Rosacea and RA

I’ve been fighting an annoying rosacea flare since November last year. It’s sort of fun (and sardonic) to blame it on the outcome of the presidential election, but I doubt that’s what actually triggered it. I’ve had the skin disease for decades now and it tends to come and go without warning.

Increased inflammation in my body is what causes my rosacea to flare, making my face look like a summer strawberry year-round. My autoimmune disease rheumatoid arthritis causes that systemic inflammation. And that brings up my next leap of logic: might rosacea and rheumatoid arthritis be related?

What is rosacea?

A quick primer: rosacea (roe-zay-sha) is an incurable skin disease that causes facial redness, flushing, skin thickening, and sometimes itchy, stinging, or burning pimples/pustules. Many people with skin rosacea also get ocular rosacea, which affects the eyes. It makes them red, watery, dry, itchy, and burn-y. Left untreated, it can cause permanent damage to the corneas and vision.1

Rosacea is common, especially in fair-skinned folks of northern European ancestry (though it can affect anyone of any race or skin type). It usually shows up between the ages of 30 and 50, and affects both genders, though women get it more often than men. It may run in families and pass from generation to generation. The mid-20th century comedian W. C. Fields was famous for his acerbic humor and bulbous, red nose, attributed to his love for strong drink. But Fields had severe rosacea that reddened and thickened the skin on his nose.2

Rosacea and autoimmune conditions

Research shows rosacea is associated with several autoimmune diseases, including multiple sclerosis, Type 1 diabetes, and, yes, rheumatoid arthritis. It’s also associated with celiac disease, Parkinson’s, Alzheimer’s, and a certain type of brain cancer.3

Rosacea and RA flare-ups

My rosacea is mild, mainly causing my skin to look ruddy — so much so that, when I don’t wear makeup, people ask me if I have a sunburn, their voices full of concern. When the disease flares up like it is right now, it adds a rude, bumpy sprinkle of pimples across my bright red cheeks and chin, an unlovely reminder of the adolescent acne of my teenaged years. Oh, joy.

Along with redness and blemishes, it causes skin thickening and even scarring (think W.C. Fields). Having an unconcealable facial disease may cause a lot of mental anguish. Some people report missed work and social isolation because of their rosacea flares.

How is rosacea controlled?

Fortunately, rosacea is usually treatable and controllable with prescription medication. I use a light cream prescribed by my doctor that works well to bring it back under control. (I’m applying it religiously to my freshly washed skin each morning and evening.) Some people take oral medications, such as minocycline, for it as well.

Could rosacea treatment cure rheumatoid arthritis?

Some researchers and doctors are looking at the possibility of rosacea being a sign of imminent or early autoimmune disease, as well. Such thinking may prompt doctors to ask patients with rosacea about possible autoimmune disease symptoms, like numbness in hands or feet, or joint pain.

Scientists are busy researching the links between rosacea, genetics, and the immune system. The hope is that one day, they’ll have better treatments for it or even a cure. And since so many diseases seem to share those genetic and other causal links, perhaps this research will trigger cures for other diseases—like MS, diabetes mellitus, and even rheumatoid arthritis.

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