Vascular Rosacea & Dermatitis

WHAT IS ROSACEA?

Rosacea is a condition that is characterised by facial redness – especially around the nose, cheeks, chin and in between the brow. People with this condition are consistently red or flush easily. Broken facial capillaries and acne-like pustules on the face are also a common consequence of having rosacea. Other signs of rosacea include; bloodshot or watery eyes, burning/stinging sensations on the face, and sensitive skin. It is a common condition that affects approximately 1 in 20 people.

WHAT CAUSES ROSACEA?

The exact cause of rosacea is unknown. Exposure to certain climates, radiation (including UV radiation) resulting in vessel wall abnormalities may play a role in the development of the disease.  Previously, it was believed that Helicobacter pylori, the bacteria that causes stomach ulcers, was involved, however more recent studies show that it may be caused by a mite called Demodex folliculorum.

HOW IS ROSACEA TREATED?

The first step in rosacea treatment is to avoid any triggers that may exacerbate the condition. Common triggers of rosacea include; certain foods including liver, yogurt, cheese, and spicy/chilli foods, direct sunlight, extremes of weather, alcohol, hot drinks, stress, heavy physical exercise, and hot flushes/menopause.

Particular skin care regimes may also exacerbate rosacea, especially those containing alcohol (e.g. in toners), topical steroids (can help initially, but in the long-term will exacerbate rosacea), and any skin care that irritates the skin such as Retin-A/Stieva-A (tretinoin). Changing your skin care or avoidance of certain skin care chemicals may be advisable.

The use of non-irritating sunscreens is important. Physical sunscreens with titanium dioxide or zinc oxide tend to irritate skin less than chemical sunscreens. Titanium dioxide and zinc oxide do not enter the skin and are not absorbed by the body, as opposed to chemical sunscreens that are absorbed by the body and skin and increasing the potential for skin irritation and exacerbation of rosacea.

Using skin care with anti-inflammatory ingredients is appropriate in the treatment of rosacea. These include; aloe vera, arnica, calendula, chamomile, cucumber, provitamin B5, feverfew, green tea, licochalone, perilla leaf extract, red algae, red clover, thyme, willow herb, and zinc.

Mineral make-up, such as Jane Iredale and do not tend to enter the skin, congest the skin and exacerbate rosacea. They may also contain some calming ingredients such as green tea extract.

More powerful anti-inflammatory agents (these require a prescription from a doctor) include metronidazole gel (Rozex) and clindamycin gel.  Both are antibiotics, but are used in this case for their anti-inflammatory properties. In the author’s opinion however,  metronidazole and clindamycin gels are not very effective in the treatment of rosacea.

Niacinamide and salicylic acid are also topical agents that have anti-inflammatory and anti-bacterial properties and have been shown to improve rosacea. 

Another good option for rosacea in is retinaldehyde. Retinaldehyde is a less irritating form of retinoid andis better tolerated by those with sensitive skin. It is available in the Cosmedix Skin Care and in the Aspect Redless has been shown to reduce endothelial growth factors which can worsen redness in the skin. Again, topical retinaldehyde should be introduced slowly to the skin to prevent it from causing any irritation that could worsen the rosacea.