Although rosacea sufferers now have access to more treatment options and sophisticated care than ever before, many are still untreated or using older therapies that may not be optimally suited for their individual cases. The National Rosacea Society (NRS) has designated April as Rosacea Awareness Month to educate the public on this potentially serious disorder estimated to affect more than 16 million Americans, and to urge those who suspect they may have it to see a dermatologist for the most up-to-date plan for effective therapy.
“Rosacea is now understood as a single disease with a wide variety of potential signs and symptoms, and fortunately there is a range of medical therapies that may effectively address each individual case,” said Dr. Linda Stein Gold, director of dermatology clinical research at the Henry Ford Health System. “Through habit, many patients may unknowingly continue with therapy that is not as effective as it could be, when there may be newer medications that achieve more successful results as well as therapy combinations that offer excellent synergistic effects.”
A recent NRS survey found that while most rosacea patients were satisfied with the oral and topical prescriptions they were using, individuals aged 60 and over were more likely to use older treatments. In the survey of 1,714 rosacea patients, 54% of those 60 and over reported they still use the first prescription therapy ever developed and approved for rosacea, compared to 41% of those under 60.1 Furthermore, 42% of those 60 and over had never changed their treatment regimen, compared to only 19% of those under 60. Although the onset of rosacea may often occur between the ages of 30 and 60, rosacea is a chronic condition where the incidence is cumulative and therefore more prevalent in older individuals.
According to the recently updated standard classification of rosacea, while rosacea’s clinical features, or phenotypes, may manifest at different times and in varying combinations, they all appear to be manifestations of the same underlying inflammatory continuum.2 The new standard management options include a comprehensive summary of treatment options for all the phenotypes as well as expert evaluations of effectiveness and quality of evidence.3
Dr. Stein Gold noted that developing a specific individual treatment plan tailored for each patient with one or more targeted therapies will achieve the best overall outcome, both objectively in terms of clear skin and subjectively in terms of quality of life. “As dermatologists, we want patients to be healthy and happy in their skin,” she said. “However, if a therapy is not doing its job, it may be time to try a different approach.”
For example, she noted that many rosacea patients have reported that persistent erythema (redness), the most common diagnostic phenotype, is the most damaging to quality of life.4 However, there are now new medical therapies specifically for erythema that are not only effective but may even modify the long-term course of disease. Advanced therapies for papules (bumps) and pustules (pimples) may also be used to achieve clear skin.
Another key to effectiveness is acting in cooperation with patients, Dr. Stein Gold said, which includes a lengthy initial visit to determine visible and invisible signs and symptoms, as well as counseling the patient on trigger factors, skin care and sun protection, and how exactly to comply with the treatment program.
“Today’s approach to rosacea treatment is different than in the past, when there were few options in our toolkit to address the variable signs and symptoms that may be present in an individual case,” Dr. Stein Gold said. “Now it’s possible for personal treatment plans to successfully combat rosacea’s effects and dramatically improve each patient’s quality of life.”
During April and throughout the year, individuals may visit the National Rosacea Society’s website at rosacea.org for rosacea news, information and patient materials, including “Understanding Rosacea,” an educational booklet that provides an overview of the disorder, its potential causes and treatment; “Recognizing Redness,” a pamphlet that includes a redness register to allow patients to gauge relative redness before and after flare-ups or treatment; Rosacea Review, a newsletter for rosacea patients; a “Rosacea Diary” to help patients identify and avoid lifestyle and environmental factors that may trigger flare-ups in their individual cases; and other booklets to help patients understand, manage and cope with their condition. Bulk quantities of educational materials are available to health professionals for their patients by ordering through the NRS website.
Information is also available by writing the National Rosacea Society, 111 Lions Dr., Suite 216, Barrington, Illinois 60010; calling the NRS toll free at 1-888-NO BLUSH; or via e-mail at email@example.com.
Rosacea is a chronic disorder of the facial skin with various potential signs and symptoms, often characterized by flare-ups and remissions. It typically begins at any time after age 30 as a flushing or redness on the cheeks, nose, chin or forehead that may come and go. Over time, the redness tends to become ruddier and more persistent, and small blood vessels may appear. Without treatment, bumps and pimples often develop, and in severe cases the nose may become swollen from excess tissue. In around half of patients, the eyes are also affected, feeling irritated and appearing watery or bloodshot.
Anyone who suspects they may have rosacea should see a dermatologist for diagnosis and appropriate therapy.
About the National Rosacea Society
The National Rosacea Society is the world’s largest organization dedicated to improving the lives of the estimated 16 million Americans who suffer from this widespread but poorly understood disorder. Its mission is to raise awareness of rosacea, provide public health information on the disorder and support medical research that may lead to improvements in its management, prevention and potential cure. More information may be found online at rosacea.org.
1. National Rosacea Society. Survey shows most patients are satisfied with therapy, but more awareness of treatment options is needed. Rosacea Review 2020 Fall. https://www.rosacea.org/rosacea-review/2020/fall/survey-shows-most-rosacea-patients-are-satisfied-with-therapy Accessed 9 February 2021.
2. Gallo RL, Granstein RD, Kang S, et al. Standard classification and pathophysiology of rosacea: the 2017 update by the National Rosacea Society Expert Committee. J Am Acad Dermatol 2018 Jan;78(1):148-155. doi: 10.1016/j.jaad.2017.08.037. Epub 2017 Oct 28.
3. Thiboutot D, Anderson R, Cook-Bolden F, et al. Standard management options for rosacea: the 2019 update by the National Rosacea Society Expert Committee. J Am Acad Dermatol 2020;82(6):1501–1510. doi:10.1016/j.jaad.2020.01.077
4. National Rosacea Society. Experts urge greater focus on facial redness at rosacea roundtable. Rosacea Review 2020 Summer. https://www.rosacea.org/rosacea-review/2020/summer/experts-urge-greater-focus-on-facial-redness-rosacea-roundtable Accessed 9 February 2021.
Reprinted with permission.