What is Rosacea?
Rosacea is a relatively common skin disorder in adults between the ages of 30 and 50, with women being affected about three times as often as men, but men seem to more severely affected.
Rosacea is a chronic acne-like eruption on the face of middle-aged and older adults associated with facial flushing. The primary involvement occurs over the flushed areas of the cheeks and nose. Most cases are associated with moderate to severe seborrhoea (excess flow of sebum).
Rosacea is not considered an infectious disease, and there is no evidence that it can be spread by contact with the skin or through inhaling airborne bacteria.
What causes / triggers Rosacea?
Many factors have been suspected of causing Rosacea – alcoholism, menopausal flushing, local infection, B-vitamin deficiencies and gastrointestinal disorders. According to another survey, some of the most common Rosacea triggers include sun exposure, emotional stress, hot or cold weather, wind, alcohol, spicy foods, heavy exercise, hot baths, heated beverages and certain skincare products.
The majority of Rosacea sufferers believe that personal trigger factors are identifiable, and avoiding those factors reduces flare-ups. Although there is no data available on how quickly a Rosacea trigger may lead to a flare-up, the time is likely to vary depending on the individual and the nature of the trigger. Monitoring your individual case will show how quickly the response time is. Not every trigger affects any individual every time.
Allergies may cause an altered reaction of the body that includes flushing, which frequently triggers Rosacea symptoms. As with more common Rosacea triggers, identifying and avoiding allergens may help control the Rosacea.
The exact cause is unknown, although several theories exist. One theory of Rosacea’s origin is that the disease may be a component of a more generalized disorder of the blood vessels, which could explain why Rosacea sufferers have a tendency to flush. Other theories include the possibility of a malfunction of the connective tissue under the skin. Gastric analysis of Rosacea patients has led to the postulate that it is the result of reduced gastric acid output. Psychological factors i.e. worry, depression, stress etc. often reduce gastric acidity. Hydrochloric acid supplementation results in marked improvement in these Rosacea patients who have insufficient hydrochloric acid secretion.
The high incidence of migraine headaches in individuals with Rosacea points to food intolerance.
Although no scientific research has been performed on Rosacea and heredity, there is evidence that suggests Rosacea may be inherited. Nearly forty percent of a survey sample said that they could name a relative who had similar symptoms. In addition, there are strong signs that ethnicity is a factor in one’s potential to develop Rosacea. Irish and English heritage is most implicated, along with Scandinavian, Scottish, Welsh or European descendents.
It is sometimes possible to identify “pre-Rosacea” in teenagers and persons in their early twenties. These individuals generally come to a dermatologist for acne treatment and exhibit flushing and blushing episodes that last longer than normal. The prolonged redness usually appears over the cheeks, chin, nose or forehead. These patients also may find topical acne medications or certain skincare products irritating. Once identified, these Rosacea-prone individuals can be advised to avoid aggravating lifestyle and environmental factors known to cause repeated flushing reactions that may lead to full-blown Rosacea.
There are no histological, serological or other diagnostic tests for Rosacea. A diagnosis of Rosacea comes after a thorough examination of your signs and symptoms and a medical history. Issues such as redness, flushing, the appearance of bumps or pimples, swelling, burning, itching or stinging should be discussed.
Facial burning, stinging and itching are commonly reported by many Rosacea patients. Certain Rosacea sufferers may also experience some swelling in the face that may become noticeable as early as the initial stage of the disease. The same flushing that brings on Rosacea’s redness can be associated with a buildup of fluid in the tissues of the face. It often occurs above the creases from the nose to each side of the mouth, and can cause a “baggy cheek” appearance. It is also believed that in some patients this swelling process may contribute to the development of excess tissue on the nose causing it to become bulbous and bumpy.
Rosacea can present itself in different ways for different individuals. Rosacea patients may exhibit varying levels of severity of symptoms over different areas of the face. Patients have often reported that the disorder actually began with a red spot or patch on one cheek or another part of the face, and then spread to other areas. On the other hand, many Rosacea patients exhibit similar symptoms on both sides of their faces.
Visible blood vessels sometimes develop with Rosacea and were likely always there, but were hidden or less noticeable because of the redness. Once medication has diminished the redness, it is not uncommon for spider veins to become more noticeable. These can be camouflaged with makeup, or removed with a vascular laser or other medical devices.
Rosacea and Acne
Rosacea and regular acne usually appear separately, but some patients will be affected by both. While both conditions in adults are often informally referred to as “adult acne”, they are two separate diseases, each requiring different therapy. Rosacea seems to be linked to the vascular network of the central facial skin and causes redness, bumps, pimples and other symptoms that rarely go beyond the face. Care needs to be taken, because some acne (Vulgaris) treatments can make Rosacea worse.
Tips to help manage Rosacea
There is no way to predict for certain how an individual’s Rosacea will progress, although it has been observed that the signs and symptoms tend to become increasingly severe without treatment. Moreover, in a recent survey, about half of Rosacea sufferers said without treatment their condition had advanced from early to middle stage within a year. Fortunately, compliance with medical and lifestyle modifications to avoid Rosacea triggers has been shown to control its signs and symptoms on a long-term basis.
- Dietary: avoid coffee, alcohol, hot beverages, spicy foods and any other food or drink which causes a flush.
- Supplementation: B-group vitamins (with minimal vitamin B3), hydrochloric acid supplements and pancreatic enzymes are essential.
- Antibiotics doesn’t address the root of the cause: The effectiveness of antibiotics against Rosacea symptoms is widely believed to be due to their anti-inflammatory effect, rather than their ability to destroy bacteria.
In all of these considerations, it must be remembered that Rosacea is a chronic disorder, rather than a short-term condition, and is often characterized by relapses and remissions.
A retrospective study of 48 previously diagnosed Rosacea patients found that 52 per cent still had active Rosacea, with an average ongoing duration of 13 years. The remaining 48 per cent had cleared, and the average duration of their Rosacea had been nine years. While at present there is no cure for Rosacea, its symptoms can usually be controlled with medical therapy and lifestyle modifications. Moreover, studies have shown that Rosacea patients who continue therapy for the long term are less likely to experience a recurrence of symptoms.
Recommended skincare routine for Rosacea
There is no standard skin type for Rosacea patients. Many sufferers experience dry, flaky skin while others may have normal or oily skin or both. The key is to identify your skin type and select the Botáni products which are best for you.
Rosacea and Dry Skin
It has been estimated that approximately half of all Rosacea sufferers may appear to experience dry skin. With treatment, this dryness often eases along with the disappearance of papules and pustules. To combat dry, flaky skin, use a moisturiser daily after cleansing.
Rosacea and Dermatitis
It is not unusual for seborrheic dermatitis to appear concurrently with Rosacea. Seborrhea manifests as reddish-yellow greasy scaling in the central third of the face. Scalp, eyebrows and beard may have fine flakes of white scale, dandruff or patches of thicker, greasy yellow scale. Eruptions may also appear beyond the face.
Rosacea and Eczema
Nothing in medical literature links Rosacea and atopic eczema. The two diseases may share some common symptoms, but may also have many differences. Rosacea is more common in fair-skinned individuals and nearly always affects the face only, causing such signs and symptoms as redness, visible blood vessels, bumps and pimples and sometimes swelling of the nose from excess tissue. Atopic eczema is more common in individuals with dry skin and can appear in various areas of the body, producing red scaling and crusted or weeping pustules that itch fiercely.