Rosacea Review

A review of recent news, research, and treatment related to rosacea.  


Rosacea Linked to Multiple Systemic Disorders 

Rosacea is associated with multiple systemic disorders, including diabetes and depression, according to the findings of a recent systematic review by Haber and El Gemayel, published in the Journal of the American Academy of Dermatology.

The review included 29 studies that reported on possible diseases associated with rosacea, of which 14 were case-control, 8 were cross-sectional, and 7 were cohort studies. Rosacea was statistically significantly associated with depression, hypertension, cardiovascular disease, anxiety disorder, dyslipidemia, diabetes mellitus, migraines, rheumatoid arthritis, Helicobacter pylori infection, ulcerative colitis, and dementia. 

“Recognition of these conditions is critical to providing appropriate screening and management of affected patients,” the researchers concluded. 


Haber R, El Gemayel M. Comorbidities in rosacea: a systematic review and update. J Am Acad Dermatol. 2018;78(4):786-792.e8.


Rosacea Severity Associated With Lower Quality of Life

Patients with severe rosacea experience higher disease burden and lower quality of life, according to the findings of a recent study by Harper and colleagues, published in the Journal of Drugs in Dermatology.

For the cross-sectional web-based survey, 409 participants with erythematotelangiectatic rosacea (ETR) answered questions on sociodemographics, clinical characteristics, bothersome symptoms, coping and avoidance behaviors, self-perceptions, and health care resource utilization. In addition, participants were asked to complete the 21-item rosacea-specific quality of life questionnaire (RosaQoL) and the 36-item Short Form Health Survey (SF-36). 

Mild erythema was reported by 63.6% of participants, moderate erythema was reported by 32% of participants, and severe erythema was reported by 4.4% of participants. 


The most bothersome symptoms reported across all severity groups were blushing/flushing and bumps/pustules. To cope with rosacea, all participants reported using makeup and managing stress and anxiety, and attempted to prevent flares by avoiding sun exposure, certain skin care products, and other triggers. 

In addition, the severity of erythema was associated with changes in self-perception. Specifically, worsening erythema severity was associated with significant decreases in satisfaction with facial appearance and increases in feelings of unattractiveness and worrying about other people’s reactions. Likewise, erythema severity was associated with increases in RosaQoL emotional domain scores. However, SF-36 scores did not differ significantly between severity subgroups.

Participants reported seeking treatment or assessment of rosacea within the past 3 months, most commonly from a dermatologist. The most frequently prescribed topical product among participants in all severity subgroups was metronidazole. Among participants with severe erythema, the most frequently prescribed treatments were doxycycline and other oral antibiotics. 

“These results demonstrate that rosacea is associated with a substantial burden of illness that spans all levels of erythema severity in patients with ETR,” the researchers concluded. 


Harper J, Del Rosso JQ, Ferrusi IL. Cross-sectional survey of the burden of illness of rosacea by erythema severity. J Drugs Dermatol. 2018;17(2):150-158.

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