Not only is rosacea now estimated to affect more than 16 million Americans, but a new survey by the National Rosacea Society documents the unusually wide range of potential signs and symptoms that may be associated with the disorder.
"While rosacea tends to develop in common patterns known as subtypes, its signs and symptoms can vary substantially from one patient to another, and many experience a variety of manifestations in succession or at the same time," said Dr. Boni Elewski, professor of dermatology at the University of Alabama-Birmingham. "That's why it's important for patients to be aware of the many possible effects of the disorder, so they know when to seek an evaluation and appropriate help from a dermatologist."
In the recent survey of 1,289 rosacea patients, 71 percent of the respondents said they had experienced persistent redness, and 63 percent said they had suffered from frequent flushing -- both hallmarks of subtype 1 (erythematotelangiectatic) rosacea. In addition, 63 percent said they had suffered outbreaks of pimples (pustules) and 61 percent reported experiencing bumps (papules) -- both signs of subtype 2 (papulopustular) rosacea.
Beyond these common effects of rosacea, however, the survey found that more than half of the respondents had been affected by a number of less well-known potential effects of the condition. Although a link between a skin disorder and the eyes may seem counterintuitive to many, 61 percent of the patients said they had also experienced eye symptoms, a condition known as subtype 4 (ocular) rosacea. In addition, visible blood vessels were cited by 56 percent of the respondents, and facial burning or stinging were reported by 51 percent.
Other widely reported signs and symptoms included facial itching, experienced by 41 percent; dry appearance, named by 40 percent; raised red patches, reported by 30 percent; skin thickening or excess tissue on the nose (rhinophyma), 22 percent; signs beyond the face, 21 percent; and facial swelling, 18 percent.
Among those who experienced eye symptoms, complaints ranged widely, including dry eye, affecting nearly 65 percent; a gritty feeling, cited by 58 percent; itching, 56 percent; bloodshot appearance, 50 percent; burning, 48 percent; watery eyes, 45 percent; reduced vision, 22 percent; and styes, 18 percent.
Of the 21 percent of survey respondents who indicated that rosacea had affected areas other than the face, 48 percent said they had signs and symptoms on the neck. Forty-six percent noted the condition had affected the scalp, while 42 percent said it was evident on the chest. Other affected areas included the ears, cited by 36 percent; the arms, 16 percent; and the legs, 8 percent.
Women experience a greater number of rosacea's signs and symptoms, according to the survey results. Visible blood vessels, in particular, were more likely to be present in females, cited by 59 percent of the women and only 43 percent of the men. Other symptoms more common in women included frequent flushing (68 percent of women vs. 52 percent of men), facial burning or stinging (57 percent vs. 43 percent) and facial itching (45 percent vs. 35 percent). On the other hand, skin thickening or excess tissue on the nose was more common in men.
"Rosacea patients should be sure to tell their dermatologist about all of the rosacea signs and symptoms they have experienced, even if they are not present at the time of the visit, so therapy can be tailored for their individual case," Dr. Elewski said.
Despite the broad disparity of symptoms, 86 percent of the survey respondents reported that medical therapy and lifestyle modifications had reduced the effects of their rosacea.