Rosacea is a chronic inflammatory skin condition that affects approximately 415 million people worldwide [1][2]! It usually develops in adults between ages 30-50 and tends to affect women more than men (by a factor of 2-3) and those with fair skin [3].
Despite its prevalence, a specific cause has yet to be discovered. One theory involves Demodex mites, which are found on the skin of all humans. However, they can be more abundant in those with rosacea. This may trigger an immune response or the inflammation seen in rosacea may be caused by bacteria associated with the mites, which get released when Demodex dies [4][5][6]. More research is needed but one of the current pharmaceutical treatments recommended targets these mites. Gut dysbiosis (microbial imbalances in the gut) may also play a role in rosacea but this too needs further investigation [7].
In addition to Demodex and potentially gut dysbiosis, there are several risk factors and triggers for rosacea [3][8]:
Sun exposure
Temperature extremes both hot and cold
Emotional stressors
Alcohol, especially red wine
Hot drinks
Caffeinated beverages such as tea and coffee
Spicy seasonings
Intense exercise
Medications including corticosteroids, benzoyl peroxide and those that enlarge your blood vessels (Speak to your physician)
Cosmetic products
The center of the face is most commonly involved including the cheeks, nose, chin and forehead and sometimes the eyes. It may start out as intermittent redness or blushing that progresses to become more persistent. Other symptoms could include red lines on the face, dry skin, burning, stinging or itching and pimplelike bumps that do not have blackheads or whiteheads [8]. Symptoms are dependent on the type of rosacea you have [3].
These are some general tips to help manage rosacea [9]:
Avoid triggers (see above). It may be beneficial to keep a diary to identify these.
Daily sunscreen (minimum SPF 30) containing:
- Base: dimethicone and/or cyclomethicone
- Active ingredient: titanium dioxide or zinc oxide
Gentle soap-free skin cleanser
Moisturizer for sensitive and irritated skin specific to rosacea
To cover up redness, use green-tinted cosmetics
Avoid these skincare products:
- Waterproof makeup
- Skin tonics, toners and astringents
- Cosmetics with sodium laurel sulphate, strong fragrances, fruit acids and
glycolic acids
- Exfoliators
Depending on your subtype, you may be prescribed internal or topical medications. The topical medications did not work for me but that is not to say they wouldn’t benefit someone else. Instead, I’ve managed with the following:
Dietary changes: eliminating gluten, dairy, chocolate, coffee, histamine-rich foods and anything processed.
Facial cleansers and moisturizers to calm redness: there are many out there that are targeted for rosacea. Avoid soapy cleansers and always make sure you keep your skin moisturized.
Topical castor oil with lavender essential oil: Castor oil is anti-inflammatory. I apply this on my face before bed and add 2-3 drops of lavender essential oil.
LED light therapy: each color (red, yellow, green, blue and violet) has specific benefits. The green light is particularly beneficial for redness.
Face masks with ground oatmeal: Oatmeal is soothing to the skin. I make this mask myself by grinding gluten free oatmeal into a powder, adding some water to make a paste and applying and leaving this on the skin for 20 minutes then rinsing this off.
These are treatments that have helped me but they may not work for everyone and these should not replace expert medical advice. It would be best to speak to a healthcare provider, who can work with you to determine the right treatment plan for your needs.
References
Gether, L., Overgaard, L.K., Egeberg, A. and Thyssen, J.P. 2018. Incidence and prevalence of rosacea: a systematic review and meta-analysis. British Journal of Dermatology. 179(2):282-289. https://www.ncbi.nlm.nih.gov/pubmed/29478264
New Study Finds 415 Million People May Suffer from Rosacea Worldwide. National Rosacea Society. 2018. Accessed from: https://www.rosacea.org/press/2018/july/new-study-finds-415-million-people-may-suffer-from-rosacea-worldwide
Family practice notebook. 2019. Rosacea. Retrieved from https://fpnotebook.com/Derm/Acne/AcnRsc.htm
Moran, E.M., Foley, R. and Powell, F.C. 2017. Demodex and Rosacea Revisited. Clinical Dermatology. 35(2): 195-200. https://www.ncbi.nlm.nih.gov/pubmed/28274359
Lacey, N., Delaney, S., Kavanagh, K. and Powell, F.C. 2007. Mite-related bacterial antigens stimulate inflammatory cells in rosacea. British Journal of Dermatology. 157(3):474-481. https://www.ncbi.nlm.nih.gov/pubmed/17596156
Whitfeld, M., Gunasingam, N., Leow, L.J., Shirato, K. and Preda, V. 2011. Staphylococcus epidermis: a possible role in the pustules of rosacea. Journal of the American Academy of Dermatology. 64(1):49-52. https://www.ncbi.nlm.nih.gov/pubmed/20943287
Weiss, E. and Katta, R. 2017. Diet and rosacea: the role of dietary change in the management of rosacea. Dermatology Practical and Conceptual. 7(4):31-37. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5718124/
Rosacea. Canadian Dermatology Association. 2019. Accessed from: https://dermatology.ca/public-patients/skin/rosacea/
Solomon, C.G. 2017. Rosacea. New England Journal of Medicine. 377(18):1754-1764. https://www.ncbi.nlm.nih.gov/pubmed/29091565
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