Psychological disorders associated with rosacea: Analysis of unscripted comments

Background: Conditions affecting the face are particularly prone to causing psychological comorbidity; patients may be reluctant to inform their physician about their psychological distress. Unscripted comments could provide novel insight regarding the psychological impact of rosacea. Aim: To assess psychologically distressing aspects of rosacea reported in an informal medical setting. Methods: Random sample of 10% of 27,051 posts analyzed, 446 comments addressed psychological effects of rosacea. Comments analyzed for symptoms of depression, anxiety, low confidence/self-esteem, and aspects of rosacea which cause distress, including symptoms, lifestyle change and difficulty with treatments. Brand names were changed to generic equivalent. Results: Symptoms of depression (n = 44) and the desire to end life (n = 6) were mentioned, but no comments expounded on any suicide plan. Anxiousness (n = 7) and negative impact on confidence/self-esteem (n = 5) were mentioned. Symptoms, or clinical manifestations (n = 29), were the most frequently mentioned distress factor, followed by lifestyle change (n = 20). Patients also voiced difficulty with treatments (n = 15). Limitations: Online forums may provide patient perceptions that patients would not share with a doctor, but the sample may not be representative of all rosacea patients. Conclusions: Inquiring about psychological impact of rosacea might be helpful in identifying patients who would benefit from supportive psychological measures.