Although emotional stress is reported to be one of the most common rosacea triggers, effective stress management can lead to a reduction in the number of stress-related flare-ups, according to results of a new National Rosacea Society (NRS) survey.

In the survey of 748 rosacea patients, 69 percent of the respondents said they experience a flare-up related to emotional stress at least once a month. Thirty-one percent said this happens every few days, while 14 percent said it happens once a week, 16 percent said it occurs every few weeks and 9 percent said once a month. Twenty-two percent reported a rosacea outbreak due to stress only every few months, and 5 percent noted a frequency of once a year. Only 5 percent said they had never experienced a stress-related flare-up.

"Emotional stress appears to be linked to a growing range of reactions in the body that have been increasingly shown to affect the skin, including flushing and inflammation,” said Dr. Richard Granstein, chairman of dermatology at Cornell University. “As a result, a great many rosacea patients should be able to benefit from either minimizing stressful situations or learning to modify their reactions to them.”

Family problems were the top causes of stress triggering a flare-up, cited by 49 percent of the survey respondents who had experienced a stress-related outbreak, followed closely by problems at work, named by 48 percent. Other common causes of stress included relationship problems, mentioned by 40 percent; financial concerns, cited by 38 percent; health problems, named by 33 percent; social events, 31 percent; criticism, 31 percent; uncertainty, 30 percent; public speaking, 27 percent; deadlines, 22 percent; and loss of a loved one, 18 percent.

Anxiety was the leading form of emotional stress, cited by 76 percent of the survey respondents, followed by worry, named by 63 percent. Other types of emotions mentioned included frustration, affecting 52 percent; anger, reported by 49 percent; embarrassment, 40 percent; fear, 27 percent; excitement, 23 percent; grief, 20 percent; indecision, 14 percent; and guilt, 13 percent.

The good news is that more than 67 percent of the survey respondents said they have been able to minimize the causes of stress and their reactions to stress to reduce their rosacea flare-ups. The NRS offers a “Rosacea Diary” that can help patients pinpoint which situations or reactions may be causing stress-related flare-ups. Once those are identified, patients can employ strategies to alter their activities as well as adopt techniques to reduce emotional stress, such as moderate exercise, cognitive therapy, relaxation or meditation routines.

“Stress can exacerbate a variety of health concerns, including rosacea, but medical therapy is also available to help rosacea patients keep their condition under control,” Dr. Granstein said. “Faithful compliance with prescribed therapy, coupled with stress-reduction techniques, can go a long way toward breaking the cycle of stress-related flare-ups.”