April is National Rosacea Month: Do You Know How to Work With These Clients?


Only on SkinInc.com: Exclusive commentary and photos from the National Rosacea Society follows this article explaining how professionals can decipher the symptoms of rosacea from other skin conditions, such as acne and sun damage.

Today's expanding knowledge of the many potential signs and symptoms of rosacea can help unmask this widespread but poorly understood facial disorder now estimated to affect more than 16 million Americans. The National Rosacea Society (NRS) has designated April as Rosacea Awareness Month to alert the public to the warning signs of rosacea and to encourage those who suffer from this conspicuous and often embarrassing condition to seek diagnosis and appropriate treatment before it increasingly disrupts their daily lives. "It has been called 'The Great Impostor' because people often confuse rosacea with other conditions, such as a sunburn or acne, or even eye irritation, and fail to seek medical help," says Jonathan Wilkin, MD, chairman of the NRS medical advisory board. "People need to be more aware of this highly prevalent disorder, and the need for treatment and lifestyle changes before it becomes progressively severe."

The incidence of rosacea is now rapidly growing as the populous baby boom generation passes through the most frequent ages of onset, between 30 and 60. Yet surveys have found that the public has little knowledge of this chronic but treatable disorder, including how to recognize it and what to do about it.

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.

In a new survey of 1,289 rosacea patients conducted by the NRS, 71% of the respondents said they had experienced persistent redness, and 63% said they had suffered from frequent flushing. In addition, 63% said they had suffered outbreaks of pimples (pustules) and 61% reported experiencing bumps (papules).

Sixty-one percent of the patients said they had also experienced eye symptoms, and visible blood vessels were cited by 56%. Other widely reported signs and symptoms included facial burning or stinging, reported by 51%; facial itching, experienced by 41%; dry appearance, named by 40%; raised red patches, reported by 30%; skin thickening or excess tissue on the nose, 22%; signs beyond the face, 21%; and facial swelling, 18%.

"Although the subtypes of rosacea represent common patterns, the manifestations of rosacea can vary substantially from one patient to another, and medical therapy must therefore be tailored for each individual case," Wilkin says. "With greater knowledge of its potential signs and symptoms, physicians [and skin care professionals] should be able to achieve significant improvements in the diagnosis and management of this chronic and often life-disruptive disorder."

Perhaps even more devastating than its physical effects, rosacea often inflicts significant emotional and social damage on the lives of its victims because of its impact on personal appearance. In recent surveys by the NRS, nearly 76% of rosacea patients said this unsightly disorder had lowered their self-confidence and self-esteem, and 41% reported it had caused them to avoid public contact or cancel social engagements.

Adding to the embarrassment is a common myth that rosacea-sufferers, who often have a red face and nose, are heavy drinkers. In fact, while alcohol may aggravate the disorder, the symptoms can be just as severe in a nondrinker. Another common misconception is that rosacea is caused by poor hygiene, while in reality it is unrelated to personal cleanliness.

Although the cause of rosacea is unknown, a vast array of lifestyle and environmental factors can trigger flare-ups of signs and symptoms in various rosacea sufferers. Common rosacea triggers include sun exposure, emotional stress, hot or cold weather, wind, heavy exercise, alcohol, spicy foods, heated beverages, humidity, certain skin-care products and many others.

"The good news is that rosacea can be effectively controlled with medical therapy and lifestyle changes to avoid factors that aggravate the condition in individual cases," Wilkin said. Individuals with any of the following warning signs of rosacea are urged to see a dermatologist for diagnosis and a skin care professional or physician for appropriate care:

  • Redness on the cheeks, nose, chin or forehead
  • Small visible blood vessels on the face
  • Bumps or pimples on the face
  • Watery or irritated eyes

During April and throughout the year, clients who suspect they may have rosacea can visit the NRS website, or call its toll-free number at 888-NO-BLUSH to obtain comprehensive information on the disorder. Information and educational materials are also available by writing the National Rosacea Society, 196 James Street, Barrington, Illinois 60010; or via e-mail at [email protected].

The National Rosacea Society, gives SkinInc.com exclusive tips on how to work with rosacea clients, as well as photos to help you with identification of this sometimes-elusive condition.

"Be knowledgeable about rosacea. Rosacea is a common but poorly understood disorder of the facial skin that is estimated to affect well over 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.

"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 some rosacea patients."

More in Physiology