Facial edema, or swelling, may be more common in rosacea patients than is widely recognized because it is a difficult symptom for physicians to spot, according to Dr. Mark V. Dahl, chairman, Department of Dermatology, Mayo Clinic, Scottsdale, at the recent annual meeting of the American Academy of Dermatology.

"We don't appreciate edema very much," he said, because often at the initial visit, "we don't know what the patient normally looks like." He noted that facial swelling is not usually the symptom that causes the patient to visit the doctor, but it can be treated along with the other effects of rosacea.

It is believed that facial swelling in rosacea may be due to increased blood flow during flushing. If dilated vessels become "leaky," extra fluid may accumulate in the tissues faster than the lymphatic system, which transports fluids throughout the body, can remove it.

Dr. Dahl noted that because swelling is related to flushing, "if you control the flush, you control the edema." There is medical therapy for flushing, he said, and facial massage and cool packs also may be useful. Cool packs for the face can be found in pharmacies.

"Edema can alter the patient's appearance, and also contribute to progressive worsening of rosacea," Dr. Dahl said. "Controlling this symptom can help halt this process."