rosaceaWhen I was in esthetician school, one of the first things we learned was that if a client has rosacea, their skin cannot handle anything except the gentlest of treatments and products. No chemical peels, no microdermabrasion, no harsh exfoliants, no steam, no electrical modalities, etc., etc. Which left just one burning question:

 

What Is Rosacea?

 

Rosacea (pronounced “roh-ZAY-sha”) is defined by the National Rosacea Society as “[A] chronic and potentially life-disruptive disorder primarily of the facial skin, often characterized by flare-ups and remissions.” It is primarily found on the cheeks, nose, chin or forehead, and essentially looks like the person is blushing (also known as subtype 1).  Over time, the redness can become ruddier and more persistent, and visible blood vessels may appear (subtype 2).  Left untreated, bumps and pimples often develop, and in severe cases the skin may thicken, and the nose may grow swollen and bumpy from excess tissue (subtype 3). This is the condition, called rhinophyma (pronounced “rhi-no-FY-muh”), that gave the late comedian W.C. Fields his trademark bulbous nose. Rosacea subtype 4 affects the eyes, making them feel irritated and appearing watery or bloodshot.

 

Rosacea is hereditary and can affect all segments of the population, although it is much more commonly seen in people with fair skin who tend to flush or blush easily. It often appears after age 30, but an earlier diagnosis is not unusual.  Rosacea is more frequently diagnosed in women, but more severe symptoms tend to be seen in men.  However, this could be because men often delay seeking medical help until the disorder reaches advanced stages.

 

While there is no cure for rosacea, there are many ways to control or reverse its signs and symptoms. Obviously, “gentle” is the name of the game here.  But what can trigger rosacea, and what exactly constitutes “gentle?”

 

What Causes Rosacea?

 

Often, ingredients in the products used on the skin can exacerbate rosacea, or indeed, any type of sensitization.  Soaps, for example, are often extremely alkaline, and strip the skin of the defensive lipid barrier that seals in moisture and keeps the skin hydrated and protected from the elements. Harsh exfoliants, both chemical and physical (the typical scrubs many associate with exfoliation), will further irritate already sensitized skin. Ingredients in many skincare products and cosmetics will irritate skin, strip its lipid barrier, and/or clog the pores. Some ingredients to avoid include lanolin, mineral oil and isopropynol myristate.  Take a look and the products you’re using — and don’t be surprised to find one or more of these in there.

 

Lifestyle and environment can also contribute to a recurrence of rosacea.  Stress is known to cause rosacea flare-ups.  Alcohol heats from within — how many people do you know that “glow” when they drink alcoholic beverages? Spicy foods are also known to make rosacea worse.  And unfortunately, almost any kind of heat can trigger rosacea, including exercise, saunas, and hot tubs. Living in a hot climate can be a trigger, and of course, it almost goes without saying that sun exposure will further redden skin that is already inflamed.

 

So What Can I Do About It?

 

Using a gentle skin cleanser with calming ingredients such as lavender, bisabolol (derived from chamomile) and panthenol (Vitamin B5) will gently clean the skin without stripping the lipid barrier. Using a thick, soft cotton washcloth, lukewarm water, and patting your skin dry will benefit sensitized skin, rather than using a rough washcloth with hot water, which will further irritate it.

 

While harsh exfoliating scrubs will also irritate already-sensitized skin, an exfoliant is still necessary to get rid of build-ups of dead skin cells and excess oil (sebum) production.  An enzymatic exfoliant acts as little “Pac-Men,” digesting the dead skin cells on the skin’s surface and leaving it smooth and glowing. Humectants such as hyaluronic acid, collagen, honey, and glycerin will help increase hydration and control the excessive dryness that usually accompanies rosacea. And as always, use your sunscreen!  There are many out there that are specially formulated for sensitive skin.

 

Although it may sound counter-productive, there actually are chemical peels that can help treat rosacea. As noted above, exfoliation will remove surface buildup and encourage skin turnover, helping its natural protective barrier function.  The key is to find the correct chemical peel blend that will do this without causing additional irritation. Peels containing low-level retinols, which are derived from Vitamin A, are very effective in assisting with cell turnover.  Peels containing brown or red algae extracts help to calm redness, and peels containing hydrocortisone, aloe vera extracts and evening primrose (to name a few), will aid in combatting inflammation and soothe the skin.

 

If you do experience a flare-up, there are many cosmetics that can help conceal the effects of rosacea. Green makeup or green-tinted foundations can be used to counter redness, followed by a skin-tone foundation with natural yellow tones, avoiding those with pink or orange hues. Of course, be sure that the makeup is pH balanced, non-comedogenic, and doesn’t contain any ingredients that will further irritate the skin.

 

If these steps fail to adequately address rosacea symptoms, it may be time to see your dermatologist. Dermatologists often prescribe initial treatment with oral and topical therapy to bring the condition under immediate control, followed by long-term use of the topical therapy alone to maintain remission. When appropriate, treatments with lasers, intense pulsed light sources or other medical and surgical devices may be used to remove visible blood vessels, reduce extensive redness or correct disfigurement of the nose. Ocular rosacea may be treated with oral antibiotics and other therapy. While there is no known cure, there is a lot that can be done to help shed the red.

rosacea