Do you suffer from rosacea? What causes rosacea? and do you need some help looking after your skin?
The most common complaint that I see in my skincare clinic is either rosacea or adult acne. I have a special interest in both because my skin has a tendency to flush and I worry that it will develop into rosacea as the menopause approaches. There are two stages of rosacea – I am at stage one. What stage are you at?
Stage One Rosacea: Flushing
Blood vessels become extra sensitive to certain triggers, so you need to work out your own personal triggers. Flushing is usually worse down the centre of the face where the blood vessels are larger and closer to the surface of the skin. Please don’t ignore this stage because over time the blood vessels lose elasticity and become permanently swollen with blood.
Stage Two Rosacea: Permanent redness accompanied by lumps and bumps
Constant flushing stimulates the oil glands and irritates the follicles, leading to bumps around the inner cheeks and nose which look a bit like acne. Adult acne, however, usually occurs along the jawline.
So what causes rosacea?
Maybe you recognise one of the top ten triggers below – they all make the skin flush red. Try and avoid as many as possible!
Alcohol relaxes the blood vessels so blood rushes to the surface of the skin. Before you know it, you have a drinker’s nose. I am so proud of one of my clients who has recently stopped drinking red wine every evening, despite being under extreme stress; now she only drinks it on a night out.
- Extremes of temperature/outdoor lifestyle
Blood vessels constrict in the cold weather to preserve heat. But when you go into the warm indoors, they relax and blood rushes to the surface. Your skin just can’t cope, and, in the end, it just gives up and stays red.
In the hot weather, blood vessels open wide to cool us down and the skin flushes red. I try in vain to persuade all my clients to use sunscreen which stops the release of inflammatory chemicals that aggravate rosacea. One client, in particular, was incredibly reluctant. We eventually found one that she liked: Skinceuticals Ultra Facial Defense SPF50, and it has helped to calm down her rosacea considerably.
- Overuse of multiple products
This has become an increasing problem due to the popularity of layering multiple serums or luxurious day creams. Less is more! The skin can’t cope and becomes hypersensitive.
One client’s skin became irritated following a stressful divorce. Initially, her GP thought that the tiny red pinpricks on her inner cheeks were dermatitis, but she didn’t have much faith in him or his diagnosis. She waited to see a dermatologist who prescribed Ivermectin, an anti-inflammatory cream which is fast becoming the favourite treatment for rosacea. It kills a common skin mite more prevalent in rosacea sufferers before it has a chance to irritate their overly sensitive immune system.
Skin becomes thinner during the menopause so blood vessels show through more. One client experienced little red bumps on her inner cheeks every time she had a hot flush. Adamantly against HRT, we are having some success using herbal remedies. Neostrata Restore Facial Cleanser has calmed down the redness on the tip of her nose which contains glucosamine to strengthen her skin’s barrier.
- Thin, sensitive skin
Sensitive skin is more prone to irritation from the elements, alkaline cleansers, grainy scrubs and anti-aging ingredients. Blood rushes with oxygen and immune cells to repair the damage and the skin flushes red. Avoid synthetic fragrances, alcohol, witch hazel, essential oils, acids and astringents.
- Teenage skin: sensitive and oily
Although most cases of rosacea occur over thirty, it can happen in a teenage skin, sometimes combined with acne.
The sixteen-year-old niece (picture) of one of my clients has widespread acne on her cheeks, which is also dry and inflamed with rosacea. Soap leaves her skin tight, so we have been using Neostrata Clarifying Facial Cleanser (which I use in the evening) and Neostrata Sheer Hydration SPF35. Her cheeks are now less dry, and we will keep an eye on the rosacea.
So how do we treat your rosacea?
That depends on how far advanced your rosacea is.
Treating Redness (Stage One Rosacea)
Whilst over-the-counter skincare can calm irritation temporarily, it can’t remove underlying redness. Visit your GP who will prescribe topical inflammatories combined with a three-month course of antibiotics. Try the following non-surgical treatments:
- IPL: can be very effective at reducing redness (as long as there are no lumps).
- Lasers: a course can close capillaries in up to 50% of cases
Treating bumps (Stage Two Rosacea)
Upgrade to stronger antibiotics combined with prescription retinoids which are anti-inflammatory and can treat both acne and rosacea. (They cleared up my acne for a good ten years). Some clients are wary of antibiotics, but this is a shame because they are anti-inflammatory. A light glycolic peel might also help.
Which skincare should I use to treat my rosacea?
Rosacea can cause tiny cracks in the skin’s barrier, so moisture escapes and clients mistakenly believe that they have dry skin. Rich creams may feel soothing initially, but they do nothing to repair the barrier long-term and can even exacerbate inflammation. Instead of buying anti-redness products (which are more designed for dry, eczema prone skin), use light, hydrating products. Always treat your skin as sensitive, even if your rosacea comes and goes.
Can diet improve my rosacea?
But skincare is only half the battle. You also need to address inflammation internally: eat plenty of nuts, seeds, vegetables and vitamin C, which is a natural anti-histamine. One of my clients will only take an anti-histamine once a flare-up has started, which is too late. Strengthen your immune system with pre and probiotics and try a cow’s dairy cleanse for a fortnight and see if your rosacea improves at all.
Let me know how you get on!