Rosacea

Rosacea affects more than 3 million Canadians, and unfortunately, research shows rosacea can significantly impact the emotional and social well-being of sufferers. Rosacea can range from mild to severe, and every person’s experience is different.

Rosacea is systemic, meaning it affects the whole body and can cause internal, as well as external, symptoms, and is categorized by erythema / red-flushing, broken capillaries & inflamed papule. Pustules may also be present. Some suffers also experience an itching or burning sensation in the skin.

Rosacea is accompanied by highly reactive and hyper-sensitive skin, so the treatment plans are very similar for both these conditions. Some common factors that both Rosacea and hyper-sensitive skins share include hyper-vascularity, impaired barrier function and exposure to excessive amounts of chronic inflammation. This can be through UV exposure, stress / emotions, hormones, and diet.

Rosacea is often misdiagnosed and mistreated as acne, because it shares similar characteristics such as papules and pustules. However they are different conditions and therefore require different treatment plans.

Types of Rosacea

As with acne, there are 4 different subtypes of Rosacea, used to determine the severity and symptoms of the condition.

Erythematotelangiectatic rosacea (Subtype 1)
Flushing and persistent redness. Visible blood vessels may also be present.

Papulopustular rosacea (Subtype 2)
Persistent redness, swelling, and acne-like breakouts.

Phymatous rosacea (Subtype 3)
Skin thickening and enlargement that is bumpy in texture, particularly around the nose.

Ocular rosacea (Subtype 4)
Red, irritated and watery eyes, possible swollen eyelids with a burning and stinging sensation. Possible blurred vision and photo-sensitive eyes.

Causes

Unfortunately, the cause of rosacea is unknown, but it could be due to a combination of hereditary and environmental factors. Rosacea is not caused by poor hygiene. Anyone can develop rosacea. Rosacea affects people in their mature ages between 30 and 60 years, is predominant for Fitzpatrick 1 and 2 types of skin and is more predominant on women, but on men is more severe. We also know that Rosacea sufferers tend to have a higher number of Demodex mites (that live on everyone’s skin) on their skin, compared to non-suffers. It is thought that this could trigger an abnormal immune response and promote inflammation within the skin. Although cause and effect have still not been determined.

Sun damage is also a factor as it affects the underlying connective tissue and dilation of the blood vessels. Studies have also shown that exposure to UV radiation led to the production of vascular endothelial growth factor (VEGF), a substance that has been linked to the development of visible blood vessels (telangiectasia).

As with acne, it is unlikely to be a single cause, but rather a collective of contributing factors.

Rosacea Triggers

As Rosacea is an inflammatory skin condition, it is important to reduce levels of chronic inflammation within the body. One of the key factors when managing this condition is to understand your ‘triggers’ i.e., the things that cause your facial redness. 

The trigger may be different for different people but common triggers include:

• Sun / UV Exposure
• Hot / Cold Weather
• Hot / Cold Water
• Wind
• Stress / Emotions
• Histamine-Rich / Releasing Foods
• Alcohol
• Extreme Exercise
• Medication

The good news about Rosacea is that with the correct treatment, diet, and lifestyle choices, and by identifying the triggers and a plan of elimination to avoid exposure to them and reduce low-level/chronic inflammation within the body, it can be managed effectively.