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Effects of skin care habits on the development of rosacea: A multi-center retrospective case-control survey in Chinese population.

PLoS One. 2020;15(4):e0231078

Authors: Huang YX, Li J, Zhao ZX, Zheng BL, Deng YX, Shi W, Steinhoff M, Xie HF

Abstract
BACKGROUND: Certain cosmetic habits may trigger or aggravate rosacea, while there is little published epidemiologic evidence to support this point.
PURPOSE: To examine if daily skin care habits have an effect on the development of rosacea in Chinese population.
METHODS: A multi-center retrospective case-control survey of 1,245 rosacea cases and 1,538 skin-healthy controls was conducted in China. Participants completed the questionnaire comprised of demographic characteristics, socioeconomic data and daily skin care habits. Data were collected retrospectively and analyzed using the chi-square test and t-test. Multivariate logistic regression analyses were used to predict rosacea.
RESULTS: The multivariate logistic regression analysis highlighted some results: Dry, oily or mixed skin (OR = 6.3-6.9, P< .001), the usage of foaming cleanser (OR = 1.45, 95%CI 1.115-1.886, P = .01), make up more than 6 times a week (OR = 2.839, 95%CI 1.962-4.108, P< .001), using facial mask more than 4 times a week (OR = 2.56-3.069, P< .001), facial treatments at beauty salon more than once a week (OR = 4.946, 95%CI 2.005-12.198, P = .0018) and using beauty salon products (OR = 2.334, 95%CI 1.435-3.976, P = .0018) are positively correlated with the development of rosacea. Using of moisturizing products (OR = 0.602, 95%CI 0.386-0.983, P = .035) and sunscreen cream (OR = 0.303-0.507, P< .001 or P = .0167 for different frequency) presented significantly negative correlations with rosacea. Frequency of cleansing showed a nonlinear association with rosacea: using facial cleansers 1~3 times per week (OR = 0.647, 95%CI 0.429-0.975, P  =  .038) showed beneficial effects while using facial cleanser excessively (twice or more daily) (OR = 2.131, 95%CI 1.394-3.256, P< .001) positively correlated to rosacea strongly.
CONCLUSIONS: Excessive use of facial cleanser (twice or more a day) and facial mask (more than 4 times a week), frequent makeup (more than 6 times a week), regular skin care in beauty salon (more than once a week), and using beauty salon products were closely correlated to the development of rosacea in Chinese population.

PMID: 32339170 [PubMed - as supplied by publisher]

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"In addition, excessive cleansing can lead to disruption of the epidermal barrier, increased transepidermal water loss (TEWL), roughened and irritated skin, increased bacterial colonization, increased comedonal formation, secondary irritant contact dermatitis, and burning and stinging. These negative effects caused by harsh soaps and aggressive cleansing make many prescription topical AV medications less tolerable."

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