1.It is more than just redness. While many may think of rosacea only as facial redness, the signs and symptoms often extend much further, such as bumps and pimples, flushing, visible blood vessels, and skin thickening. Invisible symptoms, like burning and stinging, can be unbearable for many and the disorder can even affect the eyes. This condition is classified into four subtypes by the National Rosacea Society: Subtype 1 (erythematotelangiectatic rosacea) is characterized by flushing and persistent redness and may also include visible blood vessels. Subtype 2 (papulopustular rosacea) is characterized by persistent redness with transient bumps and pimples. Subtype 3 (phymatous rosacea) is characterized by skin thickening, often resulting in an enlargement of the nose from excess tissue. Subtype 4 (ocular rosacea) is characterized by ocular manifestations such as dry eye, tearing, burning, swollen eyelids, and recurrent styes.

2. It can vary substantially from client to client. One client’s rosacea will not be the same as the next. In most cases, some, rather than all, of the potential signs and symptoms will develop and clients may exhibit more than one subtype concurrently. Flushing and persistent redness, as seen in subtype 1, are by far the most common early signs of the disorder, but some clients may start out with signs and symptoms that fall under a different subtype.

3. It can affect ethnic clients. Rosacea has been called the “curse of the Celts;” while rosacea is most common in fair-skinned people of Northern European descent, it can occur in all ethnicities. Skin of color should not be overlooked, particularly if a client complains of burning or stinging. In darker skin, the redness may present as more of a violet hue, which may help in spotting the presence of the disorder.

4. Rosacea can come and go. Its transient nature may be its most frustrating characteristic, as symptoms tends to ebb and flow and flare-ups occur unexpectedly. These outbreaks may be triggered by lifestyle and environmental factors such as sun exposure, heat, spicy foods, stress, and product ingredients, but differs for each individual. Have clients keep a diary of their signs and symptoms to help identify and avoid their individual triggers.

5. Rosacea is more common in women. Clinical studies have reported that rosacea may occur up to three times more often in women than in men. While there is not dedicated research to explain this higher susceptibility, a male’s tendency to not seek a professional diagnosis, unless severe symptoms develop might help explain the difference as health professionals have noted that the condition often appears to be more severe in men. Men and women also tend to experience different signs and symptoms of rosacea according to an NRS survey, with men seeing more symptoms on the nose while women experience more symptoms on the cheeks.

6. Other skin conditions can mimic signs of rosacea. Many other conditions may superficially resemble rosacea’s signs and symptoms, such as acne vulgaris, seborrheic dermatitis, contact or perioral dermatitis, folliculitis, lupus erythematosus, and even sunburn. Proper diagnosis is especially important because treatments for similar-appearing conditions can often make rosacea worse.

7. Certain products can trigger flare-ups. What is applied to the skin of a client who suffers from rosacea can make or break their day. Ingredients such as alcohol, witch hazel, fragrance, menthol, peppermint, and eucalyptus oil have been reported by clients to trigger their condition. Certain astringents and exfoliating agents might also be too harsh.

8. Rosacea is a treatable medical condition. It is important to recognize rosacea as a medical disease and not just an aesthetic skin issue. If not diagnosed and medically treated early on, rosacea can worsen with time and cause substantial emotional and physical distress. If a professional notices a client who may have rosacea but is not receiving medical help, they should be sure to advise them to see a dermatologist for diagnosis and appropriate medical care.

9. Clients may be at an increased risk for other health issues. Medical research has started to point to significantly-increased health risks associated with the disorder. An analysis of over 33,000 patients suggested a connection between rosacea and increased risk of cardiovascular disease; another study found that rosacea patients may have an increased risk of thyroid cancer and basal cell carcinoma. Similarly, another study found that rosacea patients may be more likely to suffer from other chronic issues, such as allergies, asthma, gastrointestinal disease and diabetes.

10. Rosacea hates heat. A study published in the Journal of the American Academy of Dermatology found that individuals with subtype 1 and subtype 2 rosacea had a significantly greater sensitivity to heat pain on symptomatic skin in comparison to skin without symptoms and to the skin of individuals without rosacea. Heat treatments, like steam, should be avoided or used with caution on a client suspected to have rosacea.

Brandy Gonsoulin serves as an online editor for the National Rosacea Society. Gonsoulin is active as a health writer and also contributes in medical communications. Gonsoulin currently resides in Chicago.