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Misconceptions about Rosacea:
Rosacea Sufferers can use Most Dermatologist-Recommended
Cleansers, Moisturizers and Sunscreens
Topics Discussed Below
- Misconception: Rosacea sufferers can use most dermatologist-recommended
- Problem with this misconception
I. Misconception: Rosacea
Sufferers can use Most Dermatologist-Recommended Cleansers, Moisturizers
This is also a common
misconception. Most general physicians assume that rosacea sufferers
can safely use gentle, dermatologist-recommended skincare products.
What general physicians do not realize is that: (1) Rosacea sufferers
have extremely sensitive skin with dysfunctional blood vessels,
making them much more reactive than normal subjects with plain 'sensitive
skin', and (2) Many products that are 'dermatologist-recommended'
contain irritating substances such as emulsifiers, detergents, alcohols,
exfoliators, and alpha- and beta-hydroxy acids. Thus, general physicians
are usually surprised when rosacea sufferers report irritation and
flushing to normal skincare products.
Some medical reports on
this important topic are detailed below:
- In a recent medical article, physicians reported on a survey
of 2,083 rosacea sufferers. (23) They found that many rosacea
sufferers could not use basic skincare products such as cleansers,
moisturizers and sunscreens; out of 2,083 rosacea sufferers, 44%
could not use facial cleansers (917 sufferers used only water
to cleanse their faces), 78% did not use moisturizers (1,625 sufferers),
and 95% did not use sunscreens (1,979 sufferers)!
- Dr. Mark Dahl, an expert in the field of rosacea, states, "Many
patients with rosacea have hyperirritability of the skin; many
creams, cosmetics, and ointments cause their skin to burn and
sting. This 'cosmetic intolerance syndrome', or 'sensory irritation'
hinders treatment, because even prescribed topical medications
and their bases can produce unpleasant sensations." (24)
- Dr. Corazza and colleagues recently reported on 29 rosacea
patients. (25) They stated, "All patients described intolerance
to cosmetics and/or topical medications, exhibited by worsening
of burning sensations and of erythema". They also emphasized,
"It is well known that rosacea patients are more susceptible
- In clinical study of 1,023 rosacea sufferers, 82% reported
that their skin was sensitive to topical skincare products. (26)
- In a major medical review by rosacea specialist Dr. Alfredo
Rebora, he emphasized, "Rosacea facial skin is extremely
sensitive to topical agents." In fact, in his clinical experience,
topical agents are, "Seldom tolerated." (8)
- In the Dermatology Times, Dr. James Leyden, a well-known dermatologist
from the Department of Dermatology, University of Pennsylvania,
indicates that rosacea patients have highly sensitive skin. (27)
In agreement with Dr. Leyden, numerous other experts indicate
that their rosacea patients have "sensitive skin", "very
sensitive skin", and "ultra-sensitive skin." (22,
- Drs. Jansen and Plewig report, "Most patients complain
of sensitive skin that stings and burns after application of cosmetics
and fragrances..... Their facial skin is unusually vulnerable
to chemical and physical stimuli." (30)
- Other rosacea experts report that even in the mild stage of
rosacea, "Some patients may report stinging or burning sensations,
including the feeling of dry or tight skin. This can cause 'angry
face syndrome' in which almost anything that the patient puts
on his or her face stings or burns." (31)
- In a recent double blind, placebo-controlled clinical study,
"Stinging and Rosacea", Dr. Lonne-Rahm and colleagues
reported that some rosacea sufferers even reacted to gentle
application of plain water with a q-tip. (32)
II. Main Problem with
This misconception usually
results in frustration for both physicians and rosacea sufferers.
If physicians understand from the beginning that rosacea sufferers
have highly reactive skin, then they will not treat patients with
potentially irritating products. If physicians also understand that
many of the supposedly 'gentle' skincare products contain rosacea
triggers, then they will be more careful before giving out harmful
recommendations. Lastly, if physicians understand that it will be
a challenge to find non-irritating skincare products for
rosacea sufferers, then they will become more focused on the 'project'
and not become as easily frustrated.
8. Rebora, A. Rosacea.
J Invest Dermatol 88: 56s-60s, 1987.
22. Garver, J.H. and J.K. Wilkin. Flushing and rosacea: overview
and nursing interventions. Dermatol Nurs 4: 271-277, 1992.
23. Shear, N.H. and C. Levine. Needs survey of Canadian rosacea
patients. J Cutan Med Surg 3: 178-181, 1999.
24. Dahl, M.V. "Rosacea: red faces and adult acne, and red
faces". Skin Care Today 5: 1999.
25. Corazza, M., W. la Malfa, A. Lombardi, C. Maranini, and A.
Virgili. Role of allergic contact dermatitis in rosacea. Contact
Dermatitis 37: 40-41, 1997.
26. National Rosacea Society. "Rosacea Review". Summer.
28. Mills, O.H.J. and R.S. Berger. Defining the susceptibility
of acne-prone and sensitive skin populations to extrinsic factors.
Dermatol Clin 9: 93-98, 1991.
29. Muizzuddin, N., K.D. Marenus, and D.H. Maes. Factors defining
sensitive skin and its treatment. Am J Contact Dermat 9:
30. Jansen, T. and G. Plewig. Rosacea: classification and treatment.
J R Soc Med 90: 144-150, 1997.
31. Erhard, M. "Rosacea: More americans now enter danger
years for rosacea". 1999. http://medicalreporter.health.org/tmr0596/rosacea.html,
National Rosacea Society.
32. Lonne-Rahm, S.B., T. Fisher, and M. Berg. "Stinging and
rosacea". Acta Derm Venereol 79(6): 460-461, 1999.