Rosacea
What is Rosacea?
Rosacea is a common chronic skin disease and unfortunately, the exact cause is unknown and still being studied. It affects an estimated 16 million Americas and 415 million people worldwide. However, many studies suggest it may a combination of an abundance of bacteria and skin mites (I know!) followed by the inflammatory response. But don't worry, both are present in all human skin it's just found in greater numbers in those with rosacea.
Rosacea is categorized by redness, swelling, broken blood vessels, stinging/burning of the skin and eye area, and sometimes cystic acne. These symptoms are typically found in the center of the face starting at the nose and extending outwards on the cheeks, chin, and forehead.
Rosacea often runs in families, it tends to be more common in women, people with fair skin/light eyes, and usually appears or is diagnosed between 30-50 years old but not unusual to appear in the 20s.
Getting Diagnosed
I highly recommend seeing a dermatologist since a doctor is the only one that can properly diagnose. Estheticians are trained to recognize and treat the symptoms of rosacea, but we definitely can't diagnosis the skin since it's out of our scope of practice. And over the years working in the facial room, I can't tell you the number of clients I have self and misdiagnose rosacea for broken blood vessels and vice versa. See a doctor for a proper diagnosis!
Different Types of Rosacea
There are actually four different subtypes of rosacea and can manifest differently in different people.
Erythematotelagiectatic Rosacea - Visible blood vessels with redness and flushing
Papulopustular Rosacea - Cystic acne breakouts with redness and swelling.
Phymatous Rosacea - Bumpy skin texture with thickening of the skin
Ocular Rosacea - Eyelids can be swollen, eyes red and irritated and it may look like a sty.
Treatment of Rosacea
Depending on the severity and how much it affects a person there are many different combinations and multi-treatment approaches to treating the symptoms. Sometimes short-term oral antibiotics are prescribed in combination with topical prescriptions to jump-start the treatment plan in addition to gentle consistent home care with skincare products.
Medical Treatments
The most common topical treatments are Rx strength azelaic acid and Metronidazole gel commonly known as Metro gel. For people that suffer from rosacea with acne sometimes low strengths of tretinoin cream or sulfur facial cleanser are prescribed. Intense pulsed light (IPL) or pulsed dye lasers (PDL) treatments often yield fantastic results in addition.
Skincare + Other Treatments
Topical and oral probiotics are a great addition to a rosacea treatment plan. This study by Leonard B. Weinstock, MD suggests that in half of the rosacea study participants there is an intestinal bacterial overgrowth in the small intestines. Interesting right? Then on the Journal of the American Academy of Dermatology website this...
"In an Italian study, half of the patients were administered an oral probiotic supplement in addition to their standard acne and rosacea treatment. The other half of the patients did not receive the probiotic supplement. The probiotic group experienced a better clearing of acne and rosacea symptoms."
So yet again, probiotics for the win! Topical probiotic skincare products also are shown to help since they deliver straight to the source.
I have compiled a handy list of "yes" and "no" ingredients, types of skincare products, and good habits that have been shown to help treat the symptoms of rosacea. Since everyone has their own unique skin and body chemistry, treatment approaches will be individual, and working with a dermatologist is a great idea.
The Rosacea “No” List
Physical exfoliating scrubs/polishes
No microdermabrasion
Simple alcohols
Anything with charcoal
Sodium lauryl sulfate - found in most cleansers, shampoos, and toothpaste
Foaming cleansers - can be too drying/harsh
Witch hazel
Synthetic fragrance
Synthetic dyes
Urea
Topical steroids like hydrocortisone cream
AHA and BHA
Hydroquinone (skin lightener)
Peppermint, menthol, camphor, and/or eucalyptus essential oils
Avoid hot baths/showers, saunas, and steam rooms
Avoid washing your face with hot water - lukewarm is best!
Little to no steam during a facial and request your esthetician to cool the hot towels to slightly warm before using them on your face.
The Rosacea “Yes” List
Azelaic acid
Gentle enzymes are the best exfoliation method for rosacea
Green tea extract
Aloe vera
Hemp seed oil and/or CBD oil
Sulfur
Zinc
Resveratrol - antioxidant
Chamomile
Niacinamide
Ice rollers
Use minimal products and stay consistent with the products that work for you
After cleansing, pat dry (instead of rubbing) with a clean cotton towel
SUNSCREEN - since sun exposure is the #1 trigger for rosacea flare-ups, W E A R I T. Mineral sunscreens are best for rosacea that contains zinc oxide, titanium dioxide, or both.
Green primers or color correctors balance out redness before foundation.
Mineral-based makeup is best for rosacea.
Topical and oral probiotics
Rosacea triggers
I know this is not what anyone wants to hear but there are food, weather, and lifestyle triggers for rosacea. If you are newly diagnosed I recommend keeping a journal on personal triggers to truly find out what affects you individually.
Weather Triggers
Sun (The #1 trigger!)
Wind
Humidity
Extremely hot or cold weather
Lifestyle Triggers
Steam rooms or saunas
Hot tubs
Hot showers/baths
Stress and anxiety
Food/Beverage Triggers
Alcohol - especially red wine, beer, bourbon, gin, vodka, or champagne (alcohol dilates blood vessels.)
Thermally hot drinks - hot drinks heat the back of the throat and produce facial flushing
Spicy Foods
Yogurt
Sour cream
Cheese (except cottage cheese)
Chocolate
Vanilla
Soy sauce
Yeast extract (bread is OK)
Vinegar
Eggplant
Avocados
Spinach
Beans- lima, navy, or pea
Citrus fruits, tomatoes, bananas,
Red plums, raisins, and figs
