title: Is the effect of smoking on rosacea still somewhat of a mystery?
abstract: BACKGROUND
  Rosacea is an inflammatory skin disease with a chronic course. In the past, the association between rosacea and smoking was examined only in a few studies.
  
  
  OBJECTIVE
  The objective of this study is to investigate the prevalence and the influence of smoking in rosacea patients.
  
  
  METHODS
  This prospective cross-sectional study includes 200 rosacea patients and 200 age- and gender-matched rosacea-free controls. Using National Rosacea Society Expert Committee classification, we divided patients into three subgroups as having erythematotelangiectatic (ETR), papulopustular (PPR), and phymatous rosacea (PhR). Demographic data, risk factors, and smoking habits were recorded.
  
  
  RESULTS
  In multivariate analysis, the prevalence of smoking was significantly higher (66%) among patients compared with controls. ETR subtype (43.5%) was found to be significantly higher among active smokers (p < 0.001). Considering the risk factors, caffeine intake and alcohol consumption could not be evaluated because of their never or rarely intake. Whereas rates of photosensitive skin type and positive family history were significantly prominent in ETR patients (p < 0.001). While PhR was mostly detected in men who are very old, a significant tendency was found to develop ETR in women.
  
  
  CONCLUSIONS
  While a significantly increased risk of developing rosacea among smokers was observed in this study, ETR seems to be the disease of active smokers. Further studies are required for better understanding of the association between rosacea and smoking.
authors.affiliation: a Department of Dermatology , Sisli Hamidiye Etfal Training and Research Hospital , Istanbul , Turkey.
authors.forename: Asli
authors.initials: A
authors.lastname: Kucukunal
authors.affiliation: a Department of Dermatology , Sisli Hamidiye Etfal Training and Research Hospital , Istanbul , Turkey.
authors.forename: Ilknur
authors.initials: I
authors.lastname: Altunay
authors.affiliation: a Department of Dermatology , Sisli Hamidiye Etfal Training and Research Hospital , Istanbul , Turkey.
authors.forename: Janset Erkul
authors.initials: JE
authors.lastname: Arici
authors.affiliation: a Department of Dermatology , Sisli Hamidiye Etfal Training and Research Hospital , Istanbul , Turkey.
authors.forename: Asli Aksu
authors.initials: AA
authors.lastname: Cerman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012393:Rosacea / Q000453:epidemiology*; D012907:Smoking / Q000453:epidemiology*; D055815:Young Adult
keywords: Erythematotelangiectatic; papulopustular; phymatous; risk factors; rosacea; smoking