If you’re a fan of Top Chef (Bravo TV), then you may have noticed that many chefs on the show have red faces. Not just this particular season, but I have seen it in many previous seasons. Of course, when you’re a chef, you’re working in a hot environment and usually under constant pressure. These working conditions are naturally conducive to developing rosacea (However, while hot environments naturally cause facial flushing, facial redness alone does not always mean “rosacea”). During my career as a research scientist, I have seen many colleagues with facial redness. As is the case for many job types, working in science has become more stressful every year, with more competition for funding and tighter deadlines.
I was just wondering, is rosacea more prevalent in certain professions (e.g. linked to a certain personality type) or is rosacea just a condition related to stress?
In the past, it was thought that rosacea was part of a certain type of personality, a personality that was thought to have differences in self confidence, emotions, affect, levels of anxiety, self-criticism and self-aggression compared to people without rosacea. However, a study by Karlsson et al. disputed this claim, by showing that rosacea can affect anyone, regardless of personality and that rosacea patients react very similarly to other people in regards to aggression toward self or others, irritability, guilt and detachment.
Most people with rosacea know that chronic stress and certain foods can make rosacea symptoms worse. It wasn’t until 2007 that the pathological mechanism of rosacea was described. A study by Yamasaki et al. found that certain antimicrobial peptides were elevated in rosacea skin and that these antimicrobial peptides were processed differently in rosacea skin leading to a chronic inflammation condition. Of course, stress, high levels of anxiety and histamine, can all further stimulate this proposed pathological pathway. (More details of this pathway in a future post).
So now we know that rosacea has a clearly defined pathological pathway, in which immune system, genetics and stress (chronically activated HPA axis) all play a part in its development. Although we may appear differently than our non-rosacea friends, our appearance has nothing to do with personality. Since the rosacea inflammatory pathway is known, one question remains: can rosacea be cured or does the pathway allow for the development of more effective treatments?
Karlsson, E., Berg, M. and Arnetz, B.B. (2004) Rosacea and personality. Acta Derm Venereol.84: 76-7.
Yamasaki, K. et al. (2007) Increased serine protease activity and cathelicidin promotes skin inflammation in rosacea. Nat Med13: 975-80.