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Rosacea, a common skin condition marked by redness and inflammation, affects a large number of people globally. A recent study has estimated that approximately 300 million individuals suffer from this disorder. Here’s what you should understand about it.
1. IT DATES BACK CENTURIES.
According to the National Rosacea Society (NRS), rosacea was first identified in the 14th century by French surgeon Dr. Guy de Chauliac, who referred to it as goutterose (meaning “pink drop” in French) or couperose. He described the condition as featuring 'red lesions on the face, especially around the nose and cheeks.'
2. SCIENTISTS REMAIN UNCLEAR ABOUT ITS CAUSE...
However, there are some plausible theories. According to the NRS, “most experts think it is a vascular disorder linked to flushing.” Additionally, scientists speculate that rosacea may be hereditary, as it often appears in families. Other factors, such as skin mites, a gut infection called H pylori (frequently found in those with rosacea), and a reaction to the bacterium bacillus oleronius, could also contribute to the development of the condition. A 2015 study pointed to an elevated risk among smokers.
3. … HOWEVER, CERTAIN PEOPLE ARE MORE PRONE TO IT THAN OTHERS.
Although rosacea can affect individuals of all ages and skin types, those with fair skin between the ages of 30 and 50, with Celtic or Scandinavian heritage and a family history of the condition, are at greater risk. Women tend to experience rosacea more often than men, although their symptoms are generally milder. On the other hand, men are more likely to develop a rare rosacea complication called rhinophyma, which causes the skin of the nose to thicken and become bulbous. This condition is often—and incorrectly—linked to excessive drinking, but the exact cause of rhinophyma remains unclear. According to the NRS, “The swelling that often follows a flushing reaction may, over time, cause excess tissue growth (fibroplasia) around the nose, as plasma proteins accumulate when the impaired lymphatic system is unable to clear them. The leakage of blood coagulation factor XIII is also thought to contribute to this excess tissue formation.” Fortunately, treatments such as surgery and laser therapy are available for those affected by rhinophyma.
4. THERE ARE FOUR DISTINCT SUBTYPES.
According to the American Academy of Dermatology (AAD), rosacea “typically begins with a heightened tendency to blush or flush more easily than others.” All types of rosacea involve some form of redness (usually on the nose, cheeks, chin, and forehead), but the condition is classified into four subtypes based on additional symptoms: Erythematotelangiectatic rosacea is marked by continuous redness and sometimes visible blood vessels; Papulopustular rosacea includes swelling and “acne-like breakouts”; Phymatous rosacea causes thick, bumpy skin; and Ocular rosacea affects the eyes, causing redness (sometimes with burning, itching, or a sensation of sand in them), swollen eyelids, and stye-like growths.
5. IT IS DISTINCT FROM ACNE.
Although rosacea was once thought to be a form of acne—“acne rosacea” was first mentioned in medical literature in 1814—today, doctors recognize it as a separate condition. While both rosacea and acne can feature small, pus-filled bumps, there are important differences: Acne often involves blackheads, typically appears during the teenage years, and can affect the entire body; rosacea, however, is a chronic condition primarily affecting the face and chest, and usually manifests later in life.
6. ROSACEA HAS APPEARANCES IN ART AND LITERATURE.
Both Chaucer and Shakespeare are believed to have referenced rosacea in their works. Domenico Ghirlandaio’s 1490 painting An Old Man and His Grandson appears to depict rhinophyma, and some art historians suggest that Rembrandt’s 1659 self-portrait shows signs that the artist had rosacea and rhinophyma.
7. CERTAIN FOODS AND ACTIVITIES CAN TRIGGER ROSACEA.
The National Institutes of Health (NIH) [PDF] notes that a variety of factors, from environmental conditions to food choices, can provoke rosacea flare-ups. These triggers include extreme heat and cold, sunlight, wind, intense physical exercise, spicy foods, alcohol, menopause, stress, and the use of topical steroids.
8. MANY MYTHS EXIST ABOUT ROSACEA.
It’s important to note that rosacea is not caused by caffeine or coffee (any flare-ups associated with coffee are due to its heat), nor is it the result of heavy drinking (although alcohol can worsen the condition). The condition is not caused by poor hygiene, nor is it contagious.
9. THERE ARE SEVERAL WELL-KNOWN PEOPLE WITH ROSACEA.
Sophia Bush, Cynthia Nixon, Kristin Chenoweth, Bill Clinton, and Sam Smith all experience rosacea. Diana, Princess of Wales also had the condition. W.C. Fields suffered from both rosacea and rhinophyma, and Andy Warhol may have had the same conditions as well.
10. IT CANNOT BE CURED—BUT IT CAN BE MANAGED.
The NRS reports that nearly 90 percent of rosacea sufferers surveyed said the condition negatively impacted their self-confidence and self-esteem, and 41 percent mentioned it led them to avoid social interactions or cancel plans. Dr. Uwe Gieler, a dermatology professor at Justus-Liebig-University in Giessen, Germany, and co-author of the report Rosacea: Beyond the Visible, said in a statement, "People with rosacea are often judged based on their appearance, which greatly affects their daily lives. For those with severe rosacea, symptoms are typically more intense, ranging from itching and burning to a persistently red central facial area. Even those with less severe rosacea report a noticeable decline in quality of life."
This makes it all the more disheartening that no cure currently exists for the condition. However, there are effective treatments available.
There are no specific tests to diagnose rosacea; diagnosis depends on a doctor's evaluation of your medical history and symptoms. Doctors recommend that people with rosacea track their flare-up triggers, which helps in selecting appropriate treatments. Antibiotics may be prescribed, and laser therapy might be utilized. Individuals with rosacea should always apply sunscreen [PDF] and treat their skin with care—avoid scrubbing or exfoliating. The AAD advises daily moisturizing and avoiding products containing urea, alcohol, or glycolic and lactic acids.
