The Reality of Rosacea
Rosacea Realness
This week’s topic was requested by a client – something we’re happy to oblige! In fact, I’d like to open this up to you all! Reply to this email with your most burning skincare questions, and we’ll pick a few to cover in our next newsletter in two weeks’ time.
Now, on to the subject at hand – Rosacea.
First things first, it’s important to recognize that rosacea is a medically defined skin condition, meaning it must be officially diagnosed by a dermatologist. You and I might suspect you have it, but until a physician decrees that you do, it’s not an official diagnosis. Now that that’s out of the way, let’s talk about what it is, why it happens, and most importantly, how to treat it.
WHAT IS IT?
Rosacea affects somewhere between 5.3% – 9.1% of the world. It is most commonly seen in women of Northern European descent, aged 30+. That said, it can and does affect people of all genders, ethnicities, skin colors and ages. It is usually identified by persistent, diffuse redness. This can present as rosy cheeks, a constant flush, or even a butterfly pattern across the cheeks and nose. It can affect the whole face or just certain areas. It may include small red bumps or pustules that resemble acne but lack comedones (blackheads). It may also appear as thickened skin, usually on the nose. This is called rhinophyma. Some rosacea includes telangectasia, or broken blood vessels. And finally, it may even present as dry, itchy, watery or red eyes – this is the type known as ocular rosacea.
WHAT CAUSES IT?
The primary cause of rosacea is inflammation. It can be caused by immune dysfunction, increased mast cells, or an overproliferation of demodex mites, which (in normal concentrations) are a healthy part of our skin. Links have been discovered between the presence of rosacea and gastrointestinal disorders like IBS and SIBO, as well as cardiovascular and autoimmune diseases. There is also reason to believe that it may be caused by UV exposure, as it initiates an inflammatory immune response, increasing keratinocyte (skin cell) damage.
Although they are not the underlying causes of rosacea, the condition is exacerbated by several common triggers. Not every trigger affects everyone, but here’s a list of the most common:
Heat (hot days, saunas, even hot showers) 🔥
Alcohol (wine is a big one, due to sulfites) 🍷
Spicy Foods 🌶
Stress (who doesn’t get triggered from stress?) 😵💫
Heavy Exercise 🏋️♀️
UV Exposure ☀️
HOW DO I TREAT IT?
Unfortunately there is no cure for rosacea, but with the right products and lifestyle changes, it can be managed, sometimes so well that you wouldn’t even know you ever had it!
1. Identify and minimize your exposure to triggers. Do you notice it flares after a couple drinks? Or maybe you’re like me and heavy cardio gives you a red tomato face 🍅 and saunas make you break out in red bumps. It’s probably worth it to minimize or eliminate these triggers from your life.
2. Heal your gut. Due to the immunological connection between gut health and rosacea, it is very much worth determining if you have an underlying digestive issue. Someday I’ll write a newsletter about the Gut-Skin Axis, but for now I recommend seeking out a functional doctor who can advise you on how best to address any GI discomfort. Or at the very least, integrate some fermented foods like sauerkraut or kimchi and take a probiotic. Our favorite REST + DIGEST tea is another great place to start.3.Revise your skincare routine. While you’re getting your rosacea under control, it’s best to pause any exfoliants (absolutely NO SCRUBS) and acidic actives – this means removing any products with L-Ascorbic Acid, Retinoic
Acid, Glycolic Acid, etc. You can still use Vitamins C & A, but it’s best to use a lipid derivative form such as Ascorbyl Tetraisopalmitate and Retinyl Palmitate, respectively. (More about that in the next suggestion.) Depending on the severity of your symptoms, you may also want to remove products with added fragrance, as it’s a common irritant and allergen. Choose a gentle cleanser – oil is great. I’m really loving the new Victoria Beckham Daily Cleansing Protocol, as the oil cleanser is silky and gentle and rinses clean. The lactic acid gel is equally lush, and although I said no acids, a gentle lactic is helpful to keep the skin hydrated. If you prefer a gel cleanser, I’m in love with Sofie Pavitt Clean Clean Cleanser.
4. Wear your sunscreen EVERY DAY. I think I’m going to mention the importance of sunscreen in every newsletter from now on. It’s crazy how vital it is. Part of my protocol when treating clients with rosacea is to get them onto a gentle lipid derivative of Vitamin A, because it helps reverse sun damage and strengthen the skin. And when we reverse existing damage and prevent new damage, we see a major decrease in diffuse redness and incidence of rosacea breakouts. My go to’s are Environ C-Quence Serum 1 and Prunier Plumscreen SPF 31. Zinc-based sunscreens are ideal to start with, as zinc is anti-inflammatory. Once the rosacea is controlled, I find most clients can tolerate chemical SPF, which may be more convenient.
5. Incorporate Red LED. Red LED decreases inflammation, increases collagen production (for stronger skin) and boosts mitochondrial function, creating more cellular energy. It’s important to choose a device that does not get hot! My faves are The Light Salon Boost and Therabody TheraFace Mask.
A FINAL WORD
Although it’s a medical condition, I tend not to love the typical medical approach to treating rosacea. It usually involves topical or even oral antibiotics, which are disruptive to the delicate balance of the skin and gut microbiome. As you may guess from the name Gut-Skin Axis, these areas of the body speak to and influence each other. Creating dysbiosis in one can create dysbiosis in the other. Although the skin biome may be out of whack with rosacea, I don’t think it’s wise to make it worse with antibiotics. I prefer a more holistic approach which involves changing lifestyle factors in order to really get to the root of the issue and see lasting improvement.
