Rosacea: Cause and treatment

Generally speaking, rosacea starts out as a reddening of the face. Depending on its severity, it can also lead to small, raised spots, blisters, and burning and itchy skin on your face. Rosacea is a chronic skin condition and those suffering from it will experience flare-ups, with typical characteristics including redness and enlarged blood vessels.

The condition mostly affects the face but the inflammation can also affect the eyes, scalp, neck and chest. A rosacea flare-up comes on very suddenly and the severity of the flare-up will depend on how severe the condition is. 

Rosacea is split into three levels of severity:

• Level 1 – Erythematotelangiectatic rosacea:
  The skin is permanently reddened, with visibly enlarged blood vessels (couperose). The skin on the face is also very dry, itchy and can be flaky.
• Level 2 – Rosacea papulopustulosa
  The permanent reddening of the first stage is accompanied by papules and pustules; rosacea papulopustulosa is often mistaken for acne, though the skin does not have any spots.
• Level 3 – hypertrophic Rosacea
  In the third stage, alongside the symptoms mentioned above, there are also growths on the connective tissue and sebaceous glands on the nose, forehead, chin, ears and eyelids – these usually appear more commonly in men over the age of 50.

The cause of rosacea is still unclear. Some theorise that the condition is caused by a genetic predisposition and a weakened immune system. However, what is clear is that a combination of certain triggers can spark a rosacea flare-up. These include:

• Diet: there are certain foods that should be avoided if you have rosacea. But what are they? In particular, you should avoid spicy, very hot and fatty foods, tomatoes, citrus fruits, liver, egg and dairy products, coffee, black tea, and alcohol, especially red wine.
  Doctors recommend that those with rosacea follow a basic diet that is low in histamines and inflammatory foods
• Stress
• Nicotine
• Hot baths and trips to the sauna
• Temperature fluctuations
• Cosmetic products that irritate the skin and contain, for example, menthol, parabens, sulphates, perfumes, fruit acids, alcohol or essential oils
• Mites: researchers have discovered that hair follicle mites can also trigger a flare-up. It is normal for these mites to be found on the skin, but those with rosacea have excessive numbers of them. Their skin reacts to this and produces antibodies that fight the mites. This then generates an inflammatory reaction on the skin surface
• Intestinal effects: those with rosacea often also suffer from intestinal problems. For this reason, it is important that they ensure they have healthy intestinal flora and that they strengthen these with probiotics
• UV radiation from the sun

Since the exact cause of rosacea is still unknown, there is no effective way of treating it. However, we do know what triggers can exacerbate rosacea. A first step, then, is to avoid these triggers (see the section ‘Rosacea: what causes this condition?’). Those with rosacea may find it helpful to keep a symptom diary to identify their personal triggers.

Other important actions are:

Creams for rosacea

We know that unusually high numbers of mites on the skin can trigger a rosacea flare-up. Certain creams containing antibiotics (such as metronidazole) have proven to be effective because they kill off the mites and therefore reduce the inflammation. Special gels containing azelaic acid are also effective for rosacea. Plus, there are now a number of cosmetic products that have been specially developed for those with rosacea. They can mostly be found in pharmacies.  

Treating rosacea naturally

Certain home remedies can help alleviate the redness caused by rosacea. Thanks to their anti-inflammatory properties, applying a camomile, honey or aloe vera cold compress can help calm irritated skin.

Laser treatment for rosacea?

Existing enlarged blood vessels (couperose) can be removed with laser treatment but since rosacea is a chronic skin condition, these may reappear over time.

Rosacea can be kept under control with the right diet, good sun protection and by avoiding certain triggers. Rely on using a high-factor sun cream every day, cosmetics for sensitive skin and an alkaline diet.