Topics Discussed Below

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• Misconception: Physicians understand what rosacea sufferers experience
  
• Most physicians do not see the 'real life' flushing episodes
  
• Main problem with this misconception

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I.  Misconception: Physicians Understand what Rosacea Sufferers Experience on a Daily Basis

Even the most caring physician can fall into this trap. It is hard to appreciate rosacea and the underlying flushing disorder when physicians only examine rosacea sufferers for a few minutes in their climate-controlled offices. Most physicians do not realize the number of triggers that we contend with on a daily basis, and the debilitation that these can cause us. Even physicians who have treated numerous rosacea sufferers, or have read most of the literature on the disease, cannot appreciate rosacea unless he or she actively studies and evaluates the disorder. To truly understand the disorder, physicians must actively examine rosacea triggers and flares (i.e., duration, intensity and frequency). This can be an eye-opening experience for most physicians.

II.  Most Physicians Never See the "Real Life" Flushing Episodes, and thus cannot Appreciate the Dynamics of the Disorder

I have personally been treated by numerous well-intentioned dermatologists who severely underestimated my flushing disorder - its intensity, duration, and effect on my lifestyle. In fact, on several occasions I have personally demonstrated to my physicians how easily and intensely my face flushed to certain triggers:

1. One general dermatologist could not understand (or believe) how badly my face flushed to cleansing. He was dismissive that non-soap facial cleansers designed for sensitive skin could elicit such a reaction. Finally, I decided to show him my reaction to facial cleansing, so I brought in one of his highly recommended cleansers and gently cleansed my face with the cleanser. Within 30 seconds after rinsing the cleanser off, my face turned noticeably flushed. Over the next 20 minutes my flush progressed to an impressive neon-red. I then sat in his waiting room for another 45 minutes to demonstrate that this flush stayed with me for quite some time after this one insult. To say the least, he was surprised.
   
   
2. A second general dermatologist did not understand (or believe) that I could not use any sunscreen on my face, even those that were designed for the sensitive skin of babies. I finally decided to show him my reaction to a highly recommended baby formulation, so I brought it in to his office, and applied a small amount of the sunscreen to half of my face. Within 15 minutes, that side of my face turned fire engine red. I then stayed in his waiting room for 90 minutes to demonstrate that this flush was long lasting. He too was quite surprised.
   
   
3. A third general dermatologist did not understand how sensitive I was to warm rooms. During one examination, I asked him to slowly increase the temperature of the examining room from 68 degrees Fahrenheit to 78 degrees Fahrenheit. As he noted, my face became significantly flushed at 72 degrees and as the temperature increased, my facial redness became more intense. At 78 degrees, my face was bright red and inflamed. He was truly impressed by my facial reaction.
   
   
4. A fourth general dermatologist could not comprehend how easily I flushed to mild exertion. So, I asked him to accompany me on a short walk up several flights of stairs. As he noted, after three short flights of stairs, my face became moderately flushed. We then walked back to his office to finish the examination. He was surprised to see that the flush stayed on my face throughout the entire examination.
   
   
   

 

III.  Main Problem with this Misconception

No matter how many rosacea patients a physician examines in his or her office, or how many articles a physician reads on rosacea, it is hard for the physician to understand rosacea flushing and its effect on the patient's lifestyle. In order to better understand the disorder, physicians must start to actively examine the patients' triggers and their flushing reactions. Without doing this, physicians cannot fully understand the disorder, and certainly cannot appreciate what they are asking of rosacea sufferers to, "avoid all triggers for flushing." They do not realize that this usually means avoiding dozens of daily tasks, relationships, work, and activities that bring on joy, happiness and pleasure.

 

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