While new research has tied rosacea to increased risk of a growing number of potentially serious illnesses – including cardiovascular disease, gastrointestinal disease, certain types of cancer and more – only a small fraction of the estimated 16 million Americans suffering from this chronic inflammatory skin disorder are currently receiving medical treatment. The National Rosacea Society (NRS) has designated April as Rosacea Awareness Month to alert the public to the early warning signs of this conspicuous and often life-disruptive condition and encourage those who suspect they may have it to see a dermatologist for diagnosis and appropriate therapy.
“While the nature of the associations between rosacea and other diseases is not yet clear and no cause-and-effect relationship has been established, these findings underscore the importance of seeking proper medical care,” said Dr. John Wolf, chairman of dermatology at Baylor College of Medicine. Unfortunately, according to a recent large-population study at the Wake Forest School of Medicine, an estimated 82 percent of people with rosacea are currently untreated.
Newly discovered rosacea comorbidities now include the results of large-scale studies of health data from the Danish National Patient Registry, showing that rosacea patients were more likely to have Parkinson’s disease, Alzheimer’s disease, multiple sclerosis, celiac disease, rheumatoid arthritis, type 1 diabetes, migraine and glioma – a form of brain cancer. Recent studies of health data in Taiwan also found that rosacea patients were more likely to have coronary artery disease, hypertension, dyslipidemia and peripheral artery occlusive disease, and rosacea was associated with an increased risk of Crohn’s disease and ulcerative colitis.
In the well-known “Nurses Health Study II” – an ongoing biennial questionnaire on the medical history of 116,000 nurses since 1989 – the more than 6,000 women diagnosed with rosacea were 1.59 times more likely to have thyroid cancer and 1.5 times more likely to have basal cell carcinoma than those without rosacea. A clinical study of 130 individuals with rosacea at Johns Hopkins University also found a significant association between rosacea and allergies, respiratory diseases, gastroesophageal reflux disease (GERD), diabetes, urogenital diseases and female hormone imbalance.
“Beyond its many potential physical effects, the impact of rosacea on patients’ emotional, social and occupational well-being has also been increasingly well documented,” Dr. Wolf said. In surveys by the NRS, more than 90 percent of rosacea patients said their condition had lowered their self-confidence and self-esteem, and 41 percent reported its effect on personal appearance had caused them to avoid public contact or cancel social engagements. Among rosacea patients with severe symptoms, 88 percent said the disorder adversely affected their professional interactions, and 51 percent said they had even missed work because of their condition.
During Rosacea Awareness Month and throughout the year, the NRS will conduct public education activities to reach the many millions of rosacea sufferers who may not realize they have a medical condition that can be treated, emphasizing the warning signs and urging those who suspect they may have rosacea to see a dermatologist. Bulk quantities of educational materials are available to health professionals for their patients through the NRS website at rosacea.org. Those interested in spreading awareness during the month of April are encouraged to visit the official Rosacea Awareness Month landing page at rosacea.org/ram for ways in which they can participate.
Although rosacea varies from one patient to another, the primary signs may include flushing or transient erythema (redness), persistent or nontransient erythema, papules (bumps) and pustules (pimples), or telangiectasia (visible blood vessels), according to the NRS standard classification of rosacea, developed by a consensus committee and review panel of 17 experts worldwide. 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 papules and pustules. 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.
During April and throughout the year, individuals may call the National Rosacea Society’s toll-free telephone number at 1-888-NO-BLUSH for information. The NRS offers Rosacea Review, a newsletter for rosacea patients; a “Rosacea Diary” to help patients identify and avoid lifestyle factors that may trigger flare-ups in their individual cases; and other booklets to help patients understand and manage their condition.
Information is also available by visiting the NRS website at rosacea.org; writing the National Rosacea Society, 196 James Street, Barrington, Illinois 60010; or via e-mail at firstname.lastname@example.org.