Study Links Sun Protection to Better QoL in Rosacea

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Although rosacea can significantly impact quality of life (QoL) through symptoms like itching and burning, it can also affect social and professional interactions, potentially influencing decisions about relationships and employment.^1-2 Research indicates that patients with rosacea often have a lower QoL compared to those with other skin conditions, but there is limited understanding of how patients perceive their illness and its impact on their QoL.¹

Sun exposure can be a major trigger for rosacea flare-ups, making sun protection crucial for managing the condition.³ With this in mind, researchers set out to evaluate the sociodemographic and clinical aspects of rosacea, examine the relationship between illness perception, QoL, and sun protection behaviors, and explore how these factors affect patients' management of the disease. ⁴

“The management of patients with rosacea should involve expert psychological support to manage the negative beliefs and emotions surrounding the condition, alongside the dermatological treatment of clinical symptoms and signs,” researchers wrote.

Materials and Methods

From December 2021 to May 2023, a study was conducted with 120 patients with rosacea and 120 matched controls at Dokuz Eylül University Faculty of Medicine. Personal and clinical data were collected through face-to-face interviews and clinical exams. Rosacea severity scores were assessed, and skin types were classified using the Fitzpatrick scale.

To evaluate quality of life (QoL), the rosacea QoL scale was used. Illness perception was measured using the Revised Illness Perception Questionnaire (IPQ-R), which includes dimensions such as timeline, consequences, personal control, and emotional impact. The IPQ-R also explored causal attributions like psychological factors, risk factors, immunity, and chance.

Sun protection behaviors (SPBs) were assessed using the Sun Protection Behavior Scale (SPBS) and the Sun Protection Decision Balance Scale (SPDBS). The SPBS evaluated the frequency of protective actions, while the SPDBS assessed motivational factors for sun protection.

Results

In the study, 88.3% of the 120 patients with rosacea were women, with an average age of 45.96 years. The most common rosacea type was erythematotelangiectatic (58.3%), followed by papulopustular (33.3%), and phymatous (8.3%). Researchers stated clinical severity varied: 51.7% had mild, 38.3% moderate, and 10% high severity.

Regarding sun protection, researchers found that 87.5% of patients sought shade, 54.1% frequently used sunscreen, and 16.6% used protective hats. They stated that most patients (85%) believed sun exposure caused their rosacea.

Analysis showed a positive correlation between QoL and sun protection behaviors, such as using sunscreen and avoiding sun exposure. Researchers noted higher clinical severity was linked to worse QoL scores, whereas a better understanding of the illness was associated with lower QoL scores. They also found effective sun protection was linked to better QoL.

The study's regression analysis identified that beliefs about illness control, attributing the disease to risk factors, immunity, or chance, and higher QoL scores were predictors of sun protection behaviors. Specifically, researchers stated understanding illness and controlling it through treatment were significant predictors of sun protection practices.

Conclusion

The study reveals that patients with rosacea’s perceptions of their illness and beliefs about its causes significantly influence their QoL and adherence to SPBs. Despite no notable differences in sociodemographic factors between patients with rosacea and controls, those with rosacea, who often have fairer skin, showed higher sun protection measures. UV exposure's role in rosacea was evident, with patients who attributed their condition to sun exposure engaging more in SPBs. On the other hand, beliefs attributing the disease to immunity or chance were linked to lower SPB adherence.

Overall, Researchers stated that improving patient understanding of rosacea and providing psychological support could enhance QoL and adherence to sun protection. They wrote that this study further highlights the need for comprehensive management involving both dermatological and psychological support for patients with rosacea.

References

1. Yang TT, Lan CE. Impacts of skin disorders associated with facial discoloration on quality of life: Novel insights explaining discordance between life quality scores and willingness to pay. J Cosmet Dermatol. 2022;21(7):3053-3058. doi:10.1111/jocd.14546
2. Yang F, Zhang Q, Song D, et al. A cross-sectional study on the relationship between rosacea severity and quality of life or psychological state. Clin Cosmet Investig Dermatol.2022;15:2807-2816. 2022. doi:10.2147/CCID.S390921
3. Morgado-Carrasco D, Granger C, Trullas C, et al. Impact of ultraviolet radiation and exposome on rosacea: Key role of photoprotection in optimizing treatment. J Cosmet Dermatol. 2021;20(11):3415-3421. doi:10.1111/jocd.14020
4. Akin G, Akarsu S, Avcı C. How does illness perception affect the quality of life and sun protection behaviors of rosacea patients?. Photodermatol Photoimmunol Photomed. 2024;40(5):e12998. doi:10.1111/phpp.12998