Tips for Dispelling Rosacea Myths

You may have heard them before: hushed whispers or suspicious comments about your appearance. Because rosacea is often misunderstood, here are some tips to keep handy for those uncomfortable moments when you just need to get the truth out about rosacea.
" Don't view comments as negative. Most reactions to rosacea are simply caused by curiosity and ignorance of the disorder, rather than some negative intent. Turn these situations into positive educational opportunities by openly discussing your condition.
" Knowledge leads to understanding. Taking the initiative to inform others about rosacea can put them at ease. At an opportune time, casually mention you have rosacea, a chronic facial condition that affects millions of Canadians and is becoming more prevalent as the baby boom generation enters the most susceptible ages.
" Describe the changing rosacea condition. Explain how rosacea causes redness, bumps and pimples that may come and go, and can become worse during a flare-up. Pass along that rosacea is not contagious and that you try to control the condition with medication and by avoiding personal rosacea triggers.
" Dispel myths. Mistakenly, some people associate red faces and noses with heavy drinking, and the acne-like signs of rosacea with poor hygiene. Point out that both are untrue in the case of rosacea. Rosacea is unrelated to hygiene and, while alcohol can aggravate the disorder, the signs and symptoms can be just as severe in a teetotaler.

Treatment of Rosacea With Topical Therapies

Due to the development and release of newer topical formulations, the diagnosis and treatment of rosacea has received renewed attention over the past 3-5 years both in the literature and at medical symposia. Rosacea is a very common facial dermatosis. In the US, rosacea is estimated to affect 14 million people, predominantly adults with approximately 60% of cases diagnosed before the age of 50. A frustrating aspect of the disease is its inherent chronicity punctuated with periods of exacerbation and relative remission. A variety of subtypes have been identified which correlate with clinical presentation. Although the pathogenesis of rosacea is poorly understood, multiple topical agents are available. The efficacy of topical therapy for rosacea relates primarily to reduction in inflammatory lesions (papules, pustules), decreased intensity of erythema, a reduction in the number and intensity of flares and amelioration of symptoms, which may include stinging, pruritus and burning. The list of main topical agents utilised for the treatment of rosacea include metronidazole, sulfacetamide-sulfur, azelaic acid and topical antibiotics (clindamycin, erythromycin). Depending on the severity at initial presentation, topical therapy may be combined with systemic antibiotic therapy (e.g., oral tetracycline derivative). Newer therapeutic choices primarily involve improved vehicle formulations, which demonstrate favourable skin tolerability and cosmetic elegance.

PMID: 14680431 [PubMed - indexed for MEDLINE] Del Rosso JQ.Department of Dermatology, University of Nevada School of Medicine, Las Vegas, Nevada, USA.

New System for Assessing Rosacea

The National Rosacea Society has introduced the first standard grading system for the study and clinical assessment of rosacea, developed by a consensus committee and review panel of 17 rosacea experts worldwide and recently published in the Journal of the American Academy of Dermatology.1

"The new standard grading system should be useful to both researchers and practicing dermatologists in addressing this often complex disorder," said Dr. Jonathan Wilkin, chairman of the consensus committee. In addition to the previously developed standard classification system, standard grading system is often essential to perform research, analyze results and compare data from different sources. This in turn provides a common reference for comprehensive patient evaluation, appropriate treatment and assessment of results in clinical practice."

The new system provides grading criteria and guidelines for the primary and secondary features of rosacea as defined in the standard classification system, and establishes a global assessment for rosacea patients by standard subtype that includes the physician's scoring of severity as well as the patient's own assessment. In most cases, some rather than all of these potential manifestations of the disorder appear in any given patient.

The primary signs and symptoms of rosacea are transient erythema (flushing), nontransient erythema (redness), papules (bumps) and pustules (pimples), and telangiectasia (visible blood vessels). For clinicians, the grading system recommends rating these signs as absent, mild, moderate or severe. Researchers are encouraged to provide more detailed measurements.
Clinicians may similarly rate the secondary signs and symptoms of rosacea -- ocular manifestations (eye irritation) and skin manifestations such as burning or stinging, plaques (raised red patches), dry appearance and phymatous changes (thickening of the skin) -- as absent, mild, moderate or severe, and are advised to note whether edema (swelling) and peripheral location of signs and symptoms are present or absent.

In addition, the system calls for a global assessment of the patient's condition according to the severity of signs and symptoms grouped into the four standard subtypes outlined in the standard classification system.

Associated Reference: Wilkin J, Dahl M, Detmar M, Drake L, Liang MH, Odom R, Powell F. Standard grading system for rosacea: Report of the National Rosacea Society Expert Committee on the Classification and Staging of Rosacea. Journal of the American Academy of Dermatology. 2004;50:907-912

What is Rosacea?

Rosacea is a hereditary, chronic (long term) skin disorder that most often affects the nose, forehead, cheekbones, and chin (Dr. Berasques).

Groups of tiny microvessels (arterioles, capillaries, and venules) close to the surface of the skin become dilated, resulting in blotchy red areas with small papules (a small, red solid elevated inflammatory skin lesion without pus, that is minor when the size is of a small measles lesion, moderate when about the size of a pencil eraser, and severe when the papule is the size of a small currency coin or the tip of the little finger) and pustules (pus-filled inflammatory bumps). The redness can come and go, but eventually it may become permanent. The skin tissue can swell and thicken and may be tender and sensitive to the touch. Note: Pustules are NOT pimples. Pimples have a bacterial component to their pathogenesis and are also mainly localized in and around the hair follicles.

This implies that there can be no cure for rosacea or even an effective treatment for your rosacea and yet many have found ways to control their rosacea through effective treatment and lifestyle changes.