The complete guide to rosacea, from causes to managing flare-ups

Everything you need to know about the common skin condition

Controlling skin flare-ups and covering up redness can feel like a constant battle, and with a rise in pollution and environmental aggressors, rosacea has never been more prominent.

According to the NHS, it’s estimated that as many as one in 10 people in the UK have rosacea – so what causes it and, more importantly, can it be treated? We spoke to an expert and a couple of rosacea bloggers to get the lowdown on how it works, from its triggers to how it can be managed.

What is rosacea?

‘Rosacea is a dermatological condition that affects between 0.5-10% of the population,’ says Daniel Isaacs, Formulation and Development Director at Medik8. ‘It’s a chronic inflammatory condition that causes the skin to redden around the centre of the face. The reddening is also referred to as erythema amongst dermatologists and skincare professionals.’

Unlike eczema, rosacea doesn’t cause any itching or dry skin, but it can be very sore. ‘Those suffering with rosacea will often experience flushed skin flare-ups, along with other symptoms such as spider veins (broken blood vessels that are visible through the skin),’ Daniel adds. ‘The complexion will often be sore and inflamed with a thicker skin texture, and red, raised bumps may be present as well.

‘Rosacea comes hand in hand with sensitive skin and eyes, and often people with rosacea will easily flush.’

What causes rosacea?

‘The cause of rosacea is not completely understood, but there are many contributing factors; an impaired skin barrier can allow irritants to enter the skin, causing inflammation, and free radical damage can also play a part in intensifying inflammation,’ Daniel explains. ‘That’s why we advise those with rosacea to implement daily sun protection as well as anti-pollution skincare in their regimes.

‘Abnormalities in blood flow through facial blood vessels can cause flushing and persistent redness, and having a family member with rosacea may also make you more prone to developing the condition. Rosacea has also been linked to certain bacteria found in the gut, which may play a role in developing the condition.

‘Many factors can aggravate the symptoms of rosacea by increasing blood flow to the surface of the skin. For instance hot food and drinks, spicy foods, caffeine, temperature extremes, stress, medications and alcohol can all play their part in the symptoms of rosacea.’

Lex Gillies, 33, was diagnosed with rosacea when she was 21. She blogs about skincare and nail art as Talonted Lex and is a British Skin Foundation ambassador for rosacea. ‘Over time, I have identified most of my triggers and learned to remove them or minimise them as much as possible, which is often easier said than done!,’ she says.

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❌When you look in the mirror, what do you see?❌ . Today I filmed with @bbc5live, talking about #rosacea and how it has affected my life. The stress of being on camera without make up resulted in this pretty severe flare up, which I'm still wrestling with hours later. I was diagnosed over 12 years ago and although I am in a much better place (physically and mentally) than I was when first diagnosed, I was reminded today that my self confidence still needs work. I've got skincare, diet etc nailed but I'd love to hear your tips on self love: any books or podcasts that have helped you; great courses; or words of advice. Feel free to tag other people who might find these recommendations useful, hopefully we can all help each other. 2018 is the year of being much kinder to myself 💕 #talontedlexrosacea . . . . . #rosaceasucks #rosaceajourney #rosaceaproblems #sensitiveskin #sensitiveskinproblems #redface #redfacesquad #flareup #flareupssuck #myskin #nomakeupday #nomakeupselfie #barefaced #bareface #30plusblogs #skincondition #skinconfidence #selflovefirst

A post shared by Lex Gillies – Rosacea/Beauty (@talontedlex) on

‘My main trigger is definitely stress, and although I’ve made some changes to reduce my stress levels – including leaving a very intense job – some stress is unavoidable.

‘My other triggers are common ones,’ she adds, ‘extremes of temperature – hot showers, the hairdryer – the sun, air conditioning, alcohol, hot drinks, and certain skincare ingredients. It was a long process to isolate what makes my skin unhappy, and was hard to accept such a drastic change in lifestyle.

‘At times it felt insurmountable, but I’ve found a great balance with my rosacea. If I want a huge plate of cheese or a glass of wine after a bad day, I’ll weigh up that need against how my skin will react; sometimes it’s worth it, sometimes it’s not. But once you know your skin better, it gives you the control to choose how you deal with it.’

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✨PONY TAILS & TALL TALES✨ . I'm currently rocking the pyjamas/hair pineapple/no make up look (Fridayyyyyy I could KISS you!) but here's a photo from Monday where I scrubbed up okay… 👀 I used the new SS18 lip products from @goshuk and they are 😍 . BASE ✌️ @iconic.london Retexturising Face Primer ✌️ @lorealmakeup Age Perfect foundation '130' ✌️ @narsissist Creamy Concealer 'Vanilla' ✌️ @itcosmetics Bye Bye Pores loose powder ✌️ @bobbibrownuk Pot Rouge 'Rose' ✌️ @maybelline Master Studio Strobing Stick ✌️ @toofaced Hangover 3-in-1 setting spray . EYES ✌️ @toofaced Sweet Peach eyeshadow palette ✌️ @goshuk Turn Me On mascara . BROWS ✌️ @miicosmetics Precision Brow Detailer 'Impeccably Blonde' . LIPS ✌️ @goshuk lip liner '016 The Red' ✌️ @goshuk Liquid Matte Lips '005 Red Carpet' . . . . . . #talontedlex #30plusblogs #lbloggeruk #lbloggersuk #redlip #redlippie #goshss18 #liquidlipsticks #matteredlips #tasselearrings #makeupisfun #bbloggersuk #bbloggeruk #glowyskin #floralfashion #boohoo #boohoofashion

A post shared by Lex Gillies – Rosacea/Beauty (@talontedlex) on

Are there rosacea treatments?

Unfortunately there’s no cure for rosacea, but there are some treatments to help reduce its prevalence.

‘Antibiotics are sometimes prescribed, as their anti-inflammatory properties can help to take down redness,’ Daniel tells us. ‘Specific skincare is often prescribed to rosacea patients, usually containing metronidazole, azelaic acid or vitamin A.

‘Some dermatologists will refer you for light-therapy, which uses laser pulses to remove visible blood vessels and reduce excess redness, but long term therapy is often required due to the chronic inflammatory nature of the condition. Treatments and their duration should be tailored towards each individual with the help of an experienced dermatologist.’

Rosacea and diet

For a lot of medical conditions, patients try to manage the symptoms with what they eat and drink – dairy and acne being a prime example. ‘Rosacea patients are advised to closely assess and identify lifestyle and environmental factors which could exacerbate redness, says Daniel. ‘In terms of diet, it is best to avoid spicy foods, hot drinks and alcohol which can naturally cause flushing.’

‘Diet has been a big change for me,’ says Lex. ‘I’ve mostly removed dairy from my diet as it has an instant effect on my skin. I’m gluten intolerant (along with a few other foods), and that intolerance often triggered my rosacea, so by removing these ingredients I’ve improved my skin.

Rosacea skincare

‘Skincare routines can either aggravate or soothe redness-prone skin. Using a soap-free, pH balanced cleanser helps to keep the skin’s protective barrier intact so as not to irritate the skin. Occlusive moisturisers can also help to restore this protective barrier to enhance the skin’s defences against the environment. High SPF sunscreens are also advised as the sun can aggravate the condition. It is also good to avoid irritating ingredients such as menthol, camphor, strong fragrances and sodium lauryl sulfate.’

When it comes to specific brands and products, Lex has her favourites that prove to be very effective. ‘Brands that I tend to go back to regularly are Avène and La Roche-Posay – the French really know their sensitive skincare!,’ she says. ‘In particular, Avène’s Tolérance Extrême range and La Roche-Posay’s Toleraine range are wonderfully gentle, but really work.’

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As you can see, my skin is not happy at the moment 😞 You would think it'd get easier to post pictures like this, but it doesn’t. Instagram always makes me feel as though I’m surrounded by perfection, which is hard when you feel imperfect. . For years I’ve used my blog to share advice on managing sensitive skin. Diet, lifestyle, mindfulness… it’s all important. But the step I’ve found most helpful – for both long-term management and short-term relief – is definitely skincare. I’m so excited to collaborate with @avene_uki – I’ve supported them ever since discovering them many years ago, and they’re one of the brands I always fall back on when my skin is unhappy. They have added 2 new products to their Anti-Rougeurs range (and left out the fragrance 🙌) and there’s a post up on the blog with a love letter to the mask shown in this image. Go and check it out! . ✨ COMPETITION✨ Want to win the 2 new Avène Anti-Rougeurs products? 💕 Comment below telling me your rosacea story: what you wish you'd known when you first developed rosacea; the tips and tricks that help you; the way rosacea makes you feel… whatever you want to share with me! 💕 If you'd like an extra entry to the competition, feel free to comment on my Avène blog post as well (clickable link in bio). . Unfortunately this competition is only open to UK & Ireland residents, but if you'd like to comment and share your rosacea story anyway I'd love to hear from you. I'm going to be sharing some quotes and stories on my channels to show that everyone's experience is different – the louder our voices, the more we learn about rosacea and its impact on us. If you want to post your own rosacea story here on Instagram, I’d love to see it so don’t forget to tag me and use the hashtag #MyRosaceaStory. The competition is open until 23.59 on the 5th of December. Good luck! AD

A post shared by Lex Gillies – Rosacea/Beauty (@talontedlex) on

The important thing to remember is that a diagnosis isn’t the end of the world. ‘At 21, it was very difficult to hear that I had an incurable skin condition and that if I was “serious about treating it”, I should give up alcohol, make-up, hair straighteners, sugar, junk food…’ says Lex.

‘I had a very unsympathetic GP who made me feel very vain and stupid for worrying about my skin – but the psychological effects of my rosacea have altered every part of my life, from my relationships to career and self-esteem.

‘One of the main reasons I talk about it so openly is to raise awareness of the condition; I hope that, by increasing public awareness, the act of showing my bare face to the world won’t be seen as “brave” anymore – that I’ll just be another face in the crowd.’

The best make-up products for rosacea

rosacea

Rose Gallagher @mixedgemsbeauty

‘Rosacea is something I’ve weirdly come to love because it has connected me with so many women!,’ Rose Gallagher, aka Mixed Gems Beauty, tells us. ‘By day, a distracting patter of redness in my skin that can drive me mad and make me feel self conscious.

‘But by night, it is something that leads me to have long and interesting conversations with other people that have rosacea who have fallen into my Instagram DMs amazed that I’ve had the balls to show my face make-up free.

‘Rosacea is definitely an emotive skin condition for me, and it impacts the way I see myself. But, I really enjoy delving into skincare and make-up, and find huge enjoyment in sourcing the best remedies in both. My friend Talonted Lex (above) has the most incredible blog about her rosacea experience that I would really encourage you to check out, complete with downloadable assets like checklists and diaries that will help you to track and manage your rosacea symptoms.

IT Cosmetics CC+ Crea SPF 5, £31, Cult Beauty

I became the UK and Ireland brand ambassador for IT Cosmetics simply because I didn’t shut up about how well this covered my rosacea… True story! Don’t be deceived by the name; this CC Cream offers a full spectrum of skincare, SPF 50 (crucial for rosacea prone skin) and a completely full coverage finish. What I love about this is that it still looks dewy even though it covers so well, so you don’t look like you’re wearing lots of make-up, you just look like you have clear skin.

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Lancôme Cream Blush Stick, £27, Fabled

rosacea products

Though you want to achieve coverage on areas of redness, it’s important to place blusher back into the complexion to add an instant well-lit glow. I love the Lancome Blush Sticks because they’re cream; you can press them gently into the skin rather than having to rub them. Rubbing is only going to make redness more prominent, so gently tapping this in with the fingers will achieve a radiant glow without lifting any coverage from the red areas.

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Becca Shimmering Skin Perfector Liquid Highlighter, £30, Space NK

rosacea makeup

‘Speaking of cream textures, this Becca illuminator is ideal for a textured skin. If you’ve had a bumpy rosacea breakout, a liquid will sit gently over any texture as opposed to a powder which may cling in places. This one is my favourite for unparalleled glow that doesn’t look or feel heavy on the skin but really catches the light in real life and in photos.’

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MAC Cosmetics Cream Colour Base in Hush, £19, Lookfantastic

rosacea makeup MAC

‘Hush is a peachy cream that simply gives a well lit complexion in one sweep. Press this into the cheekbones, temples, bridge of nose and forehead to add radiance to the skin and detract from any redness. It is my belief that everyone looks infinitely more radiant in Hush. Ultimately a highlighter, I feel like you can use this a little bit of everywhere to achieve a fresh skin look.’

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La Roche Posay Toleraine Ultra 8 Mist, £19.50, Lookfantastic

rosacea products

‘Not strictly a make-up item, but this mist from La Roche Posay will not only seal make-up in place, it will help to calm and soothe irritated skin. I use this before make-up, throughout my skincare routine, and to seal in a full face for the day. While you’re there, LRP are home to some of the simplest rosacea skincare heroes. Everything is simple, gentle and fuss-free.’

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Expert tips for dealing with rosacea

Facialist and rosacea sufferer Lisa Franklin has spent years researching the condition, and has come up with five tips to help manage flare ups:

1. Rose quartz facial tools, such as a roller or a Gua Sha, are ideal for skin conditions such as rosacea because they’re so cooling on the skin. They regulate the skin and help instantly calm any redness. For an extra cool hit, try popping them in the fridge for 15 minutes before you use it.
2. Look for nutrients in your diet that help strengthen the immune system and guard against inflammation. I love rosemary – it’s high in carnosolic acid, which helps combat free radicals (one of the main causes of DNA damage) and reduce rosacea flare ups
3. Maybe the most difficult one, but avoid touching your face too much. Cleanse with warm or tepid water and use cleansers and concealers developed for sensitive skin
4. Don’t forget your – you will need products that help limit exposure and protect against UV during a flare up. The fragile capillaries of rosacea sufferers can be easily damaged by UV, resulting in thread veins and reddened skin. Products rich in Vitamin B3 will also help protect from infrared, which has the same effect as UV rays.
5. The first product I created to help with my own rosacea was my Lisa Franklin Pro Effect Luminescent Base. It’s a mattifying serum that also primes skin for makeup. It contains both rose quartz and rosemary leaf extract to soothe, alongside diamond particles that reduce the appearance of redness and frankincense that reduces inflammation.

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