10 Facts About Rosacea

iStock
iStock

Rosacea, a skin condition characterized by redness and swelling, is incredibly common: A recent study found that an estimated 300 million people worldwide suffer from it. Here’s what you need to know about the condition.

1. IT HAS A LONG HISTORY.

According to the National Rosacea Society (NRS), rosacea was first described in the 14th century by a French surgeon named Dr. Guy de Chauliac; he called it goutterose (“pink drop” in French) or couperose and noted that it was characterized by “red lesions in the face, particularly on the nose and cheeks.”

2. SCIENTISTS AREN’T SURE WHAT CAUSES IT ...

But they have some theories. According to the NRS, “most experts believe it is a vascular disorder that seems to be related to flushing.” Scientists also think that because rosacea seems to run in families, it might be genetic. Other things—like mites that live on the skin, an intestinal bug called H pylori (common in those who have rosacea), and a reaction to a bacterium called bacillus oleronius—could also play a role in causing the condition. One 2015 study suggested an increased risk among smokers.

3. … BUT SOME PEOPLE ARE MORE LIKELY TO HAVE IT THAN OTHERS.

Though people of all ages and skin tones can get rosacea, fair skinned people between the ages of 30 and 50 with Celtic and Scandinavian ancestry and a family history of rosacea are more likely to develop the condition. Women are more likely to have rosacea than men, though their symptoms tend to be less severe than men’s. But men are more likely to suffer from a rare rosacea side effect known as rhinophyma, which causes the skin of the nose to thicken and become bulbous. It’s commonly—and mistakenly—associated with heavy drinking, but what exactly causes rhinophyma is unclear. According to the NRS, “The swelling that often follows a flushing reaction may, over time, lead to the growth of excess tissue (fibroplasia) around the nose as plasma proteins accumulate when the damaged lymphatic system fails to clear them. Leakage of a substance called blood coagulation factor XIII is also believed to be a potential cause of excess tissue.” Thankfully, those who have rhinophyma have options available for treatment, including surgery and laser therapy.

4. THERE ARE FOUR SUBTYPES.

According to the American Academy of Dermatology (AAD), rosacea “often begins with a tendency to blush or flush more easily than other people.” All rosacea involves redness of some kind (typically on the nose, cheeks, chin, and forehead), but other symptoms allow the condition to be divided into four subtypes: Erythematotelangiectatic rosacea is characterized by persistent redness and sometimes visible blood vessels; Papulopustular rosacea involves swelling and “acne-like breakouts”; Phymatous rosacea is characterized by thick and bumpy skin; and Ocular rosacea involves red eyes (that sometimes burn and itch, or feel like they have sand in them [PDF]), swollen eyelids, and stye-like growths.

5. IT’S NOT THE SAME AS ACNE.

Though rosacea was once considered a form of acne—"acne rosacea" first appeared in medical literature in 1814—today doctors know it’s a different condition altogether. Though there are similarities (like acne, some forms of rosacea are characterized by small, pus-filled bumps) there are key differences: Acne involves blackheads, typically occurs in the teen years, and can appear all over the body; rosacea is a chronic condition that occurs mainly on the face and the chest and typically shows up later in life.

6. YOU CAN FIND IT IN CLASSIC ART AND LITERATURE.

Both Chaucer and Shakespeare likely made references to rosacea. Domenico Ghirlandaio’s 1490 painting An Old Man and His Grandson seems to depict rhinophyma, and some believe that Rembrandt’s 1659 self-portrait shows that the artist had rosacea and rhinophyma.

7. IT MAY BE TRIGGERED BY CERTAIN FOODS AND ACTIVITIES.

According to the National Institutes of Health (NIH) [PDF], people report that everything from the weather to what you eat can cause rosacea to flare up: Heat, cold, sunlight, and wind, strenuous exercise, spicy food, alcohol consumption, menopause, stress, and use of steroids on the skin are all triggers.

8. THERE ARE A NUMBER OF MYTHS ABOUT ROSACEA.

No, it’s not caused by caffeine and coffee (flare ups, if they occur, are due to the heat of your coffee) or by heavy drinking (though alcohol does exacerbate the condition). Rosacea isn’t caused by poor hygiene, and it’s not contagious.

9. THERE ARE SOME PRETTY FAMOUS PEOPLE WITH ROSACEA.

Sophia Bush, Cynthia Nixon, Kristin Chenoweth, Bill Clinton, and Sam Smith all have rosacea. Diana, Princess of Wales had it, too. W.C. Fields had rosacea and rhinophyma, and Andy Warhol may also have suffered from those conditions.

10. IT CAN’T BE CURED—BUT IT CAN BE TREATED.

The NRS reports that “nearly 90 percent of rosacea patients [surveyed by NRS] said this condition had lowered their self-confidence and self-esteem, and 41 percent reported it had caused them to avoid public contact or cancel social engagements.” Dr. Uwe Gieler, a professor of dermatology at the Justus-Liebig-University in Giessen, Germany, and one of the authors of the report Rosacea: Beyond the Visible, said in a press release that "People with rosacea are often judged on their appearance, which impacts them greatly in daily life. If their rosacea is severe, the symptoms are likely to be more significant also, from itching and burning to a permanently red central facial area. However, even people with less severe rosacea report a significant impact on quality of life."

Which makes it all the more unfortunate that there’s not a cure for the condition. Thankfully, though, there are treatments available.

There are no tests that will diagnose rosacea; that’s up to your doctor, who will examine your medical history and go over your symptoms. Doctors advise that those with rosacea pay attention to what triggers flare-ups, which will help them figure out how to treat the condition. Antibiotics might be prescribed; laser therapy might be used. Anyone with rosacea should always wear sunscreen [PDF] and treat their skin very, very gently—don't scrub or exfoliate it. The AAD recommends moisturizing daily and avoiding products that contain things like urea, alcohol, and glycolic and lactic acids.

8 Enlightening Facts About Dr. Ruth Westheimer

Rachel Murray, Getty Images for Hulu
Rachel Murray, Getty Images for Hulu

For decades, sex therapist Dr. Ruth Westheimer has used television, radio, the written word, and the internet to speak frankly on topics relating to human sexuality, turning what were once controversial topics into healthy, everyday conversations.

At age 90, Westheimer shows no signs of slowing down. As a new documentary, Ask Dr. Ruth, gears up for release on Hulu this spring, we thought we’d take a look at Westheimer’s colorful history as an advisor, author, and resistance sniper.

1. The Nazis devastated her childhood.

Dr. Ruth was born Karola Ruth Siegel on June 4, 1928 in Wiesenfeld, Germany, the only child of Julius and Irma Siegel. When Ruth was just five years old, the advancing Nazi party terrorized her neighborhood and seized her father in 1938, presumably to shuttle him to a concentration camp. One year later, Karola—who eventually began using her middle name and took on the last name Westheimer with her second marriage in 1961—was sent to a school in Switzerland for her own protection. She later learned that her parents had both been killed during the Holocaust, possibly at Auschwitz.

2. She shocked classmates with her knowledge of taboo topics.

Westheimer has never been bashful about the workings of human sexuality. While working as a maid at an all-girls school in Switzerland, she made classmates and teachers gasp with her frank talk about menstruation and other topics that were rarely spoken of in casual terms.

3. She trained as a sniper for Jewish resistance fighters in Palestine.

Following the end of World War II, Westheimer left Switzerland for Israel, and later Palestine. She became a Zionist and joined the Haganah, an underground network of Jewish resistance fighters. Westheimer carried a weapon and trained as both a scout and sniper, learning how to throw hand grenades and shoot firearms. Though she never saw direct action, the tension and skirmishes could lapse into violence, and in 1948, Westheimer suffered a serious injury to her foot owing to a bomb blast. The injury convinced her to move into the comparatively less dangerous field of academia.

4. A lecture ignited her career.

 Dr. Ruth Westheimer participates in the annual Charity Day hosted by Cantor Fitzgerald and BGC at Cantor Fitzgerald on September 11, 2015 in New York City.
Robin Marchant, Getty Images for Cantor Fitzgerald

In 1950, Westheimer married an Israeli soldier and the two relocated to Paris, where she studied psychology at the Sorbonne. Though the couple divorced in 1955, Westheimer's education continued into 1959, when she graduated with a master’s degree in sociology from the New School in New York City. (She received a doctorate in education from Columbia University in 1970.) After meeting and marrying Manfred Westheimer, a Jewish refugee, in 1961, Westheimer became an American citizen.

By the late 1960s, she was working at Planned Parenthood, where she excelled at having honest conversations about uncomfortable topics. Eventually, Westheimer found herself giving a lecture to New York-area broadcasters about airing programming with information about safe sex. Radio station WYNY offered her a show, Sexually Speaking, that soon blossomed into a hit, going from 15 minutes to two hours weekly. By 1983, 250,000 people were listening to Westheimer talk about contraception and intimacy.

5. People told her to lose her accent.

Westheimer’s distinctive accent has led some to declare her “Grandma Freud.” But early on, she was given advice to take speech lessons and make an effort to lose her accent. Westheimer declined, and considers herself fortunate to have done so. “It helped me greatly, because when people turned on the radio, they knew it was me,” she told the Harvard Business Review in 2016.

6. She’s not concerned about her height, either.

In addition to her voice, Westheimer became easily recognizable due to her diminutive stature. (She’s four feet, seven inches tall.) When she was younger, Westheimer worried her height might not be appealing. Later, she realized it was an asset. “On the contrary, I was lucky to be so small, because when I was studying at the Sorbonne, there was very little space in the auditoriums and I could always find a good-looking guy to put me up on a windowsill,” she told the HBR.

7. She advises people not to take huge penises seriously.

Westheimer doesn’t frown upon pornography; in 2018, she told the Times of Israel that viewers can “learn something from it.” But she does note the importance of separating fantasy from reality. “People have to use their own judgment in knowing that in any of the sexually explicit movies, the genitalia that is shown—how should I say this? No regular person is endowed like that.”

8. She lectures on cruise ships.

Westheimer uses every available medium—radio, television, the internet, and even graphic novels—to share her thoughts and advice about human sexuality. Sometimes, that means going out to sea. The therapist books cruise ship appearances where she offers presentations to guests on how best to manage their sex lives. Westheimer often insists the crew participate and will regularly request that the captain read some of the questions.

“The last time, the captain was British, very tall, and had to say ‘orgasm’ and ‘erection,’” she told The New York Times in 2018. “Never did they think they would hear the captain talk about the things we were talking about.” Of course, that’s long been Westheimer’s objective—to make the taboo seem tame.

10 Things You Should Know About Asthma

iStock.com/Wojciech Kozielczyk
iStock.com/Wojciech Kozielczyk

To anyone with asthma, the feeling of an attack is unmistakable. Patients have compared an asthma attack's feeling of breathlessness, caused by inflammation in the lungs and airways, to being smothered by a pillow or having an elephant sit on their chest. Medical experts have already figured out some aspects of asthma, like how to diagnose and treat it, but other components, like what causes asthma and how to cure it, remain unclear. From the triggers people encounter at work to the connection to allergies, here are some facts about asthma symptoms and treatments you should know.

1. Asthma attacks are related to allergies.

The physical process that occurs when someone has a sneezing fit during pollen season is similar to what happens during an asthma attack. But while the former causes discomfort, the latter produces potentially life-threatening symptoms. When people with allergies are exposed to an allergen like pollen, they produce antibodies that bind to that allergen. This signals the body to release the chemicals that cause allergic symptoms. In most people, the symptoms are limited to the head, such as a runny nose or watery eyes, but in people with asthma, they're felt in the lungs. If the lungs are inflamed, the airways that carry air swell up and fill with mucus, constricting airflow and causing common asthma symptoms like coughing, wheezing, and shortness of breath. Such asthma attacks can be fatal when patients can’t get enough air to their lungs.

2. Asthma is the most prevalent chronic disease among children.

Asthma is common, affecting 25 million in the U.S. alone, and of those patients, about 7 million are children. Most people with the disease develop it during childhood. Asthma is the most prevalent chronic illness among kids, and each year, students miss 13.8 million school days because of it.

3. Asthma may be inherited.

Doctors aren’t entirely sure what causes asthma, but they know it sometimes runs in families. A 2010 study found that people with one parent with the condition were nearly twice as likely to have it themselves, and people with a parent and a grandparent with asthma were four times more likely to develop it. Because asthma is connected to allergies, a genetic disposition toward allergies, known as atopy, may explain some inherited asthma cases.

4. Asthma is surprisingly easy to diagnose.

One of the simplest ways to diagnose asthma is through a lung function test. If a patient is reporting asthma symptoms (coughing, chest tightness, a feeling of not getting enough air), their doctor may check the strength of their exhalations before and after having them use an inhaler. If their breathing improves with the medicine, they likely have asthma. An X-ray of the patient’s chest can also be used to reach an asthma diagnosis.

5. Kids who grow up around germs are less likely to have asthma.

A person’s environment early in life may also play a role in whether or not they develop asthma. People who grew up in rural areas, around animals, and in large families are less likely to have asthma than those who did not. One possible explanation is the hygiene hypothesis: According to this theory, kids who were exposed to germs and pathogens while their immune systems were developing are better equipped to deal with allergens, while kids who were sheltered from germs may be more likely to have an exaggerated (and in the case of asthma, potentially deadly) immune response to harmless substances. The hygiene hypothesis hasn’t been proven, however, and it’s definitely not an excuse to expose children to infections in an attempt to strengthen them against asthma attacks in the future.

6. Asthma triggers are everywhere.

To manage their symptoms, doctors tell asthma patients to limit exposure to their triggers when possible. Common asthma triggers include irritants and allergens like dust, tobacco smoke, car exhaust, mold, pet dander, and smoke from burning wood. Triggers that don’t come from the environment, like colds, sinus infections, acid reflux, and hyperventilation brought on by stress, can be even harder to avoid.

7. There's one asthma trigger patients shouldn't avoid.

Physical activity causes fast breathing, which can provoke asthma attacks in some people with the condition. There’s even a type of asthma called exercise-induced bronchoconstriction that specifically describes people who suffer from these kinds of attacks. But the risks of living a sedentary lifestyle outweigh those of exercising carefully, even with asthma. Instead of cutting out cardio altogether, doctors work with patients to come up with an exercise plan that’s safe for them. This might include warming up and using an inhaler before working out, practicing cool-down activities afterward, and wearing scarves or masks to limit exposure to irritants that may also trigger asthma symptoms.

8. There are two types of asthma treatments.

Long-term controllers and quick-relievers are the two types of medications used to treat asthma. Immediate medicines like short-acting beta agonists and anticholinergics relax muscles in the airways when flare-ups occur, and they’re typically administered directly to the lungs with an inhaler. Long-term medications help keep asthma symptoms under control over time are taken as often as once a day, regardless of whether symptoms are present. They include inhaled long-acting beta agonists and corticosteroids, biologic injections, and theophylline and leukotriene modifier pills and liquids. All of these medications suppress asthma symptoms by either relaxing muscles, reducing swelling, or preventing inflammation in the airways.

9. Asthma can be an occupational hazard.

Occupational asthma develops when a patient’s triggers come from their work environment. According to the National Institutes of Health, wood dust, grain dust, animal dander, fungi, and various chemicals are some of the most common asthma triggers that patients encounter in the workplace. Bakers, farmers, laboratory workers, millers, and woodworkers predisposed to asthma are all at higher risk.

10. There's no cure for asthma, but symptoms can lessen over time.

Though asthma is treatable, there’s no cure for the chronic illness. Some people, however, do appear to grow out of the condition after suffering from it as kids. It’s possible for asthma symptoms to become less severe and go into remission as patients get older, but once someone is diagnosed with asthma, the risk of an episode never goes away completely. Changes in hormone levels are a factor that could possibly bring asthma symptoms back in patients who haven’t experienced an attack in years.

SECTIONS

arrow
LIVE SMARTER