Rosacea, also called acne rosacea, is one of the most common skin conditions, affecting over 415 million people globally and 16 million people in the United States alone. Its most commonly presents in those aged between 30 and 50 years but can affect people at any age. While there is no cure for rosacea, there are ways to control and reduce the symptoms.
What are the key symptoms of rosacea?
Rosacea often creates constant flushing and redness of the skin, especially the central part of the face. Small blood vessels on the cheeks and nose often swell become visible, and swollen red bumps may appear. Though these red bumps are often confused with acne lesions, these are not typical comedones and usually do not appear on the neck, back, or chest. For those with moderate to severe rosacea, it may also cause eye problems. Ocular rosacea causes dry, irritated eyes and swollen red eyelids.
Rosacea symptoms may come and go, but getting treatment is necessary so that redness and swelling do not get worse or become permanent.
What is the cause of Rosacea?
The exact cause of rosacea is unknown. Dermatologists believe it may be a combination of hereditary and environmental factors.
Demodex folliculorum, a typically harmless microscopic mite, is also being researched as a potential cause of rosacea. One study showed that people with rosacea have up to 18 times more Demodex mites than those without.
- Excessively hot or cold weather conditions
- Spicy food
- Intestinal bacteria called Helicobacter pylori.
What are the different types of rosacea?
The American Academy of Dermatology (AAD) divides rosacea into five different types:
- Erythematotelangiectatic rosacea: Typical symptoms include skin redness, frequent flushing, and visible dilated skin capillaries.
- Papulopustular rosacea: Typical symptoms include, in addition to skin redness and frequent flushing, acne-like papules and pustules.
- Phymatous rosacea: The most severe type of rosacea typically includes the thickening of the skin on the cheeks and nose.
- Ocular rosacea: Typical symptoms include eye redness, eye irritation, and swollen red eyelids.
- Steroid-induced rosacea: A type of rosacea caused by prolonged use of strong steroidal creams on the face for other skin disorders such as eczema or vitiligo.
What's the difference between acne vulgaris and acne rosacea?
Acne vulgaris and acne rosacea are two common skin conditions; while they may be confused given their appearance, they are distinct in how they affect the skin. Here are some differences according to dermatologists.
What are the triggers of rosacea?
A study conducted on 1066 participants with acne rosacea lists the most common causes:
What are the most effective treatments for rosacea, according to dermatologists?
A good skincare routine is essential for people with rosacea. The optimal skincare for rosacea and acne-prone skin will contain a gentle cleanser, an oil-free active moisturizer, and a night treatment cream and/or lotion. It can be tough to find products that do not cause irritation and make redness worse, so there are things you should keep in mind before choosing skincare products.
Since dryness is a common symptom for those with rosacea, you'll want to use products that promote hydration without clogging up pores. Good choices for rosacea-friendly cleansers include products with minimal, gentle ingredients such as Cetaphil, Aveeno, and the MDacne hydrating facial cleanser.
What ingredients should I look for in my rosacea topical treatments?
The management of rosacea symptoms may vary depending on your condition's severity and skin type. However, there are a handful of topical, over-the-counter products that have proven to be effective.
Benzoyl peroxide (BPO), the most effective topical ingredient for acne vulgaris, can also help rosacea. For optimal results, apply a product containing a low percentage of BPO (2.5%) every other night. Unique formulations of benzoyl peroxide may contain aloe vera and other plant extracts with anti-inflammatory and antioxidant properties. These additions enhance benzoyl peroxide effectiveness, reducing skin dryness and irritation.
Niacinamide is another beneficial ingredient for people with rosacea. When applied topically, niacinamide has been shown to protect the skin's natural protective layer while having anti-inflammatory effects. By increasing the skin's production of ceramides and collagen, niacinamide can help treat acne and rosacea, improve skin texture, and reduce aging signs. It helps reduce facial redness and pimples in people with rosacea.
In some cases, the rosacea is due to a response to a parasite called Demodex that populates the sebaceous glands, making sulfur an excellent treatment option for people with rosacea. Thanks to its antifungal, antibacterial, and anti-parasitic properties, sulfur can reduce the number of unwanted skin parasites and reduce rosacea's signs and symptoms.
Clinical studies have shown that azelaic acid 15% gel is an effective and safe treatment option in patients with mild-to-moderate papulopustular rosacea. Reducing reactive oxygen species and inflammation azelaic acid in combination with sulfur and niacinamide can help reduce the skin redness typical to rosacea and rosacea-prone skin.
Pink clay masks
Pink clay masks are great over-the-counter options to calm redness related to rosacea. Using a pink clay mask 1 - 2 times per week is beneficial to any rosacea treatment routine. By absorbing the dead cells and excess sebum from enlarged skin oil glands, these masks can help with rosacea breakouts, reduce skin redness, and improve overall skin texture and brightness.
Oral medications, especially minocycline, can destroy acne-causing bacteria and reduce skin inflammation in rosacea.
Lasers or intense pulsed light devices (IPL)
Lasers or intense pulsed light devices (IPL) can collapse enlarged blood vessels and reduce skin redness. While useful for redness, this type of light therapy does not affect papules and pustules typical of rosacea.
Which cosmetics ingredients should you avoid when you have rosacea-prone skin?
People with Rosacea should use a good moisturizer. Moisturizers trap water on the surface of the skin and keep it inside the skin. Hydrating the skin makes and skin smoother reducing inflammation and redness. People with rosacea need to avoid cosmetic products and topical medications containing irritating ingredients such as menthol or denatured alcohol. Using alcoholic toners and alcoholic cleansing solutions is not a good idea for those with rosacea. Opt for moisturizing ingredients instead. Great ingredients for rosacea-prone moisturizers are dimethicone, niacinamide, and licorice extract.
How to prevent rosacea flareups?
Sun protection is vital as rosacea-prone skin is more susceptible to the sun's harmful rays. Light, oil-free chemical sunscreens are a better choice than physical sunscreens since zinc, and titanium oxide can clog pores and cause more rosacea breakouts. The optimal SPF for people with rosacea is SPF 30 - anything higher is often too irritating for sensitive skin.
What foods should those with rosacea avoid?
Having the right diet is essential for people with rosacea-prone skin. In one study by the National Rosacea Society, 95% of people with rosacea that improved their diets to include more whole foods have seen reported a significant reduction in breakouts. Here are some of the worst foods for people with rosacea:
- Spicy foods
- Alcohol (especially red wine)
- Citrus fruits
- Dairy products
- Soy products
- Cinnamon and nutmeg
What are the best supplements for people with rosacea?
It is not clear yet if food supplements can cure rosacea. That said, there are preliminary clinical results that omega-3 fatty acids and zinc may have a beneficial effect on rosacea. Omega-3 fatty acids are polyunsaturated fatty acids believed to reduce inflammation in several skin conditions. One study has found Omega-3 fatty acids to reduce rosacea dry eye symptoms in people that took the supplement for three months. In another study, 100 mg zinc supplements significantly reduced rosacea-related symptoms. Always contact your dermatologist to decide on the best treatment plan for you.
- Topical application of 1-methyl nicotinamide in the treatment of rosacea: a pilot study
- Botanicals and anti-inflammatories: natural ingredients for rosacea
- Update on the management of Rosacea
- A pilot study of 5 percent permethrin cream versus 0.75 percent metronidazole gel in acne rosacea
- Diet, and rosacea: the role of dietary change in rosacea management
- Oral zinc sulfate in the treatment of rosacea: a double-blind, placebo-controlled study
- Incidence and prevalence of rosacea: a systematic review and meta-analysis.
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