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

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.