Rosacea's First Appearance Survey

Please fill out the following survey to help determine the most common first signs of rosacea. Results will appear in the National Rosacea Society's newsletter, Rosacea Review, and in the Weblog of rosacea.org.

1. At what age did your rosacea first appear?

At what age did your rosacea first appear? Under 20

40-49

20-29

50-59

30-39

Over 60

2. What was the first sign or symptom of rosacea that you experienced?

What was the first sign or symptom of rosacea that you experienced? Flushing Pimples Eye irritation Swelling	Persistent redness Visible blood vessels Facial itching Raised red patches	Bumps Burning or stinging Dry appearance Thickening of nose
Other (please specify)

3. Which additional signs or symptoms developed later? Please indicate the order of appearance; more than one sign or symptom may appear at the same time.

	First	Second	Third	Fourth	Fifth	Sixth	Seventh	Eighth	Ninth	Tenth	Eleventh	Twelfth	Last
Flushing	*Which additional signs or symptoms developed later? Please indicate the order of appearance; more than one sign or symptom may appear at the same time. Flushing First	Flushing Second	Flushing Third	Flushing Fourth	Flushing Fifth	Flushing Sixth	Flushing Seventh	Flushing Eighth	Flushing Ninth	Flushing Tenth	Flushing Eleventh	Flushing Twelfth	Flushing Last
Persistent redness	Persistent redness First	Persistent redness Second	Persistent redness Third	Persistent redness Fourth	Persistent redness Fifth	Persistent redness Sixth	Persistent redness Seventh	Persistent redness Eighth	Persistent redness Ninth	Persistent redness Tenth	Persistent redness Eleventh	Persistent redness Twelfth	Persistent redness Last
Bumps	Bumps First	Bumps Second	Bumps Third	Bumps Fourth	Bumps Fifth	Bumps Sixth	Bumps Seventh	Bumps Eighth	Bumps Ninth	Bumps Tenth	Bumps Eleventh	Bumps Twelfth	Bumps Last
Pimples	Pimples First	Pimples Second	Pimples Third	Pimples Fourth	Pimples Fifth	Pimples Sixth	Pimples Seventh	Pimples Eighth	Pimples Ninth	Pimples Tenth	Pimples Eleventh	Pimples Twelfth	Pimples Last
Visible blood vessels	Visible blood vessels First	Visible blood vessels Second	Visible blood vessels Third	Visible blood vessels Fourth	Visible blood vessels Fifth	Visible blood vessels Sixth	Visible blood vessels Seventh	Visible blood vessels Eighth	Visible blood vessels Ninth	Visible blood vessels Tenth	Visible blood vessels Eleventh	Visible blood vessels Twelfth	Visible blood vessels Last
Burning or stinging	Burning or stinging First	Burning or stinging Second	Burning or stinging Third	Burning or stinging Fourth	Burning or stinging Fifth	Burning or stinging Sixth	Burning or stinging Seventh	Burning or stinging Eighth	Burning or stinging Ninth	Burning or stinging Tenth	Burning or stinging Eleventh	Burning or stinging Twelfth	Burning or stinging Last
Eye irritation	Eye irritation First	Eye irritation Second	Eye irritation Third	Eye irritation Fourth	Eye irritation Fifth	Eye irritation Sixth	Eye irritation Seventh	Eye irritation Eighth	Eye irritation Ninth	Eye irritation Tenth	Eye irritation Eleventh	Eye irritation Twelfth	Eye irritation Last
Facial itching	Facial itching First	Facial itching Second	Facial itching Third	Facial itching Fourth	Facial itching Fifth	Facial itching Sixth	Facial itching Seventh	Facial itching Eighth	Facial itching Ninth	Facial itching Tenth	Facial itching Eleventh	Facial itching Twelfth	Facial itching Last
Dry appearance	Dry appearance First	Dry appearance Second	Dry appearance Third	Dry appearance Fourth	Dry appearance Fifth	Dry appearance Sixth	Dry appearance Seventh	Dry appearance Eighth	Dry appearance Ninth	Dry appearance Tenth	Dry appearance Eleventh	Dry appearance Twelfth	Dry appearance Last
Swelling	Swelling First	Swelling Second	Swelling Third	Swelling Fourth	Swelling Fifth	Swelling Sixth	Swelling Seventh	Swelling Eighth	Swelling Ninth	Swelling Tenth	Swelling Eleventh	Swelling Twelfth	Swelling Last
Raised red patches	Raised red patches First	Raised red patches Second	Raised red patches Third	Raised red patches Fourth	Raised red patches Fifth	Raised red patches Sixth	Raised red patches Seventh	Raised red patches Eighth	Raised red patches Ninth	Raised red patches Tenth	Raised red patches Eleventh	Raised red patches Twelfth	Raised red patches Last
Thickening of nose	Thickening of nose First	Thickening of nose Second	Thickening of nose Third	Thickening of nose Fourth	Thickening of nose Fifth	Thickening of nose Sixth	Thickening of nose Seventh	Thickening of nose Eighth	Thickening of nose Ninth	Thickening of nose Tenth	Thickening of nose Eleventh	Thickening of nose Twelfth	Thickening of nose Last
Other	Other First	Other Second	Other Third	Other Fourth	Other Fifth	Other Sixth	Other Seventh	Other Eighth	Other Ninth	Other Tenth	Other Eleventh	Other Twelfth	Other Last

Other (please specify)

4. How much time elapsed from your first sign or symptom of rosacea until your last sign or symptom?

How much time elapsed from your first sign or symptom of rosacea until your last sign or symptom? A few months	About a year	More than a year
If more than a year, indicate number of years:

5. Has medical treatment reduced your signs or symptoms?

Has medical treatment reduced your signs or symptoms? Yes

Somewhat

6. Are you:

Are you: Male	Female
Number of years with rosacea:

7. Are you:

Are you: Under 30

30-39

40-49

50-59

60-69

over 69

8. Comments:

Comments: