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Awareness Rather Than Absolute Contraindications When Discussing Rosacea Triggers

Heather Roebuck

by Heather Roebuck, DNP, FNP-BC, FAANP

Toasting in the New Year cause red cheeks for you or your patients? You may be one of 16 million Americans with rosacea. This is a chronic cutaneous condition characterized by erythema, telangiectasia, edema, and papules or pustules which is most commonly found when examining the middle third of the face. The National Rosacea Society developed a classification system based on morphologic characteristics and provides a list of common rosacea triggers to discuss with your patients to prevent flares.

Top of the list is sun exposure, stress, alcoholic beverages, and exercising/overheating, spicy food, medications (corticosteroids, vasodilators, ACE inhibitors, and niacin). You may find the two week diary helpful to share with your patients to keep track of specific triggers which can be found at www.rosacea.org.

Make sure to share that these are a list of common triggers to be utilized as a guide. It is not meant to be a list of absolute contraindications. Without providing this information up front your patient may become overwhelmed with the many noted triggers identified. For example, some people may be willing to wear sunscreen to avoid excess ultraviolet exposure though are unable to go without their morning hot cup of coffee.

I once provided a married couple a brochure of rosacea triggers to review as I stepped out of the exam room to get prescription samples and skin care instructions. When I returned the husband was the first to request a note to exempt him from washing dishes at home as he noted the warm water and stress of not breaking his wife’s fancy china caused his papulopustular rosacea to flare. His wife quickly added that she would then need a note exempting her from a type of exercise her husband requests her to engage in that causes her erythematotelangiectatic rosacea to flare. After hearing this the husband decided he could give up something else to prevent rosacea triggers. To this day, he is still washing dishes!

Significant research findings related to triggers, genetics and comorbid conditions have been recently identified and will be shared during the Acne and Rosacea.

See Heather Roebuck in Las Vegas this November.