Rosacea is an underlying skin condition often termed ‘blushing’s evil twin’ by dermatologists, as it doesn’t fade away and only gets worse with time. “It’s a chronic inflammatory condition arising from external factors,” says Dr Maryam Zamani, an oculoplastic surgeon and aesthetic doctor based in London. “The numerous potential triggers can be anything from UV exposure, a hyperactive immune response, your genetics, any medication you might be taking, and even sex.” The symptoms? Excessive flushing of the skin, irritation, inflamed bumps and even sore, red eyes as well as persistent redness and broken blood vessels as the condition progresses.
How to treat rosacea: know your triggers
“In most cases, rosacea is hereditary, so you need prescription creams,” says Dr Stefanie Williams, Medical Director at Eudelo. “But triggers such as sun, spicy food, coffee and red wine may make it worse.” Which means that you can ease symptoms by identifying and avoiding those triggers. Begin recording your rosacea flare-ups in your diary: note what you ate, what you did, and what products you were using when your skin behaved badly. You should be able to recognize a pattern. If, for example, alcohol is the common denominator, try eliminating it for a month, and monitor how your skin responds.
The hidden enemy
It is not completely understood why rosacea affects some people and not others, though Professor Kevin Kavanagh, Biological & Biomedical Science Program Coordinator at Maynooth University, believes tiny critters may be partly responsible: minuscule eight-legged mites called Demodex, to be exact. Like other microbes, these mites normally inhabit the pores of the skin on our face, and healthy adults typically have around one or two mites per square centimeter of facial skin. People with rosacea, however, can have 10 times as many, and Kavanagh’s research suggests that those with rosacea react to the waste the mites produce, causing inflammation and redness.
As a result, rosacea can respond well to prescription antibacterial medication. Your doctor may offer topical metronidazole, azelaic acid or ivermectin, or oral antibiotics, which are also used to treat acne. Some aesthetic practitioners are also trialing intense pulsed light (IPL) to reduce Demodex numbers but, as yet, it hasn’t been proven as an effective treatment.
Protect your good bacteria
You can also take positive preventative action and strengthen your skin so that it is better able to tolerate a flare-up. A healthy microbiome (the body’s collective bacteria) is key for skin, and probiotics encourage healthy bacteria to thrive. Find them in fermented foods such as miso, sour pickles and yogurt, and supplement with probiotics such as OptiBac live cultures and Bodyism Ultra Probiotic.
And how about what you put on your face? Don’t overdo it, says Dr Williams: “Sufferers tend to use rich skincare as their skin feels dry. But this is often a sign of micro-inflammation, not dryness.” Instead, choose calming formulas rich in antioxidants, wash your hands before application, and make sure the lid is on tightly to prevent transferring bad bacteria.
“You should avoid high-lathering cleansing products to prevent skin from drying out,” warns Dr Zamani. “Also avoid sulphate, washcloths (that can physically aggravate the skin), toners, deodorant soaps, and anything with fragrance as they may make your sensitive skin even more so.” Instead, Zamani suggests using products containing ceramides, as “they help to lock in moisture.” Itchy and inflamed skin is notoriously unpredictable, so it’s best to steer clear of topical retinol products and peels containing AHAs like glycolic acid as they can aggravate further.
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