For the 16 million Americans who have rosacea, there is now more access to treatment options and medical care than ever before. Rosacea is a chronic facial skin disorder often characterized by flare-ups and remissions often occurring between the ages of 30 and 60. Other common signs include bumps and pimples, flushing, and visible blood vessels. Also, in about half of rosacea patients their eyes are affected with visible blood vessels on the eyelid margin, a watery or bloodshot appearance, and potential loss of visual acuity. The cause of rosacea is unknown, but flare-ups of symptoms can be triggered by different factors such as sun exposure, emotional stress, weather, wind, heavy exercise, alcohol, spicy foods, heated beverages, humidity, certain skincare products, and potentially an overabundance of Demodex mites. There is also recent research that has found associations between rosacea and other serious medical disorders such as cardiovascular diseases, gastrointestinal disorders, psychiatric and neurological conditions, autoimmune diseases, and certain types of cancer.
With the pandemic, wearing face masks can also lead to skin irritation, but it is still important to follow public health directions. “The heat and abrasion from prolonged use of face masks often leads to irritation of facial skin and a worsening of rosacea signs and symptoms, calling for more intense medical treatment and special care,” says Linda Stein Gold, M.D., director of dermatology clinical research at the Henry Ford Health System. “Because of rosacea’s conspicuous impact on facial appearance, these aftereffects may become increasingly apparent as mask mandates are eased when COVID-19 is brought under control.”
In a study of mask-related rosacea symptoms after wearing protective masks for six weeks by the National Rosacea Society (NRS), the average severity score for flushing increased 58 percent in rosacea patients with persistent facial redness, and 52 percent in patients with bumps and pimples. Persistent facial redness increased 56 percent in patients with bumps and pimples, and 44 percent in those with facial redness alone. During the same period, quality of life scores declined 69 percent in patients with facial redness and 45 percent in those with bumps and pimples. “Rosacea is now understood as a single disease with a wide variety of potential signs and symptoms, and fortunately there is a growing range of medical therapies that can be tailored for each individual case to achieve substantially improved outcomes,” says Stein Gold. “When the signs and symptoms of rosacea are virtually eliminated, the positive effect on patients’ lives is often dramatic.”
In an NRS survey of more than 800 rosacea patients, 83 percent of those who had clear or almost clear skin said their psychological well-being had improved, 73 percent said it had improved their social lives, and 63 percent reported improvement in their occupational wellbeing. “Through habit or lack of knowledge, however, many patients may unknowingly continue with therapy that is not as effective as it could be,” says Stein Gold. “In these cases, there may be newer medications that produce more successful results as well as therapy combinations that offer excellent synergistic effects.”
A recent NRS survey of about 1,700 people, found that people with rosacea aged 60 and over were more likely to use older treatments as 54 percent of those 60 and over said they still use the first prescription therapy ever developed and approved for rosacea, compared to 41 percent of those under 60. Stein Gold notes that for persistent facial redness for patients is the most damaging to the quality of life. But, there are new medical therapies specifically for redness that are not effective and may even modify the long-term course of disease. New advances in topical and oral therapy for bumps and pimples have also been introduced to help achieve clear skin while Lasers and other light therapies are used to remove visible blood vessels, and more aggressive lasers or surgery is used to correct any thickening of the skin. There are also extra-gentle skin care products to avoid irritation and soothe sensitive skin. “As scientific and medical knowledge of rosacea continues to increase, the good news is that it is now possible to tailor a personal treatment plan to address the individual signs and symptoms of each patient to substantially improve the quality of their lives,” says Dr. Stein Gold.
Individuals with any of the following warning signs of rosacea are urged to see a dermatologist for diagnosis and appropriate treatment:
• 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