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Do more women or men have rosacea?


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More Women than Men Have Rosacea?
In a significant number of medical papers on rosacea, the general consensus has been that more women have rosacea than men, particularly in certain variants of rosacea. Typical examples of medical authorities who report that more women than men have rosacea are shown below. We also have investigated and report what clinical papers mention which sex has what issue (rosacea variant or phenotype) more than the other. 

Mayo Clinic
"Rosacea can occur in anyone. But it most commonly affects middle-aged women who have fair skin." Under Risk Factors, the Mayo Clinic says, "you may be more likely to develop it if you are a woman."

National Institute of Arthritis and Musculoskeletal and Skin Diseases
Under the tab, Who gets rosacea?  "Women, especially during menopause."

American Osteopathic College of Dermatology
"Rosacea is most common in white women between the ages of 30 and 60."

National Institute of Health, Genetics Home Reference
"For reasons that are unclear, women appear to be affected more often than men."

New England Journal of Medicine
"Women are more commonly affected than men, and rosacea has been shown to be particularly common among fair-skinned people of Celtic origin." [4]

Medline Plus
"Rosacea is most common in women and people with fair skin."

John Hopkins Medicine
"It is more common in fair-skinned people and women in menopause."  UCLA also says, "is more common in fair-skinned people and women in menopause."

Anal brasileiros de dermotolgia 
"Individuals who were diagnosed with an anxiety and/or depressive disorder were more common in patient group (24.7% vs. 7.2%, p<0,01). Female patients were particularly at risk for having generalized anxiety disorder (OR=2.8; 95% CI 1.15-7.37; p=0.02)."

Journal of Cosmetic Dermatology
A poll in China of 253 "outpatients with rosacea who visited the dermatology department of the first affiliated hospital of Kunming Medical University" in China concluded "Rosacea mainly affects young females."

What Phenotype or Variant of Rosacea?
It depends on which phenotype or variant of rosacea being discussed whether more women or more men have rosacea. We will use this post to collect papers on this subject as well as pertinent subjects related to gender and rosacea. If you find any papers on this subject, please reply to this post what you have found. 

"Alcohol intake was significantly associated with an increased risk of rosacea in women." [6]

Celiac Disease
"In addition, a case–control study demonstrated that patients with rosacea had a twofold odds for prevalent CeD compared with age, sex, and calendar time-matched controls (OR 2.03, 95% CI 1.35–3.07), and stratification by gender revealed a significant association of rosacea with CeD in women, but not in men."

Glandular Rosacea 
Glandular rosacea, a variant of rosacea, occurs predominantly in males.

Phenotype 4
"Firstly, the papulo-pustular stage mainly occurs in males in whom rosacea is a more serious disease at all stages. The papulo-pustular stage is actually uncommon in females.” [2]

Phenotype 5
Phenotype 5 occurs much more often in men than in women (approximate ratio, 20:1). [3]

Rosacea Fulminans (Pyoderma Faciale or Rosacea conglobata)
This rosacea variant is possibly the most extreme form of Rosacea and usually only occurs in women.

Rosacea Lymphedema (Morbihan Disease)
Also known as Morbihan syndrome, "a rare entity that more commonly affects women in the third or fourth decade of life."

Rosacea Perioral Dermatitis 
Rosacea Perioral Dermatitis [RPD], a rosacea variant, usually effects young females and results from topical steroid use. Overuse of heavy face creams and moisturizers are another common factor. 

Severity Scores Reveal More Men than Women Have Rosacea
One report concluded, "Self-assessment severity scores were significantly higher in men (3.6 ± 1.3) than women (3.2 ± 1.0; P = .04).The authors conclude that rosacea is more severe in men and younger patients." [1]

Sexual Dysfunction
"Sexual dysfunction in female rosacea patients was demonstrated in this study." [5]

End Notes

[1] Dermatol Clin. 2018 Apr;36(2):97-102. doi: 10.1016/j.det.2017.11.004. Epub 2017 Dec 16.
Measurement of Disease Severity in a Population of Rosacea Patients.
Alinia H, Tuchayi SM, James SM, Cardwell LA, Nanda S, Bahrami N, Awosika O, Richardson I, Huang KE, Feldman SR.

[2] A Personal Critique on the State of Knowledge of Rosacea Albert M. Kligman , M.D., Ph.D.
Department of Dermatology, University of Pennsylvania, Philadelphia, PA, U.S.A.
The William J. Cunliffe Lectureship 2003—Manuscript

[3] Phymatous Explained 

[4] N Engl J Med 2017; 377:1754-1764
DOI: 10.1056/NEJMcp1506630
November 2, 2017, Esther J. van Zuuren, M.D.

[5] Int J Impot Res. 2020 Apr 14;:
Evaluation of sexual functions in female rosacea patients: a prospective, case-control study.
Aktaş Karabay E, Karşıyakalı N, Karabay E

[6] Alcohol intake and risk of rosacea in US women.

[7] Adv Ther. 2021 Jan 28;:
Rosacea, Germs, and Bowels: A Review on Gastrointestinal Comorbidities and Gut-Skin Axis of Rosacea.
Wang FY, Chi CC

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