While rosacea sufferers can benefit from prescription medications and procedures to treat the full spectrum of potential signs and symptoms, a growing range of over-the-counter (OTC) skin care products is now available to help achieve optimal results. The National Rosacea Society (NRS) has designated April as Rosacea Awareness Month to educate the public on this conspicuous facial skin disorder estimated to affect more than 16 million Americans and urge those who may have it to see a dermatologist for diagnosis, treatment and guidance on appropriate skin care.
“The general consensus among dermatologists today is that, in addition to medical care, effective skincare recommendations are a crucial part of successful rosacea therapy,” said Dr. Hilary Baldwin, associate professor of dermatology at Rutgers Robert Wood Johnson Medical School and a member of the NRS medical advisory board.1 “The use of quality OTC products can not only help improve the signs and symptoms in and of themselves, but are often used as adjuncts before and during prescription therapy and as part of long-term care.”
She noted that the use of gentle cleansers, moisturizers that help repair the skin moisture barrier and sunscreens that protect against rosacea flare-ups can work to support and even enhance medical treatment for the disorder.
The most common individual sign of rosacea is persistent redness on the central part of the face – the cheeks, nose, forehead and chin. The redness may be accompanied by itching, burning or stinging, and sufferers may also experience bumps and pimples or develop tiny visible blood vessels on their skin. Prior to diagnosis, many rosacea sufferers may turn to skin care products and cosmetics as a way to treat or cover up these signs and symptoms, mistaking them for sunburn or acne.
However, harsh cleansers, acne medications and even bar soap may make matters worse by irritating or drying out the skin and damaging the moisture barrier. Prolonged use of topical whitening or lightening creams may lead to a painful and disruptive condition known as steroid-induced rosacea. Meanwhile, even many gentle skin care and cosmetic products may contain ingredients that could cause a rosacea flare-up.
In NRS surveys, 92% of rosacea patients reported burning, stinging and itching, 82% reported that certain skin care products and cosmetics aggravated their condition, 70% said there were specific ingredients that irritated their skin and 84% were interested in more guidance on skin care. The most common irritants were astringent alcohol (63%), perfumes or fragrances (57%), witch hazel (31%) and menthol (30%). Around a quarter of respondents were affected by peppermint or eucalyptus oil, dyes and pigments, sulfates, and parabens or other preservatives.
The NRS Expert Committee published updated management options for rosacea in 2020, including the use of gentle cleansers and nonocclusive moisturizers that do not irritate their skin.2 Because sun exposure may be a leading influence on the development of flushing and redness, patients are also advised to always use sunscreen, preferably mineral-based products that contain zinc oxide or titanium dioxide, because they provide physical protection rather than potentially irritating chemical protection.
“While the use of skin care and cosmetic products can help minimize the appearance and effects of rosacea, poorly selected products may make it worse.” Dr. Baldwin said. “Fortunately, there are now many products that are formulated to be suitable for sensitive, rosacea-prone skin, without ingredients that may cause flare-ups. The primary challenge today is when rosacea sufferers face the bewildering array of options in the pharmacy skin care aisle.”
To help patients overcome these obstacles and make appropriate choices, the NRS recently launched a Seal of Acceptance program to identify skincare and cosmetic products that may be suitable for people who suffer from rosacea. The new program was developed under the guidance of Dr. Zoe Draelos, a clinical and research dermatologist, former vice president of the American Academy of Dermatology and president of Dermatology Consulting Services, PLLC, who is a well-known authority on skin care and serves on the NRS board of directors.
To be considered for the Seal, skin care and cosmetic products must be free of ingredients that cause skin barrier dysfunction, flushing (vasomotor instability) or unwanted neurosensory stimulation such as burning or itching. Each product earning the NRS Seal of Acceptance must undergo clinical testing to demonstrate safety and low risk for irritation and sensitization in people with rosacea. Applications, including study data, are anonymously reviewed by an independent panel of dermatologists to determine whether they are approved as acceptable. The NRS Seal of Acceptance is displayed on the packaging of approved products, and more information about the Seal and a directory of accepted products may be found online at rosacea.org/seal-of-acceptance.
During Rosacea Awareness Month and throughout the year, the NRS will conduct public education activities to reach the many millions of rosacea sufferers who may not realize they have a medical condition that can be treated, emphasizing the warning signs and urging those who suspect they may have rosacea to see a dermatologist. Those who experience any of the following warning signs 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
Bulk quantities of educational materials are available to health professionals for their patients through the NRS website or by writing the National Rosacea Society, 4619 N. Ravenswood Ave., Suite 103, Chicago, IL 60640; calling the NRS toll free at 1-888-NO BLUSH; or via email at info@rosacea.org.
Those interested in spreading awareness during April are encouraged to visit the official Rosacea Awareness Month landing page at rosacea.org/ram for ways in which they can participate.
What is Rosacea?
Rosacea is a chronic disorder of the facial skin that is often characterized by flare-ups and remissions. According to the updated standard classification of rosacea, the presence of persistent facial redness (erythema) or, less commonly, phymatous changes where the skin thickens are considered diagnostic of the disorder.3 Additional major signs, which often appear with the diagnostic features, include bumps (papules) and pimples (pustules), flushing, visible blood vessels (telangiectasia) and certain eye (ocular) manifestations. The presence of two or more major features independent of the diagnostic signs is also considered diagnostic of rosacea, and secondary signs and symptoms include burning or stinging, swelling (edema) and dry appearance.
References
- Baldwin D, Alexis A, Andriessen A, et al. Evidence of barrier deficiency in rosacea and the importance of integrating OTC skincare products into treatment regimens. J Drugs Dermatol 2021;20(4):384-392. Doi:36849/JDD.5861
- 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
- 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;78(1):148-155. Doi:10.1016/j.jaad.2017.08.03