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Rethinking rosacea in people with skin of colour

Rosacea may appear more often in people with skin of colour than previously suspected and may be underdiagnosed or misdiagnosed, according to a researcher for the Acne and Rosacea Society of Canada.

“Emerging research is showing rosacea is more common in those of various ethnicities and darker skin phototypes than previously thought,” said Dr. Jerry Tan, medical director of Healthy Image Centre for Cosmetic Dermatolog in Windsor, Ont., and an adjunct professor at Western University, Windsor campus, in a press release.

Canadian Egyptian actress, Christine Solomon, has joined the society’s 2018 Rosacea Awareness Campaign during Rosacea Awareness Month to bring attention to the issue of rosacea in people of colour and share her experiences with the condition.

Dr. Tan, Canadian co-author of Rosacea comorbidities and future research (Acad Dermatol Jan. 2018; 78:167–170), a study discussing the issue of research into rosacea in people of colour, explained that diagnosing rosacea in those with darker skin types can be challenging.

“One of the classical hallmarks of rosacea is background facial redness,” said Dr. Tan. “This feature, however, is particularly hard to evaluate in the context of dark skin. Because of that, it is likely that rosacea has been underdiagnosed and understudied in populations with darker skin.

“Rosacea symptoms in people of colour may well be the same, but the sign of redness is often not prominent,” he added. “In darker skin types, the facial redness of rosacea can look like a dusky brown or purple discolouration.

“An alternative means of detection would be to ask about the sensations of rosacea, such as skin burning, stinging, frequent flushing, as well as bumps and pimples.”

On the emerging issue of rosacea in people in colour, Dr. Tan adds a final insight: “There is a possibility that rosacea is a global skin condition that affects people all over the world of different ethnicities and skin types. More research is needed as well as a clear means of diagnosis for patients of various ethnicities and phototypes when facial redness is not completely apparent.”

Drs. Tan and Andrew Alexis, chair of the Department of Dermatology at Mount Sinai St. Luke’s and Mount Sinai West in New York City and director of the Skin of Color Center, will present on acne and rosacea in patients with pigmented skin during the 4th annual Skin Spectrum Summit in Montreal on May 12 and in Vancouver on June 2. Find out more about the one-day educational Canadian conference of ethnodermatology at

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