What is Rosacea?

Rosacea is a common skin condition that primarily affects middle-aged individuals and people with fair skin. While the exact cause is unknown, it’s believed to result from a combination of genetic factors, environmental influences, and an overgrowth of Demodex mites. These tiny creatures live in our hair follicles, and although they’re present in everyone, people with rosacea are thought to be more sensitive to them. This sensitivity can trigger skin inflammation, leading to redness and flushing.

What Triggers Rosacea?

Several factors can trigger rosacea flare-ups, with the most common being direct sunlight. That’s why it’s essential to wear sunscreen regularly to help prevent rosacea. Other common triggers include caffeine, alcohol, spicy foods, and even exercise—essentially anything that dilates the blood vessels beneath your skin can worsen rosacea symptoms.

Types of Rosacea

Rosacea has different subtypes, and it’s important to understand them, as each type may require different treatment options. Let’s break them down:

1. Erythematotelangiectatic Rosacea (Vascular Rosacea):

• This type causes redness, flushing, and visible dilated blood vessels (telangiectasia).
• Initially, flushing may be temporary, but it can become permanent over time.

2. Papulopustular Rosacea (Inflammatory Rosacea):

• This subtype is marked by red, angry-looking bumps called papules and pustules.

• It often resembles acne, but unlike acne, rosacea doesn’t have blackheads or whiteheads.

  How to differentiate rosacea from acne:

• Rosacea triggers, like sunlight, don’t typically affect acne.
• Rosacea lesions are mostly found on the central face (forehead, cheeks, nose, and chin), while acne may appear on the temples or jawline.

3. Ocular Rosacea:

• This affects the eyes, causing symptoms like burning, itching, and grittiness.
• If left untreated, it can lead to permanent eye damage, so it’s important to seek help early.

4. Phymatous Rosacea (Rhinophyma):

• This subtype causes thickening of the skin, particularly on the nose, leading to deformities.
• It’s challenging to treat with creams or gels, and more aggressive treatments like laser therapy or surgery may be necessary.

Managing Rosacea

Managing rosacea involves identifying and avoiding triggers, as well as following a good skincare routine. Here are some tips:

1. Keep a Diary

• Track anything that worsens your rosacea so you can gradually limit or avoid triggers one at a time.
• For example, if spicy food triggers your rosacea but you love it, you don’t need to avoid it entirely. Instead, you might try limiting how often you eat it.

2. Sun Protection

• Wear a broad-spectrum sunscreen every day, as sunlight is the most common trigger for rosacea.

3. Gentle Skincare

• Use non-fragrance, non-comedogenic (won’t clog pores) cleansers and moisturizers. Look for products with a pH similar to your skin, around 4 to 5, instead of harsh soaps.
• Example: CeraVe Hydrating Facial Cleanser.

4. Keep Your Routine Simple

• Avoid toners, as they can strip the skin of natural oils and worsen inflammation.
• Stick to a basic skincare routine with gentle, hydrating products.

Treatments for Rosacea

For Erythematotelangiectatic Rosacea:

• A common topical treatment in the UK is MovaSo Gel, which contains brimonidine (0.03%) to reduce redness and flushing. Use it once a day.
• Oral propranolol is another option to shrink dilated blood vessels, but it’s only prescribed in severe cases due to potential side effects.

For Papulopustular Rosacea:

• Topical treatments, such as Ivermectin cream (brand name: Soolantra), Metronidazole gel (brand name: Rozex), and Azelaic acid (brand name: Finacea), are effective for mild to moderate symptoms.
• If rosacea is severe, oral antibiotics like Lymecycline or Doxycycline may be used to reduce inflammation.

For Severe or Persistent Rosacea:

• If topical and oral treatments aren’t effective, low-dose Isotretinoin (similar to Roaccutane for acne) may be considered.
• For the phymatous subtype, laser treatments or surgery may be needed to reduce tissue thickening.

For Ocular Rosacea:

• Keep your eyelids clean by gently wiping them with cotton wool soaked in warm water. If necessary, use baby shampoo to clean the eyelids.
• Lubricating eye drops without preservatives can help keep your eyes moisturized.

Camouflage and Support

If rosacea causes psychological distress or visible symptoms, camouflage makeup can help correct redness. Green-tinted makeup bases can balance out redness, and some charities, like Changing Faces, offer camouflage services.

While rosacea isn’t life-threatening, it can significantly affect your confidence and quality of life. If you’re dealing with rosacea or any skin condition, don’t suffer in silence. Reach out for support from healthcare professionals or online communities.