Experiences of rosacea and its treatment: an interpretative phenomenological analysis

Abstract

SummaryBackground While rosacea is a chronic skin condition, it can often have a large psychosocial impact on the individual. There is therefore a need to understand the experience of living with rosacea from the patient perspective. Objectives To examine the experience of living with rosacea and the experience of seeking and receiving treatment. Methods Nine participants took part in semistructured interviews, which were analysed using interpretative phenomenological analysis. Results Three superordinate themes were identified within the data: 'self-consciousness', which focused on the fear of others assigning blame to participants for having caused symptoms; 'avoidance, concealment and hiding emotions', referring to the coping strategies participants employed in response to rosacea; and 'inconsistencies in general practitioner treatment and guidance', which focused on the need for medical professionals to assess the psychosocial wellbeing of patients with rosacea. Conclusions Rosacea can have a negative impact on the daily life of people with the condition, contributing to lowered self-esteem, embarrassment and feelings of shame. Engaging in emotion-focused and behavioural/avoidant-focused coping strategies increased participants' confidence and reduced their avoidance of social situations. However, such strategies might still serve to maintain underlying unhelpful cognitive processes. Consequently, it is important for medical professionals to assess for the presence of cognitive factors that might contribute to maintaining distress in patients with rosacea, and where unhelpful thoughts or beliefs are reported, patients may need to be referred for psychological support.

Psychosocial Impact of Rosacea on Women

“…Furthermore, Kent noted in a study that cosmetic camouflage worked in boosting confidence, but did not play any role in changing the underlying negative cognitive processes or beliefs [15]. Thompson, et al also noted in a 2017 qualitative study that patients were unable to interact confidently in social situations without any cosmetic camouflage, as it played a huge role in boosting self-esteem [16]. This is in line with the findings of the current study in which use of cosmetic camouflage did not help eliminate the negative feelings such as embarrassment and frustration.…”

A qualitative examination of the experience of skin camouflage by people living with visible skin conditions

“…[3][4][5] Nevertheless, some studies indicate that there may be some downsides to the use of camouflage. 6 There are no in-depth studies of camouflage use, thus we conducted a qualitative study aimed to develop an understanding of the psychological processes associated with camouflage use, and the perceived benefits and drawbacks. We used the qualitative method of interpretative phenomenological analysis (IPA), 7 as we wanted to gain accounts of individual experience, and this method has been used to provide insights into experiences of patients with a range of skin conditions.…”

“…We used the qualitative method of interpretative phenomenological analysis (IPA), 7 as we wanted to gain accounts of individual experience, and this method has been used to provide insights into experiences of patients with a range of skin conditions. 2,6 Participants were recruited through U.K. National Health Service (NHS) and charity camouflage clinics following review by an NHS ethics committee. Children (< 16 years), those newly using camouflage (< 2 months of experience) and people with self-harm scars were deemed not eligible to participate, as we wished to gain accounts of adults who were regularly using camouflage.…”

“…The first two themes (society's ideals and being visibly different; the views of others) mirror findings of previous studies that demonstrate that there can be a significant social impact associated with living with a skin condition. [1][2][3][4][5][6] However, our later themes (appearance, camouflage and the self; camouflage and other people) uniquely capture the experience of camouflage use. As the psychological effects of visible skin conditions are well documented in the extant research, we will focus the remaining letter on participants' experiences of camouflage use (themes 3 and 4).…”

Subtyping, phenotyping or endotyping rosacea: how can we improve disease understanding and patient care?

“…Rosacea ranges from very mild cases, which are not recognized by most individuals or their families, to severe cases with visible facial skin changes that can result in low-self esteem and depression. 2,3 In 2002, the National Rosacea Society expert panel established diagnostic criteria for rosacea and proposed four subtypes that are now well established among dermatologists and have been used in multiple studies. These include (i) erythematotelangiectatic, (ii) papulopustular, (iii) phymatous and (iv) ocular rosacea.…”