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Lifestyle and Rosacea
an editorial by Brady Barrows
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Please note: In my book, Rosacea 101, I wrote a chapter based on this editorial and you can read it on page 83.
One of the theories of what causes rosacea is the vascular theory, which basically means that there is a dysfunction of the blood vessels of the facial area and is related to flushing. Classifying rosacea as a vascular disorder puts this disease with other vascular disorders such as heart disease, hypertension, stroke and diabetes to name a few. [Diabetes is primarily a metabolic endocrine disorder, and secondarily a vascular disease] |
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With vascular disorders, the prevailing opinion is that genetics plays a key role. For instance, if your parents have heart disease, hypertension, stoke or diabetes, there is no doubt that the odds are that you have a genetic predispostion to whatever vascular disorder you parent(s) have or had. Rosacea seems to have this same genetic predispostion to run in families.
There is a debate in the vascular theory field whether gentics plays a key role, or the environment. Some feel that a combination of the two seems to be the most reasonable explanation. Somehow the environment triggers the genetic predispostion for rosacea. The prevailing view of most clinical researchers on this subject is that genetic factors cannot be controlled, but there are controllable risk factors. For instance, notice this statement made by the American Heart Association:
"Males and people with a family history of premature cardiovascular disease have an increased risk of atherosclerosis. These risk factors can't be controlled. Research shows the benefits of reducing the controllable risk factors for atherosclerosis." source
Most literature says that the environmental factors, including lifestyle factors, have a bearing on the progression of any of the vascular disorder diseases. What are some of the key lifestyle factors usually mentioned by clinical researchers and physicians?
Diet (Junk food, obesity)
Obesity or Overweight
Exercise (or physicial inactivity)
Psychological Factors, (ie., Quality of life, stress or the Type A personality)
Tobacco Free (tobacco use or exposure to tobacco smoke)
If rosacea is a vascular disorder, which is the prevailing view among professionals today, then the lifestyle factors should come into play just like all the other vascular disorders. Why would lifestyle be excluded for rosacea if it is a vascular disorder? Some would like to believe that lifestyle isn't a factor in this disease because they simply want to keep their present lifestyle without altering their present eating, drinking, lack of physical inactivity, obesity, tobacco exposure, or current psychological habits.
Whether the lifestyle factors are considered in the pathophysiology of rosacea or not, research should be done to show whether lifestyle factors are rosacea triggers or not. At present lifestyle factors are dismissed by most medical professionals for rosacea treatment and rarely discussed.
However, rosacea, even though it has been around for a long time, has not had the numbers of cases in the millions as it has today worldwide, just as there is also a significant rise in all types of vascular disorders worldwide. Research suggests that genetics and family history is the prime reason for this rise in vascular diseases, but the environmental factors are contributing to the progression of this. If the environmental factors aren't related to the progression of this increase, what accounts for this rise in numbers? And why do medical authorities mention that controllable risk factors can help reduce the odds of having a problem?
There is evidence that vascular diseases begin in childhood. Note this quote from the AHA:
"Atherosclerosis is a slow, complex disease that typically starts in childhood and often progresses when people grow older." source
One report done in 2002 on this subject puts the matter clearly, "Dermatoses may have a significant impact on a patient's quality of life, namely the relationship to others, self-image and self-esteem.' source The same report concluded, "Improvement of quality of life reached statistical significance among patients with acne (2.8 versus 7.8, p = 0.0078) and among individuals with a less severe initial impairment of quality of life (2.4 versus 4.2, p = 0.007)."
There is even evidence that rosacea may begin in childhood evidenced by children who are known to flush. Note this quote:
"Rosacea tends to begin in childhood as common facial flushing, often in response to stress. A diagnosis beyond this initial stage of rosacea is unusual in the pediatric population." source
With rosacea all the potential triggers are environmental factors and usually related to flushing. Lifestyle which includes, diet, obesity, exercise, smoking, psychologicial factors such as quality of life, stress, or the Type A personality should also be considered factors when trying to control rosacea.
Having a healthy diet, getting the appropriate exercise, stopping smoking, reducing your weight, and having a good quality of life with appropriate self-esteem should be part of the regimen to help control rosacea.
Have you ever heard anyone say much about these factors when considering rosacea? Most dermatologists simply hand you a prescription for Metrogel and antibiotics or offer IPL. When other vascular disorder patients are given education on what to do, lifestyle is usually discussed with the patient. Patients with vascular disorders are encouraged to change their lifestyle which may have been the factor that aggravated the problem whether it is genetic or not. The nature verses nurture debate on what causes rosacea will continue until research pinpoints the cause of rosacea. Lifestyle may have an effect on the progress of rosacea.
In the meantime, why not consider changing your lifestyle to see if your rosacea improves?
Many rosaceans have changed their lifestyle with diet and have noted a remarkable way to control rosacea with the Rosacea Diet. While no clinical studies have been done on this lifestyle change, there has been research articles on this subject with acne. In the past, the traditional view among researchers and physicians is the diet has no role in the pathophysiology of acne. However the following article in the Detroit News of February 19, 2003 says a report in the "December issue of the Archives of Dermatology, a Western diet may be a reason 79 percent to 95 percent of American teen-agers have acne." source Here is another report. There are many anecdotal reports that rosaceans who have tried altering their diet lifestyle have marvelous success in controlling rosacea. source
Rosacea and Emotions:
Effect of Rosacea on Quality of Life
