Are they isolated events or a trend? Extraordinary heat waves – extremes in high temperature and humidity – may be the norm rather than the exception this year as weather maps display the bright orange that signals the arrival of yet another round of very hot weather. For rosacea patients especially, these are reminders to take cover from the effects of the sun. Fortunately, in a recent National Rosacea Society (NRS) survey, patients said they frequently used sun protection and are vigilant about protecting their skin.

Although rosacea may often run in the family, the mechanism of this is poorly understood, with specific information often incomplete and limited to relatives from only a few generations, according to researchers in a recent study in Italy published in the Journal of Clinical and Aesthetic Dermatology. In a search through six generations, they uncovered cases that went unrecognized, and suggested that having a family member with rosacea may be an opportunity for many to avoid rosacea’s worst effects by seeking early diagnosis and management, if needed.

Tackling rosacea flare-ups — as well as a time when redness may be helpful — were discussed at the recent American Academy of Dermatology annual meeting in Boston.

Dr. Hilary Baldwin, associate professor of dermatology at Rutgers Robert Wood Johnson Medical School, presented on the phenomenon of “mask rosacea” during the pandemic. She noted that face masks may aggravate rosacea in several ways, including increasing temperature, humidity and sebum production; disrupting skin barrier function; and causing changes in the skin microbiome.

Ocular rosacea signs and symptoms may include itching, burning and stinging; inflamed eyelids and styes; red or bloodshot eyes; a gritty feeling; and visible blood vessels on the eyelids or whites of the eyes. The meibomian glands, which secrete an oil that helps tears keep the eye moistened, may become clogged, causing tears to break down faster and leading to dry eye. As the condition worsens the cornea may become damaged, leading to loss of visual acuity.

A recent NRS survey found that most respondents experience many of the eye signs and symptoms of ocular rosacea. In the survey of 609 rosacea patients, 73% had signs and symptoms of ocular rosacea, including 76% with dry eyes, 64% with a gritty foreign-body sensation or itching, and about half with light sensitivity, burning, or stinging. Forty-six percent reported red or bloodshot eyes, 41% said they had visible blood vessels in their eyes and 43% had watery eyes.

For Natalie Flores, persistence paid off. Like many individuals with rosacea, she discounted the occasional redness that began occurring when she turned 30 years old.

“Just after 30, I noticed I would get that flushed redness, but it was pretty mild. I’m part Irish, and many people in my family had it,” Natalie said. “When I was closer to 34-35, my face started getting redder. It felt like sunburn, but it wasn’t. Then I got bumps and pimples.”