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Article: What is Rosacea?

What is Rosacea?

What is Rosacea?

Rosacea is the skin concern we are asked about most often. It is a complex skin issue that regularly goes undiagnosed or misdiagnosed often causing great distress for many sufferers.

If you are someone who experiences red flushing after drinking a few glasses of wine, an unexpected flare up following a day of sun, sand and wind, or when you moisturise dry, red inflamed skin it seems to cause acne breakouts, then you may have rosacea.

As a company dedicated to providing natural solutions to all skin concerns, we want to share with you the research we’ve done on this particular condition. While most information presents a gloomy prognosis, the good news is that we have seen clients heal this condition and reverse their skin back to its original state. It requires a persistent approach and a targeted mindset.

There is expansive information about rosacea and how to treat it naturally, so we’ve broken this topic into two parts.

Firstly we’ll look at understanding the basics of Rosacea: What it is, what it looks and feels like, what causes and aggravates it and what studies have been done to help us understand the condition. After that we’ll look at getting a diagnosis and caring for your skin while it heals.

According to the Australian College of Dermatologists, Rosacea is a common skin disorder that is considered chronic (it doesn’t go away naturally and recurs at regular intervals) and which affects the central face. This means it mostly occurs across the cheeks, nose and lower lids of the eyes. It can appear in many different forms, which we will discuss in detail below, but classically it presents as acne-like bumps (these can also be called pustules or papules), reddish pink patches and broken capillaries. The condition usually (though not always) occurs in people with fair skin and blue eyes who are of European or Celtic ancestry.

The origins or causes of Rosacea are not completely understood, but there is clearly a genetic component as it frequently affects family members and is connected to ethnicity.  An issue of the Australian Family Physician, a peer-reviewed Australian medical journal, dedicated an article to it in 2017 (link in sources) and referenced several important world-wide medical studies that have given us some important facts about Rosacea. Firstly, while it can manifest as early as childhood, it mostly appears in adults between 30 and 50. Overall women are affected more often than men, but there are certain types of Rosacea that affect men more frequently. 

There is a strong link between Rosacea and the “dermodex mite”, a mite that lives in the sebaceous follicles of the skin. While everyone has these mites, Rosacea patients have more of them and the follicles then tend to be more inflamed than a normal follicle. Patients with rosacea also have elevated levels of certain peptides in the skin that are pro-inflammatory and this, combined with the fact that rosacea patients also tend to have compromised skin barriers, causes a general heightened inflammation response.


Clinical studies have recorded the most common symptoms of Rosacea to be blushing (also called flushing), which is frequent and causes persistent facial redness, broken and visible blood vessels, and inflamed bumps that can resemble teenage acne. This is why Rosacea is sometimes called ‘acne-rosacea”.


The condition is easily inflamed, but the most common causes of further inflammation are:

Ø  Emotional stress


Ø  Extremes in temperature


Ø  Sun or wind exposure


Ø  High intensity exercise


Ø  Hot drinks and spicy foods


Ø  Alcohol


Ø  Dairy products


Ø  Hot baths or showers


Ø  Certain skin care products and cosmetics – particularly those with harsh chemicals, alcohol and synthetic ingredients


Ø   Active ingredients such as AHAs, Vitamin C serums


Ø  Some medications (e.g. topical steroids, niacin, beta blockers)


There are four main diagnosed forms of Rosacea:


  1. Erythematotelangiectatic rosacea is characterised by frequent blushing, hot skin flushes, temporary or persistent redness and broken blood vessels.


  1. Papulopustular rosacea shares similar symptoms with the previous, but has added pustules and papules that resemble acne. The skin will be extremely sensitive to temperature, sunlight, wind and many skin products.


  1. Swollen Rosacea is a form that affects the lymph and will manifest as hot and swollen skin, including an ‘orange peel’ like thickening of the skin over the nose, cheeks, forehead and chin. It may even go as far as causing an enlarged and bulbous nose with dilated pores. In the extreme forms, the nose can become deformed. This is called Rhinophyma and is more common in men.


  1. Ocular Rosacea occurs in about 50% of people who already have rosacea. It presents as sore, red eyelid margins. It can result in inflamed eyes, conjunctivitis and episcleritis (inflammation of the white part of the eye).  If it isn’t treated Ocular rosacea can cause permanent vision problems.


Getting the right Diagnosis

Diagnosis can be problematic.  While it can - by a skin expert such as a dermatologist - be diagnosed based on history and skin signs, it does also reflect the symptoms of other skin conditions and illnesses and so misdiagnosis often occurs.


Rosacea vs Acne

Rosacea and acne present in similar ways and sometimes patients will have both simultaneously. Many of the traditional treatments for acne can be far too harsh for Rosacea skin and will cause further problems. There are several types of dermatitis and keratosis pilaris that present like Rosacea and can also co-exist with it. Treatments for these may again cause further problems for Rosacea patients. One of the most similar conditions in appearance is Systemic lupus erythematosus (Lupus) which looks, feels and reacts in almost identical ways to Rosacea but is underscored by a very serious auto-immune condition.


To get an accurate diagnosis a doctor or dermatologist must rule out all other potential causes. They may be able to do this with information from the patient and with skin presentation, but a skin biopsy or blood test may be required for the most accurate diagnosis.


If you suspect you may have a Rosacea condition it is important to get an expert and accurate diagnosis before you begin any treatment, but it is never too soon to avoid Rosacea triggers, just in case. Keeping your skin protected from the sun is very important, with both a very natural sunscreen and a hat. It is also good for all sensitive skin to keep your skincare routine very natural and very simple and your skin will thank you for keeping it at a neutral temperature as often as is possible.


Rosacea and your gut

In a study published by the US Library of Medicine, a team of medical researchers linked rosacea to gut health, showing it to be a reflection of a disruption of the gut immune system. Another study of Danish patients shows that people with rosacea were also more likely to have celiac disease, Crohn’s disease, ulcerative colitis, irritable bowel syndrome and HPI. Inflammation of the gut and bowel seems directly connected to rosacea and will be the first port of call in treatment. This suggests that a diagnosis of rosacea from a dermatologist should also include a trip to a general practitioner and potentially a gastroenterologist to search for and treat the root cause of the problem. 

 Some studies have suggested a high-fiber intervention can cause improvement in rosacea as can a careful course of antibiotics – however, the antibiotics must be carefully diagnosed so as not to interfere with gut health. A further study suggested that synbiotics (a combination of probiotics and prebiotics) were extremely effective in treating rosacea symptoms via the gut. These studies illuminate something valuable for rosacea sufferers – a potential cause, which makes it possible to work towards healing rather than just symptom management.

The other thing it makes clear is that if you suffer from rosacea, you may need to seek the advice of more than one medical professional.

The other thing it makes clear is that if you suffer from rosacea, you may need to seek the advice of more than one medical professional.