Patient discussions
Advise patients to consider using a diary to track lifestyle and environmental factors that may be triggering their symptoms.[16]
Patients should be provided with a list of potential triggers that they should avoid. However, they should be made aware that even the most disciplined avoidance of triggers does not always prevent the progression of rosacea. Common triggers include:[14][15][16]
Sun/ultraviolet exposure
Hot, cold, or windy weather
Humidity, indoor heating, hot baths, hot beverages
Heavy exercise
Alcohol consumption
Spicy foods
Emotional stress
Some skincare and toiletry products (e.g., those that contain menthol, camphor, or sodium lauryl sulfate)
Some medicines
Some fruits and vegetables, or certain dairy products.
One of the main triggers for rosacea attacks seems to be sun exposure, so advise patients to:
Use sun cream on their face every day
Avoid the midday sun
Wear a wide-brimmed hat in the sun.
People with erythema, telangiectases, or papule and pustules phenotypes often describe sensitivity to various cosmetic agents. Products and ingredients such as astringents, toners, menthol, camphor, and sodium lauryl sulfate (a key component of the majority of shampoos) can be quite harsh on skin, causing worsening of the condition. A gentle soap-free cleanser applied with the fingers is best tolerated. This can be followed by a gentle emollient, preferably with a sun protection factor (SPF) of at least 15.
People diagnosed with rosacea will have the condition for life, with better control at times and intermittent flare-ups at others. Therefore, counsel patients that, while it is likely their condition can be greatly improved with treatment, it cannot be cured. Patients with telangiectasia should be warned these will appear more prominent with the treatment of erythema.
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