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Recognizing Rosacea

Christian Jurist, MD September 2011 issue of Skin Inc. magazine
Subtype 1

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Rosacea is a chronic skin disorder characterized by microcirculation problems that primarily affect the face. It’s comprised of several related symptoms, such as couperose, or the dilation of facial blood vessels, and erythema, or redness. Extra-facial lesions on the neck and upper chest are not uncommon. The word “rosacea” comes from the Latin rosacea, derived from rosaceus meaning “pinklike.”

Approximately 16 million Americans and 45 million people worldwide suffer from rosacea. According to the National Rosacea Society (NRS), a Gallup survey found that 78% of Americans have no knowledge of this condition, including how to recognize it and what to do about it. (See Be Knowledgeable About Rosacea.) Although symptoms may occur during the teenage years, most people experience the onset of rosacea in their 30s, 40s or 50s, and it is more predominate in fair-skinned women. The precise cause of rosacea remains unknown, but research has shown that many factors are involved, such as genetic predisposition, heredity—especially European/Celtic descent, stomach dyspepsia and Helicobacter pylori infection, seborrhea, Demodex folliculorum mites, endocrine disorders, vitamin deficiency, liver disease and stress-related causes.

Discerning the enigma

Rosacea clients are generally prone to flushing and blushing mainly on the t-zone and cheeks. This can occur either spontaneously or can be precipitated by certain triggers that play a particular role in the development of this skin disorder, including the following.

  • Emotional stress
  • Heat and abrupt temperature changes
  • Caffeine
  • Sunlight and repeated sunburning
  • Alcoholic beverages
  • Spicy foods
  • Foods that contain histamine or cause the body to release histamine, such as tomatoes and pineapples
  • Medications, such as steroids

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Be Knowledgeable About Rosacea

Rosacea is a common but poorly understood disorder of the facial skin that is estimated to affect more than 16 million Americans. Let clients and patients know that any one of the following warning signs is a signal to see a dermatologist or other knowledgeable physician for diagnosis and appropriate medical treatment before the signs and symptoms become increasingly severe: redness on the cheeks, nose, chin or forehead; small, visible blood vessels on the face; bumps or pimples on the face; and watery or irritated eyes.

Characterized by relapses and remissions, rosacea typically begins as a redness or flushing on the cheeks, nose, chin or forehead that may come and go. Throughout time, the redness becomes ruddier and more persistent, and visible blood vessels may appear.

This condition, known as Subtype 1 rosacea, often occurs before or at the same time as Subtype 2 rosacea, which includes facial redness with bumps and pimples if left untreated. In severe cases the skin may become swollen and bumpy, especially around the nose, a condition known as Subtype 3 rosacea, or rhinophyma.

In many rosacea-sufferers, the eyes are also affected, feeling irritated and appearing watery or bloodshot. Without proper care, this condition, known as Subtype 4, or ocular rosacea, can lead to further irritation and, in severe cases, reduction of vision.

To help attract prospective clients with rosacea, let them know you are knowledgeable about rosacea and the special need for extra-gentle care. Individuals with rosacea often have very sensitive skin and also tend to flush. In a survey of 1,289 rosacea patients conducted by the National Rosacea Society, 63% said they had suffered from frequent flushing, 51% had experienced facial burning or stinging, and facial itching was experienced by 41%. Thus, it is key to stay away from irritating ingredients that may cause stinging or flushing, such as alcohol, menthol, peppermint, eucalyptus, witch hazel or certain fragrances. Likewise, avoid procedures that heat or peel the skin; for example, steaming the face, using hot towels or hot wax, skin peels or exfoliating the skin with coarse cleansers.

When performed properly and with appropriate care and skin care products, a facial can be relaxing for many rosacea patients.

—From the National Rosacea Societyp>

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