Fully 77 percent of respondents said they experienced persistent redness.

The great majority of rosacea patients have experienced persistent facial redness, and most of them report it is the most frequently bothersome sign they face, according to a recent National Rosacea Society (NRS) survey on rosacea redness sponsored by EPI Health. 

Furthermore, two-thirds reported experiencing flare-ups more than once a week.

“The results of this survey serve as a strong reminder that persistent facial redness is the defining feature of rosacea, and one that should not be ignored when treating patients,” says Dr. Hilary Baldwin, associate professor of dermatology at Rutgers Robert Wood Johnson Medical School, in a news release.

While once conventionally divided into four subtypes, rosacea is now classified as a single disorder with many potential clinical features, or phenotypes, that may occur in various combinations, with persistent facial redness (also known as erythema) as the primary diagnostic sign. Thickened skin (phymatous changes) is also considered diagnostic, although it is less common. In addition, major signs of rosacea include bumps and pimples (papules and pustules), flushing, visible blood vessels on the face (telangiectasia) and certain ocular manifestations. The presence of any two of the major phenotypes may be considered diagnostic of rosacea, and secondary phenotypes include burning, stinging, swelling (edema) and dryness. Although these signs and symptoms may appear at different times and in varying combinations, scientific research indicates they may all be manifestations of the same underlying inflammatory continuum.

In the survey of 986 people with rosacea, 77 percent of respondents said they experienced persistent redness, while 61 percent reported having bumps and pimples, and 53 percent had visible blood vessels on their face. Forty-six percent said they experienced burning, stinging and itching; 43 percent had red, irritated or watery eyes indicative of ocular rosacea; and 27 percent reported having a red, swollen nose or rough and thickened skin due to phymatous changes.

About 60 percent of respondents said persistent redness was the most frequently bothersome sign they experienced, compared to 38 percent who said bumps and pimples bothered them frequently. About 30 percent of respondents said they suffered from flare-ups of their facial redness daily, and a further 34 percent experienced facial redness flares several times a week.

Asked how the redness of rosacea affected them, 59 percent of respondents said it made them feel self-conscious and that people were looking at their face, and 57 percent said they were frustrated or annoyed with their appearance. Forty percent said they stayed out of the sun or limited outdoor activities, and 38 percent said they thought the redness made them look unhealthy. Only 4 percent of respondents said their rosacea redness didn’t affect them.

Most survey respondents (80%) said they have discussed treatments for redness with their healthcare provider. Eighty percent discussed a topical prescription medication, 40 percent discussed an oral prescription medication, and 24 percent had discussed treatment with a laser or light device. About two-thirds (62%) of those who were prescribed a topical medication used it daily or as directed by their healthcare provider, while 11 percent used it occasionally, 13 percent applied it only during a flare-up, and 12 percent had stopped using it. In comparison, 40 percent of those who were prescribed an oral medication used it daily or as directed, 8 percent took it occasionally, 12 percent used it only when flaring up, and 17 percent had stopped.

Among those who stopped using a topical or oral prescription therapy, 24% percent said it was because the treatment stopped working. Seven percent said it wasn’t convenient, 13 percent said it was due to unpleasant side effects, 8% said the medication was too expensive, and 5 percent ran out and didn’t refill their prescription.

“As dermatologists, we want patients to be healthy and happy in their skin,” Dr. Baldwin says. “With today’s increasingly sophisticated tools, it is now possible to tailor therapy to address each patient’s individual signs and symptoms, and substantially improve the quality of their lives. If a therapy is not doing its job, rather than quitting treatment altogether, patients should consult with their doctor to find a different approach.”

About 44 percent of survey respondents said they had a family member with rosacea. Of those family members, 70 percent had persistent facial redness, 48 percent had visible blood vessels on their face, 37 percent had bumps and pimples, and 24 percent experienced stinging, burning and itching. More than 72 percent of respondents said their family member’s rosacea had worsened over time.