Rosacea is a chronic skin condition that affects the face of adults. Women are more prone to developing the disease than men are and the targeted age group is 30-40. However, there have been cases among young and old patients as well.
Symptoms can be observed on the patients’ cheeks, nose, forehead, and chin, but not around the mouth or the eyes. Initially, the skin is flushed and red and then a fixed erythema can be observed, accompanied by dilated capillaries (telangiectasia). Patients may also present papules, pustules, or plaques, but not comedones or seborrhea, as can be observed in acne.
Treating rosacea could prove to be quite challenging because recurrences are extremely common. Local care of the skin needs to be correlated with systemic treatment to get the best possible results. Let us tell you the main aspects of the disease so that you can get a better idea of how the skin condition can be managed correctly.
What Is Rosacea?
Rosacea is a common skin condition that mainly affects adult women, but that also occurs in men. The key symptom of the condition is reddened facial skin that looks like severe sunburn. It is commonly known as “acne rosacea” because patients present papules on their skin. However, this skin condition is actually quite different from acne and, as such, it requires a very different course of treatment.
What Causes Rosacea?
While rosacea has been linked to several pathogens and predisposing factors, the exact etiopathology of the disease has yet to be discovered. It seems that genetic and environmental factors play a key role in the development of the disease.
Scientists have suspected a connection between rosacea and the hair follicle mite, Demodex folliculorum, which is commonly present on human facial skin. Recent studies, however, have proven that there is no noteworthy link between the two.
The main focus of current rosacea research is the involvement of an antimicrobial peptide called cathelicidin in the development of the disease. This peptide determines inflammation and the dilatation of the blood vessels and it seems that rosacea patients express unusually high levels of the compound.
People who have a tendency to flush easily when they are exposed to sunlight and warmth, or when they have spicy food or alcohol seem to be particularly prone to developing the disease. Also, people with fair skin have higher chances of getting rosacea.
While a clear cause for the condition has not yet been discovered, it seems that there are some elements known to be able to determine the immediate onset of symptoms in rosacea patients. These are called triggers and include the following:
- Spicy Food
- Embarrassment or Other Strong Emotions
- Intense Physical Effort
As suggested by the name of the condition, rosacea determines the reddening of the skin. The condition only affects the face and particularly the checks, the nose, the center portion of the forehead, and the chin. Moreover, the fact that it does not affect the area around the eyes (with the exception of ocular rosacea) and the mouth plays an important role in the diagnostic process.
The main symptoms of the skin condition are as follows:
- Red facial skin in the mentioned areas;
- The tendency to blush extremely easily when exposed to common triggers;
- Red dilated veins in the affected areas (telangiectasia);
- Pimple-like lesions in the affected areas;
- Inflamed eyelids (blepharitis) and conjunctivitis – only in ocular rosacea;
- Exacerbated reddening and inflammation of the nose area (rhinophyma).
The Four Types of Rosacea
The vast majority of rosacea patients only experience the reddening of the skin and localized telangiectasia. However, there are four known types of rosacea that differ in symptomatology and development.
1. Erythematotelangiectatic Rosacea
The main symptoms of this form of rosacea are the flushing and the fixed erythema. The condition can evolve with or without the telangiectasia.
2. Papulopustular Rosacea
As the name suggests, this form of rosacea is characterized by the development of papules and pustules on the reddened areas of the face. The most affected areas are the cheeks.
3. Phymatous Rosacea
This type of rosacea is very different from the others. Its main symptom is a rhinophyma, which is the exacerbated growth of connective tissue and sebaceous glands in the nose region. As a result, the nose appears enlarged and red and this does not go away without corrective surgery. Extranasal sites have also been observed, but these cases are extremely rare.
4. Ocular Rosacea
This type of rosacea affects the eye region and it is extremely common. Up to 50% of patients of the skin condition manifest it at some point, but it quite frequently goes undiagnosed. It becomes problematic when complications arise, as these include blepharitis, conjunctivitis, and even keratitis.
Medical Treatment for Rosacea
One of the most common mistakes in treating rosacea is using topical steroids. While using strong topical anti-inflammatory medicine might appear to be the ideal treatment for the disease, it seems that long-term effects are quite dramatic. These include skin addiction, chronic redness, and extreme telangiectasia.
Moreover, the overuse of topical steroids on the face region for various dermatologic conditions can actually lead to the onset of “Iatrosacea” or “Topical Steroid-Induced Rosacea-Like Dermatitis” (TSIRD). This condition is similar to rosacea, but it is caused by the proliferation of Propionibacterium acnes and Demodex folliculorum, as a result of the use of topical steroids.
Instead of using topical steroids, the first line of treatment for rosacea is the use of oral antibiotics. The tetracycline family, erythromycin, and metronidazole have been proven to be particularly efficient in correcting the symptoms of the disease. The preferred treatment plan includes 10 week-long courses.
Oral antibiotics can be correlated with topical antibiotics, such as metronidazole gel, azelaic gel, and sulfacetamide/ sulfur gel. Rosacea patients are also advised to use sunscreen on a regular basis in order to protect their skin from the sun.
Rosacea Natural Treatment
If patients are reluctant to undergo a long-term treatment based on antibiotics, there are a few natural alternatives that they can opt for. Please note that these are only applicable to non-complicated cases. If patients present papules and pustules, then oral antibiotics should be the basis of their rosacea treatment.
These natural alternatives should always be prescribed by a dermatologist so as to avoid aggravating the symptoms. Moreover, it is advisable that they are used alongside the classic medical treatment, rather than alone.
A successful natural treatment for this skin condition should include three core elements: a rigorous skin care routine, a specialized diet that includes the most important nutrients for the skin, and healthy lifestyle choices.
Skin Care for Rosacea
Phytotherapy can prove to be extremely useful for treating the skin condition. Plant extracts can be administered both topically and internally, and there is a wide range of choices available. The most efficient ones are the following:
- Olive Leaf Extract – administered internally.
- Aloe Vera Extract – administered topically.
- Chamomile Tea – administered both internally and topically.
- Honey and Turmeric Face Masks.
- Green Tea – administered both internally and topically.
- Marigold Extract – administered topically.
The main idea behind a successful rosacea diet is that trigger-foods should be eliminated from the patient’s diet and replaced with food items that can nurture the skin. Abiding by a fixed diet is not necessary, but respecting the core principles might provide patients with noteworthy improvements.
Trigger-Foods to Avoid
Some foods could determine the onset of rosacea symptoms, so patients should try to avoid them at all costs. Here are the main categories:
- Foods that Cause Allergies – Patients should avoid consuming any foods that might cause them allergic reactions.
- Alcohol – This is one of the main triggers, so patients should eliminate it from their diet completely.
- Caffeine – While it might not appear so at first glance, caffeine can actually cause flushing and worsen rosacea symptoms.
- Fried Food and Trans Fats – Refined vegetable oils have a marked pro-inflammatory effect and, therefore, they should be avoided in order to improve skin conditions.
Healthy Foods to Include
The rosacea diet should mainly include foods that are rich in nutrients for the skin. These are the main categories that should be considered:
- Healthy Fats – Nuts, seeds, and olive oil are rich in essential fatty acids, and they should be included in the daily diet of patients.
- Anti-Inflammatory Foods – Ginger, onions, garlic, green tea, or turmeric are only some of the foods that have significant anti-inflammatory properties.
- Organic Fruit and Vegetables – These are rich in antioxidants, vitamins, and minerals and can, therefore, improve and support the development of healthy skin cells.
- Quality Protein – High-quality protein is necessary for the healthy development of the skin. Lean meat, eggs, and fish should be included in the diet for impressive results.
Learning to manage stress could have a striking effect on the evolution of skin disease. Stress is one of the main rosacea causes but in spite of this, its management is frequently omitted from the treatment plan.
Embarrassing or deeply emotional situations trigger flushing in patients and, therefore, learning how to cope with these events could lead to a significant improvement in symptoms. Patients need to be referred to psychologists, who can then collaborate with the dermatology specialists for the development of a long-term treatment plan.
Psychotherapy can be correlated with yoga and meditation for augmented results as patients could learn special stress release techniques such as breathing exercises, which they could apply when they are met with future stressful situations.