Rosacea triggers skin care

Can Rosacea Go into Remission?

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If you’ve been diagnosed with rosacea, most likely you’ve been living with its symptoms—perhaps for some time. You may be worried about how your disease will progress or if you’ll find relief. Although there isn’t yet a cure for rosacea, there is a lot you can do to control the disease. Many people find that with medical treatment and lifestyle changes, they’re able to reduce or eliminate symptoms.

Seek Treatment Early

If possible, start treatment as soon as you’re diagnosed. This is important even if your rosacea symptoms don’t bother you much. Getting help early on leads to better control of the disease. In fact, early treatment may actually help stop rosacea from progressing.

Identify Triggers

It’s common for people with rosacea to have periods of remission (having few if any symptoms) interrupted by disease flare-ups. A survey by the National Rosacea Society found that about half of people with rosacea have an outbreak or increase in symptoms at least once a month.

The good news is that you can greatly reduce the intensity and frequency of flare-ups by learning what causes them. Some triggers—like sun exposure, alcohol, and stress—are more common than others. But every person’s triggers are different.

To identify your personal triggers, keep a diary of day-to-day activities and symptoms. You can download a trigger diary from The National Rosacea Society. A new smartphone app called The Rosacea App is also available to help you zero in on the cause of your flare-ups.

Find (and Follow) the Right Treatment

Depending on your type of rosacea, there are many treatment options available to control it. And if you follow your treatment plan exactly as your doctor instructs, you increase your chance of staying in remission.

For example, people with ocular rosacea, whose eyelids are affected by the condition, may benefit from taking an oral antibiotic or steroid eye drops. After therapy, patients often remain symptom-free for months or even years if they wash their eyelids carefully.

Those who have the type of rosacea that causes bumps and pimples may be prescribed a combination of oral and topical medicine. Together, these therapies have been shown to reduce symptoms quickly. Once the disease is in remission, many people can stay symptom-free by continuing to apply the topical medication faithfully. In fact, one six-month study found that 77 percent of rosacea patients who continued long-term topical therapy stayed in remission. About 42 percent of those who didn’t follow the treatment plan had a relapse of symptoms.

In addition, laser light therapy is a fairly new treatment that can be combined with other types of therapies. It eliminates visible blood vessels, which reduces redness and flushing—some of the most difficult symptoms to treat. Laser treatment on blood vessels is permanent, although some people will eventually develop new blood vessels in their place. However, results can last quite some time. Some people report a reduction in redness and flushing for up to eight years after laser treatment.

Don’t Give Up

There are many advances in the treatment of rosacea, and new research continues to improve the outlook for those with the disease. The key to controlling your rosacea is to work closely with your doctor, identify and avoid your triggers, and follow your treatment plan.

The first thing you need to know about rosacea is that the condition is chronic. A chronic condition is one that persists for a number of years. Because there’s no known cure for rosacea, the condition may recur indefinitely. If you’ve been diagnosed with rosacea, your skin will always be prone to this condition. But once you’ve identified your rosacea triggers, you may be able to reduce the frequency of flare-ups and achieve remission.

Study Gives Hope to Rosacea Sufferers

The National Rosacea Society of the United States conducted a retrospective study of patients with an official diagnosis of rosacea. In 48% of cases, rosacea suffers no longer experienced active symptoms after nine years. The study also found that if lifestyle triggers were actively managed, patients were much less likely to experience recurrence.

So the good news is that while you might have active rosacea over a number of years, flare-ups can be managed through lifestyle changes.

How Long Does Rosacea Last?

You’ve learned that rosacea never truly disappears. However, an isolated rosacea flare-up can last anywhere from one day to one month. One week is the average duration of a flare-up.

A Critical Effort: Keeping a Rosacea Diary

There’s a wide range of rosacea triggers, from food intolerances to stress to inappropriate skincare. This is why it’s important to keep a rosacea diary.

Whenever you do experience a flare-up, make notes on your diet, skincare routine, and activities for the previous week. Continue this though the duration of your flare-up. Over the long term, this information can help you to understand:

  1. Your rosacea triggers

  2. Factors that help shorten flare-up duration

Through active management of these factors, flare-ups can be minimised or even prevented.

To begin with, the logging process may feel frustrating. But remember that each flare-up will help you learn what does and doesn’t work for your condition. While your approach will be one of trial and error in the short term, you’ll develop a tested lifestyle management plan in the long term.

For further advice on the lifestyle changes that can help control your rosacea, please consult your doctor.

For advice and skincare recommendations to help control and minimise your symptoms, you can contact our trained team of experts through our skincare recommendation form. Remember that Adore Beauty also has a dedicated shop section full of pre-selected products that are perfect for your rosacea-prone complexion.

Triggers could be causing your rosacea flare-ups

Hair spray on the face triggers rosacea in some people. Knowing your triggers and making some simple changes can dramatically reduce flare-ups. Rosacea makes the skin extremely sensitive. Because the skin is so sensitive, many things can cause rosacea to flare. Time spent in the sun can lead to unexpected flushing that lasts for hours. Any number of skin care products may cause your face to sting, burn, or itch for what seems an eternity.

Anything that causes your rosacea to flare is called a trigger. Sunlight and hairspray are common rosacea triggers. Other common triggers include heat, stress, alcohol, and spicy foods.

Triggers differ from person to person.

Important to know what triggers your rosacea

Rosacea flares are more than a minor inconvenience. Each time your skin flushes, it can stay red a little longer. Rosacea may start to appear on more of your skin. In some people, repeated flushing leads to skin that stays permanently red. Visible blood vessels may start to appear. Skin can thicken.

With repeated flushing, treatment can also become more difficult. Treatment that may have worked earlier is no longer effective. Your dermatologist may need to prescribe stronger medicine or talk with you about an in-office treatment like laser therapy.

Knowing what triggers your flare-ups and making some simple changes can help you:

  • Reduce flares

  • Get better results from treatment

  • Prevent rosacea from worsening

This is why dermatologists often ask patients to find their triggers before beginning treatment. Even when treating rosacea, triggers can cause rosacea flare-ups.

You can find your own rosacea triggers by using the following 3-step process.

Step 1: Discover what could be triggering your rosacea

To find your triggers, you’ll have to do a bit of detective work. A good place to start is by looking at this list of common rosacea triggers. Do you think any could be causing your rosacea to flare?

  • Sunlight

  • Stress

  • Heat

  • Alcohol, especially red wine

  • Spicy foods

  • Some skin and hair care products

  • Some makeup

  • Wind and cold

  • Some medicines

  • Exercise

You may have other triggers. You’ll find a more extensive list of triggers at, Factors that may trigger rosacea flare-ups.

Step 2: Confirm your triggers

Now that you have an idea of what could be causing your rosacea flares, it’s time to gather the evidence. The National Rosacea Society offers an online form to help you do this.

Are you flushed?

If you’re not sure when your face turns red, ask a close friend or relative to let you know when you seem flushed.

The National Rosacea Society recommends that you:

  • Complete this form every day for at least 2 weeks.

  • Look at the items you checked on the form to see what coincides with your rosacea flares.

You’ll find the online form at, Rosacea diary booklet.

Another option is to keep a notebook. Write down what foods you eat, beverages you drink, personal care products you use, and things you are exposed to (like cold and heat) that could cause a rosacea flare-up.

Check your cheeks

Are you unsure when your face turns red? If your cheeks feel warm to the touch or you feel warm, you may be flushing.

You’ll also want to describe your rosacea symptoms, jotting down how serious they are.

Keeping track of these things for a few weeks (or months) can help you pinpoint what causes your flare-ups.

Step 3: Make some changes

Once you know what’s triggering your rosacea flares, taking action can help you avoid those triggers. The following article offers some simple solutions that can leave you feeling better without dramatically changing your life, How to prevent rosacea flare-ups.

Images
Getty Images

Pelle MT, Glen H. Crawford GH, et al. “Rosacea: II. Therapy.” J Am Acad Dermatol 2004;51:499-512.

Steinhoff M, Schmelz M, et al. “Facial erythema of rosacea — Aetiology, different pathophysiologies, and treatment options. Acta Derm Venereol. 2016 Jun 15;96(5):579-86.

Salicylic acid peeling in the treatment of rosacea1

Rosacea is a very common disease that may be classified in 4 stages:

  • 1.

    Flushing stage or transitory congestive redness

  • 2.

    Erythrosis stage or persistent teleangiectatic redness

  • 3.

    Papulopustular or granulomatous stage

  • 4.

    Phyma stage

The etiology and pathogenesis of rosacea remain poorly understood. Improvements in our understanding of the etiology would probably facilitate a more rational approach to treatment, which has developed along largely empiric lines.

We report here the results of a study performed on 10 patients (9 females and 1 male, aged between 30 and 45 years) affected by papulo-pustular rosacea. All patiens were treated with topical 0.75% metronidazole and with systemic tetracyclines or clarithromycin until complete or almost complete resolution of the papulopustular lesions. Patients were then treated with a series of 3–4 peelings with a 25% salicylic acid solution performed at 3–4 weeks intervals.

Complete resolution of the remaining inflammatory lesions and improvement of erythrosis was obtained in all the patiens. Salicylic acid penetrated more deeply in the areas of inflammation which showed decreased erythema; papule and pustules were rapidly dried at 1 or 2 days after the peeling. These beneficial aspects of salicylic acid peeling are probably determined by the antimmicrobic activity of salicylic acid which also stimulates fibroblasts inducing an improvement of the vascular component of rosacea.

Rosacea Routine

Treatment – I’d recommend both the salicylic acid and the lactic acid which you would use one every 3 days, for example Monday lactic acid, Thursday salicylic acid, Sunday lactic acid and so on. If however you don’t experience any spots or pustules, just the lactic acid would be fine.

Avoid using any facial scrubs or sonic brushes when using these or it could cause a breakout, these provide enough exfoliation. The reason I recommend the two is because the salicylic acid works within the pores to clear any blockages and reduces inflammation but it can also be a little drying, using alongside the lactic acid can help prevent the skin from becoming dehydrated. If you have any broken capillaries (little veins) avoid these when using the exfoliators.

For best results I recommend applying the acids with our chemical peel brush, this gives a more even finish and also ensures that you don’t waste any of the product as it doesn’t absorb the product.

I know that sounds like a lot, this is a full skincare regime, which is needed to get the skin in great condition. You don’t have to use all Bravura products to get results, as long as you cleanse, tone and moisturise with suitable products you can simple choose what you need from the list above.

Please also remember that anything that touches your skin needs to be clean, be sure to only use clean face cloths and face towels, change your pillow case once a week and if you use make-up brushes, try cleaning them after each use but at the minimum, they should be cleansed once a week.

Disclaimer – I’m happy to give recommendations for products but can’t offer any guarantees that these will work for your skin. Although we have a lot of positive feedback from customers, everyone is different, obviously I can’t take in to account any allergies or sensitivities you may have which is why I recommend you read the ingredients list for all products I recommend. To get great results you MUST cleanse, tone and moisturise daily, no matter what treatment you use, without a good daily skincare routine, you won’t get the best results.

Treating Skin with Salicylic Acid

Dr. Jetske Ultee

We’re all familiar with scrubs to remove dead skin cells. Exfoliating with (fruit) acids is less well known, even though this is in fact milder for your face than the scraping granules. One of the most used for this is Salicylic Acid. A unique substance, which does far more than the removal of dead skin cells.

Salicylic Acid and aspirin

Salicylic Acid was, for a long time, obtained from the bark of the Willow, but nowadays is mostly produced synthetically. Other natural sources are almonds, nuts, mushrooms and tomatoes, and also fruits such as blueberries and kiwis. The substance supposedly fulfils an important defensive role in plants. The ‘power’ of Salicylic Acid in people has already been established for a couple of hundred years. Extracts from the willow bark was broadly used in the treatment of fever and flu, malaria and rheumatic pain. Later in the nineteenth century Salicylic Acid was further developed in laboratories into the chemical variant acetylSalicylic Acid, better known as aspirin.

For blackheads and other impurities

In the meantime Salicylic Acid also offers a broad range of services in the skin. The substance helps dead skin cells shed from the skin more easily by reducing the bond between the cells in the top skin layer. Because Salicylic Acid is fat soluble, and penetrates deep into the pores, it is also effective in reducing blackheads, enlarged pores and removing excess sebum. It is not so strange then that Salicylic Acid is one of the most used ingredients in treating acne.

Rosacea and pigmentation spots too

Salicylic Acid is also considered an effective ingredient for soothing rosacea. Salicylic Acid, in general, causes less irritation than other (fruit) Acids and is therefore very suitable for sensitive skin. For the face Salicylic Acid is effective in a concentration between 0.05% and 2%. Higher concentrations are used for warts, keratosis pilaris or psoriasis. And as well as this, Salicylic Acid has a proven effect on reducing pigmentation spots. Exfoliating can give almost every skin a super boost, and provide a fresh, smooth radiance.

What should you be aware of with an Exfoliant?

The pH level.
The effectiveness of an Exfoliant does not only depend on the concentration of acids used; the pH level (Acidity) is also important. This should be between 3 and 5. At a higher or lower Acidity there is a risk that the product will irritate the skin or that it is not sufficiently effective. The Exfoliant by Dr. Jetske Ultee fulfils this requirement.

Introduce gradually.
When you begin exfoliating it is important to let your skin adjust. Increase the use slowly. Start with two to three times a week. If you see that your skin goes red or starts to flake or peel, take it a step back. For a more detailed instruction for use you can find more on Dr. Jetske Ultee’s own blog.

Extra protection from the sun.
Salicylic Acid can cause the skin to become more sensitive to the sun. So protect your skin properly with a sun cream. Alhough that is, in fact, always important, even if you don’t use an Exfoliant.

Which skin type.
Lastly, before use first have a good look at your skin type. A dry skin will benefit more from Glycolic Acid than Salicylic Acid. This water soluble Acid not only dissolves dead skin cells, but also improves the moisture balance. You can read more about the use of this Exfoliant in Dr. Jetske Ultee’s blog. And, by the way, did you know that Glycolic Acid is derived from honey and sugar cane? And that many (fruit) Acids are derived from natural products?

Do you have a question? You can speak to one of our skin experts via [email protected]

How to combat rosacea

What is rosacea?

Dr Stephanie Munn, Bupa Consultant Dermatologist, explains: “If you have rosacea, the skin on your face (or sometimes elsewhere on your body) may tend to flush easily. The skin can become red and sore to the touch. A rash of bumpy spots (papules) and pus-filled pustules can appear across your nose, cheeks and forehead.

“Other symptoms include potentially serious eye conditions like blepharitis, where the eyelids become red and swollen. Men are also prone to thickening skin around the nose (rhinophyma).”

This photo shows what rosacea looks like:

When it comes to rosacea triggers and causes, Dr Munn says: “Rosacea can be made worse by sunshine, stress, exercise, alcohol, spicy food and extremes of temperature. Its cause is unknown, but there are theories that reactions to tiny mites that live on your skin, or to bacteria in your gut, may be involved. Nothing has been proven yet, but we do know rosacea isn’t contagious.”

How rosacea starts

Rosacea often starts with flushing. As a teenager, I’d be embarrassed by going red at the slightest thing. Then around 15 years ago, when I was 38, I started getting the rash as well. It was probably in response to the stress of starting a new business.

A tactless client spurred me to do something when she said: “Did you know you’ve got a rash across your face?” Like many people, my reaction was to buy a basket-load of different creams from the chemist, including witch-hazel and eucalyptus oil, which stung terribly.

But nothing worked. Finally, I turned to my GP, who took one look at my face and diagnosed mild rosacea.

What’s it like having rosacea?

Like many people who live with rosacea, the biggest issue for me is the embarrassment the redness causes. This is especially true when you’re middle-aged and you thought blushing was behind you.

You go to a social event and suddenly look as if you’ve had too much wine after one small glass. Or your face is still bright red an hour after a gym workout. You feel the flush happening and there’s nothing you can do about it. I sometimes try yoga breathing (deep breaths in through the nose, slow breaths out of the mouth) to calm myself down. Or, if I see people noticing, I explain the condition.

Chalazions (lumps in the eyelid which are not styes) can become much more frequent. This sometimes painful irritation can often be controlled with regular eyelid hygiene. You can use over-the-counter eyelid cleansing lotion, which comes in liquid form or wipes, to wipe your eyelids top and bottom in the morning and evening. It’s good for taking off makeup too if you’re a woman.

My optician recommended daily eye drops to combat dryness. They’re a tears-substitute containing a lubricant called carmellose sodium and they work a treat for me.

Medical treatments for rosacea

The good news is that long-term treatments can be very effective against the rash and spots. My doctor put me on a course of an antibiotic called oxytetracycline to clear up the initial rash. That was followed by a topical (applied to the skin) gel called metronidazole for eight weeks. Since then, I’ve also been prescribed azelaic acid, a cream that treats the papules and pustules of rosacea. But when there’s the occasional serious flare-up, it’s back to antibiotics.

Dr Munn says this is a common treatment path, although as you’d expect in the ever-progressing world of dermatology, some things have changed slightly since my treatment began. “We would often now prescribe a once-daily tetracycline antibiotic (such as doxycycline or lymecycline) instead of oxytetracycline. And metronidazole gel is now used less frequently, with azelaic acid or another gel called ivermectin prescribed in its place.”

The redness can also be treated. For me, a dermatologist has recommended laser treatment, which shrinks the blood vessels that are visible without hurting the skin around them. There are also topical treatments to reduce redness – Dr Munn says that mirvaso gel is one that can work, although it can cause irritation for some people. Some people may be given a prescription for beta blocker tablets.

Treating rosacea at home

There’s also plenty you can do yourself to combat rosacea. Here are some tips and suggestions.

  • Use a daily gentle redness-reducing cleanser.
  • Avoid perfumed soap and alcohol-based products.
  • Blot your face dry or let it dry naturally.
  • Use a sun block with an SPF (sun protection factor) of at least 30 and wear a hat on sunny days.
  • Moisturise with an anti-redness moisturiser.
  • Avoid alcohol, stimulants such as caffeine and spicy foods, all of which can trigger rosacea.
  • Camouflage the skin with green-tinted make-up.

My best advice to anyone beginning on their rosacea journey is to start by making a diary tracking your triggers so you can avoid them. Rosacea may be embarrassing and distressing, but you can keep it at bay.

We understand that skin conditions like Rosacea can be distressing. That’s why our dermatologists are here to help you find the dermatology treatment you need.

What Is It?

Published: December, 2018

Rosacea (rose-ay-shah) is a common, long-lasting skin condition that causes inflammation and redness of the face. It usually starts with redness on the cheeks and nose, and also can affect the forehead and chin. The late comedian W.C. Fields, who was known for his wicked wit and red, bulbous nose, had an advanced case of rosacea.

Rosacea tends to affect fair-skinned adults between ages 30 and 50 who have “peaches and cream” complexions and a history of blushing easily. Women develop rosacea more often than men, but men are more apt to develop lumpy, enlarged noses, a condition called rhinophyma. Rosacea often is mistaken for sunburn and often goes undiagnosed. It is a very treatable condition.

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