When you have rosacea, controlling skin flare-ups and concealing redness can feel like a never-ending battle. It’s more common than you might think, with one in 10 people in the UK suffering with the condition. When it comes to working out the right treatment plan, first, we have to understand a bit more about it.
What is rosacea?
Rosacea is a vascular inflammatory skin condition that is characterised by hypersensitive skin, red rosy cheeks, pimples and pustules. It usually occurs on the face, but the neck and décolletage can be affected too. The rash is usually symmetrical and presents in a butterfly shape across the forehead, nose, cheeks and chin.
Those who have rosacea will usually, at first, experience flushing and redness across their cheeks, nose and chin. As the condition progresses, dilated blood vessels, pustules and blemishes appear that could be mistaken for acne. Over time, if the condition is left unmanaged, it can result in enlarged pores, distorted skin tissue, such as a bulbous nose, and even eye irritation .
The redness that comes with rosacea may go unnoticed in dark skin, especially if you already suffer from hyperpigmentation. This is why rosacea is often misdiagnosed. Those with darker skin tones should look out for warmth and flushing, especially after certain triggers, as well as a burning or stinging sensation after applying certain products. At Kate Kerr London, we analyse the skin and take a thorough skin history in order to assess if there is an underlying condition.
What causes rosacea?
Whilst the exact cause of rosacea is largely unknown, the following factors are collectively believed to be possible culprits:
- Genetics, since rosacea tends to run in families, particularly those from Celtic origin (it’s often referred to as the ‘curse of the celts’)
- An immune system reaction to a bacterium called bacillus oleonious, which causes acne-like breakouts
- Higher than normal amounts of protein called cathelicidin, which may lead to inflammation triggering redness and bumps
- Sebaceous gland hyperactivity aka skin that overproduces oil, which has an inflammatory effect on the skin
- A mite called demodex that lives on everyone’s skin – researchers have found that people with rosacea have more of these mites than others, however, more research is needed and we actually believe that this a by-product of producing excess oil, which the mites feed on
So we don’t know the exact cause of rosacea, but we do know that there are several things that can increase your risk. For example, fair-skinned women aged between 20 and 50 are most at risk and typically suffered with acne in their teens before the first stages of rosacea started to appear. Whilst women are more likely to suffer with the condition, men can suffer with it too, and they tend to experience more stronger symptoms.
So there’s a lot to consider, but before we get into treatment options, first we need to understand the different types of rosacea.
Types of rosacea
There are five different sub-types of rosacea. These include:
- Erythematotelangiectatic Rosacea (ETR)
Presents as: flushing, redness on the cheeks.
Presents as: visible blood vessels. It might be just a few on the sides of the nose or very visible capillary networks on the cheeks, forehead and chin.
- Acne (Papulopustular) Rosacea
Presents as: blistery or pustular breakouts that are more dome-like than acne lesions and tend to last longer. Also tiny pin-prick-size pustules that disappear instantly when cleansed. There is also redness and flushing.
- Ocular Rosacea
Presents as: redness, itching and burning around the eye area and within the eyeball. There may also be a gritty, sandy feeling. It’s caused by an overreaction of the oil glands (the meibomian glands) in the lashline.
- Rhinophyma & Tissue Distortion
Presents as: a thickening of the skin, resembling a cauliflower on the nose. This is due to an overgrowth and clustering of the sebaceous glands (the glands responsible for oil production). Pores become enlarged and the skin becomes unevenly textured.
How to prevent rosacea
As rosacea is a genetic condition, it isn’t always possible to prevent it, but it can be controlled. It is a progressive condition and progression to the more extreme stages is what we aim prevent – this is the As rosacea is a genetic condition, it isn’t possible to prevent or cure it, so management and control is the main aim. It is a progressive condition and progression to the more extreme stages is what we aim prevent – this is the number one objective when treating the skin. Here are a few things that you can do to prevent flare-ups and keep the skin stable…
Know your triggers
When you’re experiencing a rosacea flare-up, your skin will flush or burn. These episodes can be triggered by a number of factors, including:
- Diet – for example, common triggers include caffeine, alcohol, spicy foods and high-histamine foods
- The environment – think cold wind blowing on your face, high temperatures and harsh sunlight, changing environments (going from hot to cold quickly) and having the central heating too high
- Medical conditions and some medications
- Emotional influences, such as stress
- Exercise – all that heat generated when we work out can exacerbate rosacea as the blood vessels dilate to cool the body down. It’s best to workout in front of a fan or opt for swimming to keep the skin temperate
- The use of certain products – for example, harsh exfoliators, irritating soaps, make-up, essential oils and heavily plant-based products.
If you can identify your triggers, you can take steps to avoid them and hopefully dodge a flare-up. Keeping a diary can be a really useful way to identify your triggers so that you can reduce your symptoms. This is really key as repeated flare-ups can cause your skin to stay red or flushed for a longer period of time and encourages the progression of the condition, which can make treatment more challenging.
Prioritise sun protection
With rosacea, you must be extra vigilant about protecting your skin from sun damage. UV radiation from the sun is one of the most common triggers of rosacea, so wearing a daily SPF 50 with UVA and UVB protection is essential.
It is necessary to wear an SPF even if you’re staying indoors (remember, light inside means that UVA rays are bouncing around) and when outside, you need to re-apply your SPF every two hours. When outside, be sure to wear a wide-brimmed hat and sunglasses and seek shade between 10 and 4pm, during those peak sunshine hours.
How to treat rosacea
There are a number of ways that we can treat rosacea, from prescription and over the counter skin care through to advanced treatments. At Kate Kerr London, we have a lot of experience treating rosacea and treat it daily in the clinic – our founder, Kate, suffers with it herself so is personally invested and passionate about offering the best possible treatment, as well as educating clients in order to minimise symptoms.
Use the right skincare
Rosacea can be very tricky to treat – a lot of professionals serve to treat symptoms and just calm the skin. At Kate Kerr London, we have a very different approach where we actively stimulate the skin and encourage it to work for itself and initiate repair.
Our key goals are to:
- Repair and strengthen the skin’s protective barrier
- Regulate the Keratinocyte Maturation Cycle (that’s the life cycle of ‘keratinocytes’, which help to protect our skin against pathogens, prevent UV damage, improve skin cell function, minimise heat and water loss and improve luminosity)
- Target sebaceous gland hyperactivity to minimise oil production
- Minimise inflammation
- Ensure the skin is hydrating itself properly
- Ensure the skin is generally healthy with a luminous glow
For us, it isn’t just about soothing and calming the skin, it’s about getting to the root cause of the issue and preventing inflammation in order to minimise symptoms and avoid exacerbating the condition. .
We provide our clients with a comprehensive skincare regime that’s tailored to their individual rosacea symptoms in order to actively manage the condition. We recommend papain, papaya and lactic acid for gentle exfoliation. We also encourage the use of salicylic acid, which helps to control oil production and has an anti-inflammatory action. Ingredients such as niacinamide help to repair the skin’s barrier, while antioxidants such as Vitamin A, C and E prevent oxidation and inflammation. Azelaic acid is great for preventing congestion and minimising inflammation, while retinol is key for helping to strengthen the skin – although building up slowly is key and it’s best to start with a lower dose.
You’ll need to avoid any products that are perfumed or alcohol-based (although some alcohols are fine; it’s best to seek professional advice). You also shouldn’t use any skincare products that contain ingredients like camphor, sodium lauryl sulfate or menthol as these can exacerbate rosacea flare-ups.
Have the right treatments
We recommend booking in for a Clinical Rosacea facial once per month, alongside an at-home skincare regime that is designed to strengthen the skin, repair the skin’s barrier and make it more resilient and resistant to triggers. Intense Pulsed Light (IPL) treatments can also be used to target broken capillaries and diffuse redness.
We recommend Venus Viva Nano Fractional Radio Frequency treatments in order to encourage collagen production as providing more cushioning in the skin helps to blur any redness. Nano Fractional Radio Frequency also helps to minimise pore size as pores can become enlarged with rosacea; it also dissolves the broken capillaries and improves redness. Our Advanced Skin Peels can also be tailored to have an anti-inflammatory action – we can combine LED light and skin peels to refine the skin texture, calm inflammation, reduce oil flow and minimise redness.
What about oral medications?
Oral medications, such as antibiotics, are a temporary relief – they don’t offer a long-term cure. Certain medications can be effective in taking down inflammation when you’re having an acute worsening of symptoms and low-dose roaccutane can be very effective as it minimises oil production and can have a longer-term effect.
Seek professional advice
Rosacea tends to become increasingly severe without treatment and the earlier you treat it, the better the outcome. We successfully treat rosacea every day because we are active in how we treat the skin. We not only focus on treating the condition itself, but also on improving general skin health for increased luminosity and to help support your skin through the natural ageing process. If you would like support with managing your symptoms, do book in for a consultation – we would love to help.