The key to controlling rosacea is a holistic approach that addresses not only the signs and symptoms of the disease but also the personal and environmental factors that can exacerbate the condition, according to leading dermatologists. The National Rosacea Society (NRS) has designated April as Rosacea Awareness Month to educate the public on this chronic facial skin disorder estimated to affect more than 16 million Americans, and to urge those who suspect they may have it to see a dermatologist for diagnosis, treatment and guidance on gentle skin care.
“There are more FDA-approved treatments for rosacea than ever before, with multiple options available for each sign and symptom of the disease. However, skin care also has a role to play,” said Dr. Zoe Diana Draelos, clinical faculty in dermatology at Duke University and president of Dermatology Consulting Services, PLLC. “The use of gentle cleansers, moisturizers that help repair the skin barrier, and sunscreens that protect from solar radiation can improve the skin’s ability to resist environmental triggers and augment medical therapy.”
The most common individual sign of rosacea is persistent redness (erythema) on the central part of face — the cheeks, nose, forehead and chin — often accompanied by itching, burning or stinging. Sufferers may also experience bumps and pimples (papules and pustules) or develop tiny visible blood vessels (telangiectasia) on their skin. In as many as 50% of patients the eyes may be involved, feeling irritated and appearing watery or bloodshot. In severe cases, the skin may thicken, particularly around the nose, a condition known as rhinophyma.
Prior to diagnosis, some rosacea sufferers turn to skin care products and cosmetics as a way to treat or cover up these signs and symptoms, mistaking them for a 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. Even many gentle skin care and cosmetic products may contain ingredients that could cause a rosacea flare-up, such as alcohol or fragrances.
In an NRS survey of 1,104 rosacea patients, 82% reported that certain skin-care products and cosmetics aggravated their condition, and 70% said there were specific ingredients that irritated their skin. 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 launched a new Seal of Acceptance program in 2024 to identify skin care and cosmetic products that may be suitable for people who suffer from rosacea. More information about the Seal and a directory of accepted products may be found online at rosacea.org/seal-of-acceptance.
In addition to medical therapy and gentle skin care, patients can help minimize their chances of a rosacea flare-up by avoiding their personal triggers and making diet and lifestyle changes that reduce stress and inflammation. The most common triggers reported by patients include sun exposure and hot weather, emotional stress, wind, heavy exercise, alcohol consumption and spicy foods.
“Each individual’s triggers are different, and patients may find it helpful to keep a diary to track when flare-ups occur and which foods, activities or environmental conditions may have contributed,” Dr. Draelos said. “Beyond avoiding physical triggers, patients may find that a focus on emotional well-being and stress-mitigating techniques such as yoga and meditation can be effective in reducing the likelihood and severity of rosacea flare-ups.”
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. Bulk quantities of educational materials are available to health professionals for their patients through the NRS website at rosacea.org 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 e-mail at info@rosacea.org. Those interested in spreading awareness during the month of April are encouraged to visit the official Rosacea Awareness Month landing page at rosacea.org/ram for ways in which they can participate.