It’s estimated that 415 million people are affected by Rosacea worldwide. A chronic skin disorder, Rosacea is sometimes hereditary and most common in people of English or Scottish descent. It occurs equally in dry and oily skin types. Rosacea causes facial redness and flushing, making it difficult to conceal. It’s basically the sole reason green concealer was invented (green makeup can help to counteract redness, instantly).
What is Rosacea?
Rosacea is a chronic skin disorder characterized by redness. Rosacea symptoms also include stinging, itching, flushing and acne-like bumps. It most frequently appears along the nose and cheek area, and can be so severe that it causes swelling (rhinophyma). This results in a bulbous, bumpy skin texture.
Rosacea Symptoms
Rosacea can be a very uncomfortable skin condition to have, affecting facial skin and dermatologists have seen mild to extremely severe cases. In addition to redness, swelling and other symptoms, Rosacea sufferers may also experience swelling and subsequent sagging once the fluid drains. This is usually most apparent in the cheeks. Rosacea can also cause acne-like bumps, like papules (red bumps) and pustules (bumps filled with yellowish, liquid puss), usually resulting from irritated hair follicles. Lovely.
Rosacea Causes
The exact cause is unknown, but when you have Rosacea, facial blood vessels dilate too easily. This brings excess blood to the surface, causing flushing and redness to occur. This coupled with bacteria, sun damage, microscopic skin mites (Demodex), irritation of the follicles and an unusual immune response bring on red, bumpy irritated skin.
Rosacea Triggers
Rosacea has some common triggers. Here are just a few:
Sun Exposure
We all know sun exposure causes redness, however it also dilates blood vessels, which creates heat in the skin. This increases irritation and inflammation. UV rays also break down collagen over time, making skin more transparent and causing blood vessels to become more visible, and, in some cases, trigger rosacea.
Emotional Stress
Stress affects your immune system in many ways, and changes your body’s inflammatory response. When you’re stressed, it’s common to have a Rosacea flare-up. Anything from losing a job, to losing a loved one, to planning a wedding or a cross country move can induce stress, causing a slight raise in blood pressure as well as symptoms of rosacea beginning to appear and worsen.
Hot or Cold Weather/Wind
Dry, cold air and harsh winds are irritating to those with Rosacea. So is hot weather, regardless of whether it is humid or dry. Heat not only triggers inflammation, but can also cause sweating and heat rash. Can sweating make rosacea worse? Commonly, yes, as sweating and heat rash both aggravate this skin condition. This is why many people experience rosacea while perspiring, or notice rosacea heat rash when warm.
Beverages: Alcohol and Hot Liquids
Hot liquids are often consumed in the winter, so this reaction is probably due to a combination of factors. Alcohol is also a known trigger, especially red wine which have high levels of tannins. Tannins act as natural histamines and can stimulate allergic reactions. Alcohol can cause redness and flushing even in those who don’t have Rosacea.
Spicy Foods
Spicy foods cause blood vessels to dilate, which aggravates Rosacea. There are other foods that can irritate your skin, including citrus fruits which are very acidic. That’s why it’s helpful to keep a diary of what you eat along with your symptoms so you can keep track of your reactions and try to avoid foods that can trigger flare-ups.
Strenuous Exercise
Exercise dilates your blood vessels and causes heat, friction and sweat. Unfortunately, this can be very irritating for those with Rosacea and heat only further aggravates Rosacea symptoms, which means heavy exercise can also cause flare ups. It’s always a good idea to keep a facial cleanser in your gym bag so you can cleanse away dirt and perspiration, whether or not you are struggling with this skin condition.
Hot Baths and Showers
Heat and Rosacea go hand in hand, and as we mentioned above, heat can trigger inflammation of Rosacea. Hot water causes sensitivity and dryness in all skin types, so it’s no wonder it makes Rosacea symptoms worse. Though a hot shower is tempting, especially during winter months, keep the water temperature warm or even on the cooler side, if possible. And, once you step out of the tub, reach for a moisturizer.
Certain Skin Care Products
Anything that dries out your skin, dilates your blood vessels or causes irritation will exacerbate Rosacea. Alcohol, Fragrance, Glycolic Acid, Menthol and SLS are just a few irritating ingredients that can make Rosacea worse. If Rosacea is undiagnosed or appearing for the first time, many suffers try random topical treatments at first, thinking an over-the-counter acne product or treatment for sensitive skin will address the issue. Some products can make the condition worse, triggering additional side effects like swelling, pimples, breakouts, soreness and even more redness.
Rosacea Treatments
Azelaic Acid
This gentle exfoliator is also an anti-inflammatory. It helps to relieve the bumps and inflamed follicles associated with Rosacea. It can be difficult to exfoliate the skin when you have Rosacea because scrubbing or using AHAs like Lactic and Glycolic Acid are out of the question. That’s why Azelaic Acid is so good at helping with skin turnover.
Niacinamide
This Vitamin B derivative helps to soothe inflammation associated with Rosacea. As a bonus, it also helps to even your skin tone and strengthen your skin barrier.
SPF
Since sun is such a well-known Rosacea trigger, it’s important to use sun protection. Choose an SPF, preferably a daily broad spectrum moisturizer, plus wear a sunscreen if you’re headed to the beach, to protect your skin from inflammation and redness, especially if you have fair skin. Titanium Dioxide and Zinc Oxide are especially soothing because they are inert, physical blockers that won’t irritate your skin and you do not want to experience sunburn along with other skin conditions. So if you are someone who struggles with rosacea and sun exposure isn’t something you actively guard against, using daily SPF is a crucial step in your skin care regimen.
See a dermatologist
While Rosacea can be irritating and, quite frankly, annoying, it can also be painful in the most severe cases. There are several treatment options like topical medications and lotions as well as oral antibiotics including minocycline and tetracycline that can be prescribed to ease symptoms. Some dermatologists may even recommend light therapy, a series of professional treatments to reduce facial redness, flushing and telangiectasia (small blood vessels that are dilated). You can also refer the national rosacea society website (www.rosacea.org) for more information on this skin condition.
Start a personalized, daily skincare regimen.
Consistently using skincare for your individual skin needs and issues will help in managing Rosacea and improving skin health. Dermatologists and the National Rosacea Society recommend avoiding common irritants found in some skincare including, witch hazel, alcohol (often found in toners and astringents), fragrance, menthol, peppermint and certain skin oils.
Dr. Yuan
Dr. Yuan is a data scientist and computational physicist. She has a PhD in Material Science, a Master in Computer Science and a postdostdorate in Computational Physics from Stanford.