Rosacea is an inflammatory condition. It is characterised by intense and frequent flushing or blotchy redness, with the appearance of ‘broken blood vessels’ on the cheeks, chin, and nose, and in most cases, acne-like pimples. It is often mistaken for adult acne, however it usually lacks the blackheads and true whiteheads (‘comedones’) of acne vulgaris. It is important to distinguish between the two as the treatments that work for acne are not good for rosacea.
We are not 100% sure of the exact cause, but we do know:-
- It runs in families
- Sufferers usually have sensitive skin
- Hormones play a role
- Certain infections can may play a role
- Gut Health is often connected (see Gut-Skin) – there is in fact a a higher incidence of rosacea in people with SIBO (small intestinal bacteria overgrowth).
- The regulation of blood flow to the skin in rosacea is abnormal.
- Is most common in light skinned women between the ages of 30 to 50.
- Many sufferers also have facial seborrhoea dermatitis. This can also be known as facial dandruff.
There are 4 different Subtypes of Rosacea
The inflammation is more diffused into the skin and is associated with redness and flushing. There is often episodes of flushing which occur due triggers (see triggers below).
The inflammation is heavily centred around the pore, causing pimple like redness and swelling. Sometimes pustules and nodules are present. Skin may be sebaceous and even oily in areas.
Is more commonly seen in men who had a history of teenage acne. It is typically around the nose area. Skin is thick and reddened, pores are large and can be filled with plugs of dead skin cells and sebum. There is usually enlargement and swelling of the oil glands on the nose which makes the nose look larger and rounded at the end.
The oil glands along the eyelash line. Ocular rosacea can be seen with the other types of rosacea.
- Spicy foods
- Heat – including saunas and spas
- Alcohol– particularly Red wine
- Stress, anxiety and embarrassment
- Physical exertion
- Cosmetic & skincare products that contain high levels of alcohol, glycolic acids or fragrance.
- Hot drinks
- Excessive physical exertion.
- Due to the skins weakened barrier, certain skin treatments need to be avoided. This includes facial acid peels and microdermabrasion.
What else we know about all types of Rosacea
- Demodex mites have been linked to rosacea in some studies. This microscopic mite likes to reside in hair follicles and have been shown to be more numerous in the skin of rosacea sufferers.
- Intestinal bacteria ‘h. pylori’ may play a role.
- Sebaceous hyperplasia papules are often present. These are enlargements of the oil glands which look like small waxy yellow bumps and have a central pore. They are often mistaken for milia.
What can help
Although rosacea can not always be 100% cured, there are a variety of lifestyle changes and treatments that can help keep it under control.
- See Kleresca
- Topical agents such as azelaic acid, benzoyl peroxide (because P. acnes may play a role in rosacea), sulfacetamide (10%), and sulfur (5%).
- Advances in ‘peptide technology’ have been found to help calm the inflammation associated with rosacea.
- Specialised laser therapies – eg IPL (non-Laser intense pulsed light) or PDL (Pulsed dye Laser).
- Short term oral antibiotics- however this is not ideal for gut health SO it should be followed with a course of probiotics.
- One anti-aging product that is usually well tolerated is Retinol. Ideally it should be combined with gentle peptites.
- Omega-3’s (Fish oil, flaxseed, walnuts, Sea Buckthorn
- Probiotics …..see Gut-Skin
- Avoiding or decreasing inflammatory foods such as wheat and unfermented dairy.
- LED Light Therapy
The Skin barrier strength in rosacea is abnormal making a lot of skin products and cosmetics irritating.
Use emulsion type soap-free cleansers which sweep away makeup and other skin impurities without the use of harsh surfactants. Barrier nurturing ceramides are essential.
Dimethicone and allantoin can help to fortify the skin’s barrier and relieve irritation and dryness.
It is important to replenish the skins natural moisture without the use of traditional emulsifiers. The aim being to hydrate and nourish.
Sun can play a role for rosacea sufferers. Daily lightweight sun protection is important.
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