With this condition affecting around 1 in 10 people, Rosacea is a fairly common skin condition that many suffer with and can easily be misdiagnosed and/or sadly mismanaged. To find the best and most effective treatment plan, we need to first understand the condition intricately and determine it’s triggers, which can differ from person to person.

In this blog, let’s deep dive into what Rosacea is, how to identify the symptoms and triggers of it, and how to best manage the condition.

So, 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.

Typically, people suffering with rosacea will experience facial flushing and redness across their cheeks, nose and chin. Heat, discomfort, and sensitivity can too be felt. As the condition progresses, dilated blood vessels, pustules and blemishes can occur, leading some to mistake it for acne.

Overtime and if the condition is left unmanaged, it can result in enlarged pores, distorted tissue and in some cases, eye irritation.

Types of rosacea

There are five different sub-types of rosacea. These include:

Erythematotelangiectatic Rosacea (ETR)
Presents as: flushing, redness on the cheeks.
Telangiectasia
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.

What causes rosacea?

The exact cause of rosacea is still unknown, however, there are a number of factors believed to play a role in the development of the condition:

Genetics, especially those of fairer skins.
Environmental factors that cause stress to the skin and/or compromise the skin barrier function.
Sebaceous (oil) gland hyperactivity - this has an inflammatory effect on the skin.
A mite called demodex that lives on the skin – researchers have found that people with rosacea have more of these mites than others, however, more research is needed to determine.
A bug that causes infections in the intestines may play a role. This bug, H pylori, is common in people who have rosacea.
An immune system reaction to a bacterium called bacillus oleonious, which causes acne-like breakouts and the immune system to ‘overreact’.
Higher than normal amounts of protein called cathelicidin, which may lead to inflammation triggering redness and bumps.

Although the cause is unknown, there are a number of factors 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. Also, those with a family member that have rosacea and a hereditary link are susceptible to having the condition.

Did you know?

Whilst women are more likely to suffer with the condition, men can suffer with it too, and they tend to experience more stronger symptoms.

Know your triggers

When you’re experiencing a rosacea flare-up, your skin will flush or have a burning sensation. These episodes can be triggered by a number of factors, including:

Diet – i.e., alcohol, caffeine, spicy foods and high-histamine foods

The environment – cold climate, high temperatures and harsh sunlight, and changing environments (going from hot to cold quickly)

Medical conditions and some medications

Emotional influences, such as stress

Exercise – heat generated when we work out can exacerbate rosacea as the blood vessels dilate to cool the body down.

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 avoid a flare-up!

How to treat rosacea

There are a number of ways that we can treat rosacea, and this ranges from prescription and over the counter skin care, through to advanced treatments, and referrals to medical practitioners for medications.

Rosacea can be very tricky to treat – a lot of professionals serve to treat symptoms and just calm the skin. At MiSkin, we have a lot of experience treating rosacea and treat it daily in the clinic and we have a very different approach; we (gently) stimulate the skin and encourage it to work for itself and initiate repair.

With our treatments and skincare regime, our key goals are to:

Repair and strengthen the skin’s protective barrier
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
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)

Repairing and supporting the skin barrier function is incredibly vital and a key focus of ours. For us, it isn’t just about soothing and calming the skin though, it’s about getting to the root cause of the issue and preventing inflammation in order to minimise symptoms and avoid exacerbating the condition.

using the right skincare for rosacea

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 gentle exfoliation that enhances the skin’s natural enzyme activity. 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.

Avoid products that are perfumed or alcohol-based, and you 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 our repairing, hydrating and restoring facial Reverse Inflammageing, 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.

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?

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. However, oral medications, such as antibiotics, are a temporary relief – they don’t offer a long-term cure or management of rosacea.

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.

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 this is the number one objective when treating the skin.

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.(Even if staying indoors). Reapply sunscreen every two hours and when outside, be sure to wear a wide-brimmed hat and sunglasses and seek shade between 10 and 4pm, during those peak sunshine hours.

So, if you would like to learn more about rosacea, or wondering if you have this, feel free to get in touch with us today.

Managing rosacea