Rosacea’s psychological impact

The results of a multi-country survey appear to confirm the belief that rosacea - including facial erythema - negatively affects a person’s psychological and emotional wellbeing.

Researchers in Germany, Italy, the United Kingdom and Canada designed the survey to assess the impact of facial erythema on subconscious perceptions and initial reactions of others and how these affect their resulting attitudes.  The survey also measured the impact of facial erythema on an individual’s emotional and psychological health.

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From online general-population research panels, the investigators recruited a total of 6,831 people, 25 to 64 years of age, from eight countries: Germany, Ireland, Sweden, Denmark, the UK, France, Italy and Mexico. Using online computer-assisted web interviewing, participants answered questions from psychological assessments based on an association test.

Participants were shown photos of people with and without facial erythema who were representative of the participants’ country or region. They were asked to accept or discard descriptive words shown next to each image - for example, trustworthy, relaxed, healthy, tired - with the speed of each response directly linked to the participant’s initial, subconscious perception of the face. According to the study, this provided quantitative and qualitative data that the researchers could analyze and interpret at various levels of complexity.

Participants also completed a traditional questionnaire designed to ascertain comparative attitudes toward further images of facial erythema associated with rosacea versus non-affected images. In addition, all participants who had self-reported facial erythema during recruitment were asked to answer questions about their views of living with the condition and how it affects their day-to-day life.

In This Article

What Researchers Found

Expert EAB Opinion

What Researchers Found

Survey results showed that respondents strongly associated facial erythema with poor health and negative personality traits, with participants reporting negative impacts of rosacea emotionally, socially and in the workplace. Nearly 80% reported difficulty in controlling facial erythema; however, those with physician-diagnosed rosacea had significantly improved control compared with those whose rosacea was undiagnosed (39% versus 20%, respectively).

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“This survey shows that first impressions are a powerful driver of perception,” the authors write. “People suffering with facial erythema associated with rosacea not only have to manage their own psychological barriers to cope with the disease but also deal with the prejudice and perceptions of others. Facial erythema tends to generate a negative first impression and has a negative impact on people both personally and professionally. The results highlight the need to treat those with facial erythema of rosacea from both a physiological and psychosocial perspective - treating not only the physical symptoms, but also the person experiencing the symptoms.”

The authors add that people who have rosacea must manage the triggers of their condition more effectively. One way of doing so, they write, is to get a formal medical diagnosis, which according to the survey results makes it likelier that the person can control it.

Expert EAB Opinion

Expert EAB Opinion

Dr. SchlessingerDermatology Times asked Omaha, Neb., dermatologist and Editorial Advisory Board member Joel Schlessinger, M.D., to comment on this international survey.

“Rosacea clearly impacts the self-confidence of individuals,” he says. “The problem is that rosacea, as a disease, is so poorly characterized that our patients are not always treated in the correct way by dermatologists. Marketing has replaced medical information, and we now have a lower expectation for results that relies more on simply treating the effect of rosacea - the redness - rather than focusing on the cause.

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“I have found that in addition to treatments such as lasers and topical creams, it is even more important to find out the cause when possible,” Dr. Schlessinger adds. “The take-home message is that rosacea isn’t just a cover-it-up process - it requires a significant thought process on the part of the dermatologist in order to consider it fully addressed.”

The study appears in the journal Dermatology and Therapy.