Everything you need to know if you think you might be suffering
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?
April is Rosacea Awareness Month, so we spoke to an expert and a sufferer 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.
‘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.’
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.
‘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.’
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.’