Seeing red? A Kind, Balanced Guide to Managing Rosacea

Today, we’re exploring a common yet often misunderstood skin condition: rosacea.

If you're dealing with persistent redness, flushing that feels like a sudden internal furnace, and little red bumps that make you think, "Is this acne? What gives?!" I see you, and I understand how frustrating it can be.

The good news? While rosacea is a chronic condition, it is incredibly manageable when you understand what it is and how to work with your skin, not against it.

Rosacea may be a part of your story, but it doesn't define it. Read on as we delve into the intricate relationship between Rosacea triggers, the crucial connection between gut health and skin, and the gentle yet effective ways to restore your skin's narrative. 

What Is Rosacea?  

Rosacea is a chronic, long-term inflammatory condition that primarily affects the central part of the face (cheeks, nose, chin, and forehead). It involves a breakdown in the skin's defence systems and blood vessel regulation.

It typically manifests in different ways, with 4 main types:

• Erythematotelangiectatic Rosacea (ETR): Features flushing and persistent redness with visible blood vessels. 
• Papulopustular Rosacea (most common) Characterised by acne-like breakouts, making it often mistaken for acne. 
• Phymatous Rosacea: This thickens skin, particularly around the nose, resulting in a bumpy texture. 
• Ocular Rosacea: Irritates the eyes, redness, and swollen eyelids. 

What Is The Cause Of Rosacea? 

We don't know the exact single cause of rosacea, but we know it involves genetics, an overactive immune response, inflammation, and blood vessel reactivity. Our skin has a complex microbiome filled with microscopic organisms. One likely culprit is a type of mite called Demodex, which can be found living harmlessly in our skin. Studies confirm that many rosacea sufferers have an overabundance of these little guys, yet whether this is the cause of rosacea or a result of it is still unknown.

What we do know very well are the triggers: the things likely to cause a flare-up:

• Heat: Hot drinks, hot baths/showers, saunas, and intense exercise.
• Weather: Sun exposure (a major one!), wind, and extreme cold.
• Diet: Spicy foods, alcohol (especially red wine), and sometimes chocolate or cheese.
• Emotion: Stress, anxiety, and sudden strong emotions.
• Skincare: Harsh cleansers, scrubs, abrasive tools, and fragranced products.

Recognising and avoiding these food and non-food triggers is crucial in managing rosacea symptoms, offering a starting point for those seeking to minimise flare-ups. 

Your GP or Dermatologists can prescribe topical treatment to reduce the aforementioned demodex mite population, which may help control flare-ups in the short term. Many of my clients have seen success with the use of topical ivermectin (brand name Soolantra) prescribed by their medical professional.

The Gut-Skin Link

Research has also shown links between rosacea and gut health issues, such as celiac disease, irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), small intestine bacterial overgrowth (SIBO) and most notably Helicobacter pylori infection. Remarkably, addressing these gut conditions can significantly improve Rosacea symptoms, highlighting the importance of a holistic approach to treatment that includes evaluating and treating underlying gut health issues. Some studies suggest that over 70% of those with Rosacea have a Helicobacter Pylori (H. Pylori) infection, and treating the infection can lead to Rosacea going into remission. So if your Rosacea is persistent, it may be worth consulting your healthcare professional about H. Pylori testing.

Can diet changes help?

A diverse gut microbiome enhances the immune system and reduces inflammation, which is particularly crucial for individuals with rosacea. Eating a wide range of fruit and vegetables, nuts, seeds, grains, and legumes can promote a balanced gut microbiome.  While probiotics can benefit gut health, they may exacerbate rosacea symptoms in individuals sensitive to histamine. Professional guidance is essential when exploring probiotics as part of rosacea management. 

An anti-inflammatory diet rich in omega-3 fatty acids and low in omega-6 fats has also been shown to alleviate rosacea symptoms in some people, including reducing dry eyes. Furthermore, a low histamine diet may benefit some individuals with rosacea. However, such a diet should be navigated with the help of a specialist to avoid unnecessary restrictions and ensure gut health is not compromised. 

Consulting with healthcare professionals and naturopaths is crucial for long-term success in managing rosacea. They can guide you through addressing potential gut issues significantly affecting the condition's manifestation.  

How can a Dermal Therapist help?

As your Dermal Therapist, my focus is always on calming inflammation, strengthening your skin barrier, and providing a long-term maintenance plan.

• Clinical Treatments:
• LED Light Therapy for its anti-inflammatory, redness-reducing properties, and skin barrier strengthening. 
• Skin Needling: Done correctly, this treatment can help strengthen the skin and stimulate healthy vascular changes
• Referral for Vascular Lasers: I can prepare your skin and refer you on to have safe, professional laser treatments. Laser can target and reduce the visible blood vessels, dramatically reducing the overall red appearance.
• Product Recommendation: I help you become a skin detective. We identify and eliminate your personal triggers and build a simple, effective routine based on non-irritating, barrier-supporting ingredients like:
• Azelaic Acid: Excellent for both redness and bumps, as it is anti-inflammatory and mildly exfoliating.
• Niacinamide: Helps strengthen the skin barrier and reduce overall reactivity.
• Broad-Spectrum Mineral Sunscreen: Essential every single day to prevent UV rays from causing damage and triggering a flare.

Example of product recommendation: In the morning, I recommend skipping the cleanser and starting with a soothing and strengthening serum, such as the Epicure Recovery Serum. followed by Epicure Soothing Hydrator and, as always, finished with a broad-spectrum sunscreen like Airyday Pretty in Zinc to protect sensitive skin from sun damage. 

In the evening, my go-to gentle cleanser recommendation is Cereve Hydrating Cleanser, with its low-irritant formula and soothing and moisturising ingredients to cleanse without stripping the skin. I recommend following with Epicure Oil Control Hydrator, followed by a layer of Azclear Medicated Lotion (build up use slowly) on top.   

Once rosacea symptoms are under control, carefully adding Vitamin A and C to your regimen can offer additional benefits, including improved skin texture and tone. However, these potent ingredients should be introduced slowly and under the guidance of a skincare professional to avoid exacerbating rosacea symptoms. 

What about makeup? Can I cover it up?

Makeup is a trigger that Rosacea sufferers know all too well, but CC8 Cream by Issada is a fantastic alternative that offers light daily coverage and therapeutic benefits, helping to conceal redness while supporting skin health. Or for fuller coverage, I love 1Skin Natural Fusion Treatment Foundation. Investments like these can support your skin throughout the day and boost your confidence, knowing you can apply makeup without running the risk of a flare-up later that day.  

As always, for personalised advice and individualised care for your skin, a skin consultation is recommended.

Remember, you're not alone on this journey. Seeking guidance from medical professionals such as your GP, dermatologist and naturopath alongside your Dermal Therapist for personalised support will help you navigate the challenges of rosacea with informed, compassionate care.