Topics Discussed Below

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• Misconception: Rosacea sufferers can use most dermatologist-recommended products
  
• Problem with this misconception
  
• References

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I. Misconception: Rosacea Sufferers can use Most Dermatologist-Recommended Cleansers, Moisturizers and Sunscreens

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 to irritants."
  
  
• 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, 28, 29)
  
  
• 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

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.

 

III. References

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. 1997. Drake,L.

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: 170-175, 1998.

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.

 

 

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