While some signs and symptoms of rosacea can be challenging to control, effective medical therapies have been extensively studied and approved for the treatment of the bumps and pimples of subtype 2 (papulopustular) rosacea, according to the standard management options for rosacea recently published by the National Rosacea Society.¹

If potential complications and side effects of oral antibiotic therapy were minimized, the vast majority of rosacea sufferers would be more likely to accept oral therapy to treat their condition, according to results of a recent National Rosacea Society survey of 520 rosacea patients.

The National Rosacea Society (NRS) has published new standard patient care options for rosacea, developed by a consensus committee and review panel of 26 rosacea experts, and articles on the various options for controlling the many potential aspects of this widespread disorder will appear in the coming issues of Rosacea Review.¹

Rosacea can be a trying condition under the best of circumstances, but it can be particularly vexing to women during menopause and even their monthly cycle.

Many women report more flushing episodes and increased numbers of bumps and pimples during these times, according to Dr. Wilma Bergfeld, head of the clinical research section of the dermatology department at Cleveland Clinic and former president of the American Academy of Dermatology.

While rosacea is usually treated by a dermatologist, a new survey by the National Rosacea Society suggests that other health specialists are often the first to notice a patient might have the disorder.

In the survey of 1,584 rosacea patients, 38 percent said a non-dermatologist first noticed their condition and 26 percent were referred to a specialist. Nearly 73 percent of the latter were referred to a dermatologist, and 12 percent were referred to an eye doctor for treatment of ocular rosacea.

Conspicuous disorders like rosacea can involve so many other areas of life that even a mild case can be severely distressing, said Richard G. Fried, M.D., clinical psychologist and director of Yardley Dermatology Associates, at the recent meeting of the American Academy of Dermatology. But giving patients control over their disease can break the self-destructive cycle and help keep flare-ups at bay.

Rhinophyma, in which the enlargement of tissue results in a bulbous and bumpy appearance of the nose in some rosacea sufferers, may usually be effectively addressed with laser surgery, according to Dr. Jeffrey Dover, associate clinical professor of dermatology at Yale University.

"Although rhinophyma may be generally unresponsive to oral or topical therapy, it is usually very amenable to surgical approaches," he said. "Besides manual surgery, electrosurgery and lasers are often very effective in reducing the excess tissue and returning the nose to a more normal appearance."

Special care may be needed for rosacea patients with severe forms of ocular rosacea, according to Dr. Sandra Cremers, instructor of ophthalmology at Harvard Medical School. As part of a National Rosacea Society (NRS) research grant, she recently developed a scoring system to identify severe cases of this rosacea subtype, which may affect half of all rosacea patients.

The American Society for Dermatologic Surgery (ASDS) has issued consumer safety tips for patients considering treatment involving lasers, light devices, chemical peels, microdermabrasion and other medical procedures, and emphasizes that such services should be performed only by a physician or under direct physician supervision.

Sensitive facial skin has been widely observed as one of the most common features of rosacea. Fortunately, however, this problem can be minimized with medical treatment, special precautions in facial care and avoidance of skin-care products that may cause irritation.