Rosacea fact or fiction: Test your knowledge of the skin disease

Rosacea, the skin condition that can cause flushed cheeks, bumps and thick skin patches on your face, has spawned myths over the years.
I find my dermatology patients at The Ohio State University Wexner Medical Center generally develop a good knowledge base about their rosacea, which affects light skin tones.
But if they have prominent red spotting, pus-filled bumps or the kind of rosacea that makes the nose bulbous, they still face critical comments from people who don’t understand the disease.
Part of the mystery about rosacea comes from the fact that doctors and researchers are still working to understand the disease fully.
Let’s tackle some common ideas about rosacea by exploring whether they’re fact or fiction:
1. People with rosacea have acne
Even though some types can look similar to pimples, this myth is flat-out wrong. Bacteria or hormone fluctuations cause acne, while rosacea is a malfunction of the immune system that causes inflammation and enlarged blood vessels. One clue to their difference is that rosacea doesn’t cause blackheads or whiteheads.
Scrubbing with strong cleansers and astringents that you might use for acne would be too harsh for sensitive skin with rosacea.
2. Drinking alcohol – especially lots of it – causes rosacea
This notion was common years ago and was pushed aside as research evolved, but a new investigation has added credibility to the idea.
Women who drink alcohol are more likely to develop rosacea, according to the 2017 study in the Journal of the American Academy of Dermatology. The link between rosacea and drinking more glasses of white wine and liquor was particularly high, compared with less risk for red wine and beer, according to the research using surveys from about 83,000 women over 14 years.
This old belief might not be a myth at all.
However, others studies have questioned the link with alcohol. And while red wine often is a major trigger for people who already have rosacea, that doesn’t mean it’s responsible for causing the condition.
I advise patients to eliminate or to cut back on anything, including alcohol, which makes red patches or pustules pop up.
3. Caffeine makes rosacea worse
Studies show caffeine is not linked to rosacea. Instead, the heat from a steaming cup of coffee or tea is likely to blame for flare-ups.
Since the disease widens blood vessels, any hot food, light or weather can cause an outbreak.
If these things bother your rosacea, avoid them or turn down the temperature:
  • spicy foods
  • hot showers
  • steamy facials
  • high heat in your car or house
Some people with rosacea can eat a flaming-hot bowl of chili with no problem. Others would be overwhelmed with flushing and bumps on their faces.
That’s part of what we don’t quite understand with rosacea. Why are some people reacting so specifically to certain triggers and others aren’t?
4. Rosacea is difficult to treat
All types of rosacea respond well to treatment. For example, the kind of rosacea that resembles acne is controlled with inexpensive creams or low-dose antibiotics.
But some treatments can be costly for rosacea variations that simply make your cheeks red (more common in women) or that make your nose bulbous (typically in men). One such treatment is using a laser to get rid of visible red blood vessels.
Your doctor will work with you to find a treatment that fits your particular symptoms and your budget.
5. Sun makes rosacea worse
Sun seems to be the No. 1 trigger that my patients mention. The heat doesn’t help, and the sun over time can increase the size of blood vessels.
If you’re tempted to go without sunscreen one day, don’t do it. Always use a mild moisturizer for sensitive skin with sunscreen.

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