Rosacea affects around one in ten women in the UK. Which is a huge number! Characterised by facial redness, flushing across the cheeks, nose, chin and forehead, a bit like a butterfly shape, alongside increased sensitivity and sometimes spots and bumps -it’s not surprising it can really impact on those experiencing symptoms, self-confidence.
I find that lots of the advice around rosacea can sometimes be oversimplified and a little vague – not taking into account the complex variety of triggers that can be behind rosacea, and the wealth of effective solutions available. If rosacea is an issue for you, read on to learn more about what it is, why it is happening and how you can start to get on top of it.
Rosacea is a skin condition that causes visible redness on the face, often on the cheeks and nose. It can affect anyone – but it’s most common in lighter-skinned women over the age of 50. It’s also a lesser-known side-effect of the menopause.
Rosacea is related to our vascular blood supply. It occurs when skin becomes inflamed, causing red bumps, pimples and uneven tone and texture. It’s key to mention that there are different types of rosacea, and some symptoms can be mild.
Sadly we still don’t know for sure what exactly causes rosacea – some say it is genetic, medication, or hormones. There’s strong evidence to suggest that a microscopic mite called Demodex could be a contributing factor in some cases. The good news is that we do know more about triggers – things that cause rosacea flare-ups and make it worse – so there’s hope on the horizon.
Rosacea tends to come and go – sometimes with a slight constant flush in certain areas. Your triggers can be hard to identify and avoid, they can vary from person to person and there is a huge amount of trial and error – which can result in a cycle of anxiety and stress (which coincidentally can make things worse).
Often oral antibiotics are prescribed, which can for some give short term relief – but this can be problematic for a number of reasons. Over time, our bodies can become resistant to the overuse of antibiotics and they are not treating the root cause. Antibiotics also disrupt the delicate balance of gut flora – essential not only for overall health, but for skin health, too, especially tricky skins that want to play up. Antibacterial and antifungal creams are also prescribed but like some steroids tend to work for short-term then begin to exacerbate symptoms.
Sometimes, knowing what not to do is just as important as knowing what to do – and that’s especially true when it comes to rosacea!
Most people tend to find that a number of specific things can worsen their rosacea – sometimes the culprit is obvious, but at other times remains a mystery making any attempt to soothe the condition even more frustrating. Histamines found in cells are an essential part of the body’s immune and inflammatory systems. When they are released into the bloodstream during a ‘histamine response’ they cause itching and flushing. Common triggers include:
Stress: Stress is a huge contributing factor for many skin conditions, including rosacea. Unfortunately when stress triggers rosacea it makes us more stressed, often resulting in a vicious cycle.
Food: Certain foods have higher histamine levels than others and can trigger their release, so you may want to avoid them if you suffer with rosacea. These foods include cheese, bananas, tomatoes, chocolate, avocado, jam, yoghurt, strawberries and pineapple. Other foods that can cause flare-ups include alcohol, caffeine, spicy foods, acidic foods (citrus, vinegar) and smoked foods. But please be aware we are all unique and a trigger for one, might be totally fine for another AND it might change over time.
Weather: Extremes in temperature can be triggering – but take extra care during hot, sunny weather. The heat of the sun’s rays can worsen flushing, and chemicals found in sunscreens can also act as a trigger. I generally prefer a mineral sunscreen with zinc oxide or titanium oxide that’s better suited to sensitive skin, even better is to wear light, loose clothing to protect from UV rays with a large brimmed hat and sit in the shade.
Medications: Certain medications, including long-term antibiotics, can make rosacea worse over time.
Skincare: Many of my clients who suffer with rosacea have to be careful and quite specific about what skincare they select. As a rule avoid anything containing fragrance or colour and seek out products specially designed and or recommended by an expert (natural isn’t necessarily best – more on this below).
Make-up: Wanting to try and cover up the issue is understandable, but this can often make it worse. Some mineral make-ups are amazing, giving good coverage and little to no irritation.
Exercise: Strenuous exercise can bring on flushes which can be hugely frustrating. Lower-impact exercise such as yoga, Pilates, walking or cycling etc are great. However a hot yoga class is going to be your worst nightmare!
So many people go through all sorts of strife seeking to calm their rosacea, partly because everyone has individual causes and triggers behind their condition.
If you’re looking for relief from rosacea, I advise starting with the following:
Simplify your skincare routine: Hypersensitive skin doesn’t respond well to being exposed to lots of different ingredients when it’s aggravated. Pare back your skincare routine to the essentials and build from there. Take care when introducing new products, too, to avoid triggering the skin and also helping in identifying what products your skin loves and doesn’t love.
Opt for a clean cosmeceutical skincare approach: Lots of people with rosacea are advised to go ‘all natural’ and whilst I agree with this to a point, it isn’t specific enough to be good advice. I recommend very specific skincare brands which I have worked with in clinic and know the results. These have been specially created to support the skin in quite a different way than a lot of beauty hall brands, it’s not just about picking an organic product or something for sensitive skin, it’s a lot more specialised if we want results. Avoid physical exfoliants as these will be super irritating.
Reduce stress: This is a tough one, but wherever possible look for ways to reduce the levels of stress in your life. This could mean starting a meditation practice, journaling or learning breathwork techniques. It could involve going deeper and readdressing your work/life balance, removing toxic people from your life or trying to address your money worries (I know easier said than done) However reducing stress looks like for you, try to make that as a priority to minimise the number of future flare-ups and support overall health and skin.
Supplement: Supplement your diet with probiotics to support gut health – an essential step especially if you have been prescribed antibiotics. It’s often not just about adding in a probiotic, if the gut flora is out of whack I have found sometimes throwing in a random probiotic can flare things up. We need to look at pre-biotics and make some dietary changes to support the process.
Herbal supplements and teas such as chamomile, fennel, milk thistle and marshmallow root can also be a support.
Alongside topical treatments, a targeted skincare regime and lifestyle supports there are some promising treatments that can be really effective.
I personally love a treatment using specific infusions of vitamins and other key ingredients, (see treatment menu – skin fusion) which not only reduce the symptoms, they also help strengthen and support the skin to function more effectively and be less responsive. And I cannot stress how important someone’s homecare is when we are treating rosacea.
One of the most well-documented treatments is IPL therapy – which stands for Intense Pulsed Light Therapy. You might have heard of this before as a hair-removal treatment – it’s similar, but with a different target for the light, so just because a clinic offers hair removal does not mean they automatically can treat rosacea. I’ve been championing it as a skincare therapy for years. It’s not treating the root cause, so this is more of a reduce the appearance of the symptoms for a period of time. For clients with rosacea, it can reduce redness, minimise the appearance of broken capillaries through targeting the blood vessels beneath the skin and triggering the body’s natural healing response. A course is always needed and results do vary, many feel relief from angry redness for many months before needing a top up treatment. (you can find more on IPL and how it is helpful for rosacea here).
Lymphatic drainage can also help to minimise build-up of toxins and lymph within the skin. It’s a no-oil method of gently massaging the face, great for calming the skin and the mind.
Once the skin is in a better place you will be pleased to know there are some retinoids you can safely use! I recommend retinaldehyde as a gentle introduction to retinol.