This can substantially improve the quality of their lives.”

In addition to mimicking the signs of other disorders, rosacea’s signs and symptoms may vary from one patient to another. According to the NRS standard classification of rosacea, developed by a consensus committee and review panel of 17 experts worldwide, any of the following primary signs may indicate rosacea: flushing or transient erythema (redness), persistent or nontransient erythema, papules (bumps) and pustules (pimples), and telangiectasia (visible blood vessels). Secondary features may include burning or stinging, plaques (raised patches on the skin), a dry appearance, edema (swelling), ocular manifestations and phymatous changes, in which the skin thickens.

The standard subtypes of rosacea reflect the most common patterns of signs and symptoms, and characteristics of more than one subtype may occur at the same time. Subtype 1 (erythematotelangiectatic) rosacea is characterized by flushing and persistent redness on the central portion of the face, while subtype 2 (papulopustular) rosacea also features bumps and pimples.

Subtype 3 (phymatous) rosacea includes thickening of the skin, irregular nodularities and enlargement, especially of the nose. Subtype 4 is ocular rosacea, where the eyes may have a watery or bloodshot appearance, the sensation of a foreign body, burning or stinging, dryness, itching, light sensitivity or a host of other potential signs and symptoms.

For more information, visit All About Rosacea.