Rosacea is a common chronic, relapsing inflammatory skin condition affecting the central areas of the face (cheeks, chin, nose, central forehead). It used to be referred to as “acne rosacea”. It affects three times more women compared to men with the peak age of onset between 30yr-60yr.
What does Rosacea look like?
Although symptoms of rosacea can occur at any age, it is more common in those 30-60 years old. Symptoms may be intermittent or persistent and can cause redness of the cheeks, nose, chin and central forehead. There can be flushing, swollen bumps and small visible “spider veins”. In some, the nose becomes enlarged and bulbous looking due to enlarged sebaceous glands, mainly affecting men. Some people get eye symptoms, such as bilateral sensation of a foreign body, inflammation of the eyelids and stinging/burning of the eyes (ocular rosacea).
What causes rosacea?
There’s still some uncertainty regarding the exact cause of Rosacea. It is thought to be linked to multiple factors including genetics, environmental factors as well as dysregulation of the immune system and can also be linked to the helicobacter pylori infection. It is more prevalent in mature women who are fair skinned, particularly those with Fitzpatrick skin types 1-3. It can be exacerbated by hot/spicy foods, caffeine, smoking, alcohol, emotional stress, hot drinks, cold temperatures, and aerobic exercise. Many people have undiagnosed rosacea.
How do you diagnose rosacea?
There are no tests to diagnose rosacea. The diagnosis is made based on the clinical picture after a consultation involving an assessment of your skin and a detailed history of your symptoms. The erythema (redness) should have been present for at least 3 months. The NICE Guidelines on Rosacea state that diagnosis should include at least one of the following “diagnostic” features OR two of the “major” features:
Diagnostic features: phymatous changes (skin thickening, irregular /nodular surface of nose, chin, forehead), persistent erythema (redness of skin)
Major features: flushing/transient erythema, papules and pustules, telangiectasia (spider veins – dilated or broken blood vessels near the skin surface, they whiten when pressed), eye symptoms (ocular rosacea).
Minor features: burning or stinging sensation, dry skin, oedema (swelling)
How do you manage rosacea?
Management is based on the type of presenting features. It is helpful to keep a diary of trigger factors and then avoid these triggers (e.g. sun, alcohol, spicy food, caffeine, emotional stress)
Maintaining a healthy intact skin barrier is one of the key aspects of management. Skin is the body’s first line defence to the elements such as pollution, toxins and dehydration. A good barrier moisturiser such as Obagi Hydrate or Obagi Hydrate Luxe, both give long lasting moisture control (up to 8 hours) and reduce trans epithelial water loss. Keeping your skin barrier healthy will give you radiant, smooth, plumped skin that feels soft to the touch. Well moisturised skin also helps reduce rosacea exacerbations by 50%
Whilst sunshine can help conditions such as psoriasis, it exacerbates rosacea and should be avoided. Wearing good quality high SPF suncream such as the Obagi Sunshield Matte SPF50 broad spectrum sunscreen every day is essential in managing this condition.
Obagi Repair Foundation Kit containing Obagi NuDerm Gentle Cleanser, Obagi Hydrate and Obagi Sunshield Matte SPF50 make an ideal trio to tackle the redness and inflammation associated with rosacea.
For those on a tighter budget, the Thoclor GF2 “miracle mist” containing Hypochlorous acid, the innate immune molecule, can be used twice daily to tackle the inflammation and bring rosacea under control. Check out Luceo Aesthetics social media pages to see some amazing before/after pictures using Thoclor GF2 spray. Check out Thoclor Labs Instagram https://instagram.com/thoclorlabs?igshid=YmMyMTA2M2Y= for more information on this amazing spray, that is easy and safe to use.
Helicobacter Pylori (H Pylori) can stimulate the immune system to produce inflammatory mediators leading to rosacea. This common gut infection can easily be detected with a simple test and if this is positive, it can be treated with antibiotics. Treating gut symptoms can impact on improving your skin health.
Rosacea that is not responding to good restorative skincare may need topical prescription creams or even oral antibiotics to help bring it under control. This may include topical brimonidine for persistent erythema, topical ivermectin for mild-to-moderate papules/pustules, and the addition of oral doxycycline for moderate-to-severe papules/pustules. For severe telangiectasia (spider veins) that do not respond to topical treatments, intense pulse laser may be recommended.
A great source for further information is The British Skin Foundation - www.britishskinfoundation.org.uk
If you would like to discuss your skin concerns, contact us to arrange your personal consultation with our aesthetic nurse prescriber.
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