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Take The Red Out Of Rosacea

Posted: Monday 7 June 2010 01:28pm

Put simply, rosacea is a skin disorder that is characterised by flushing, redness, and blushing and inflammatory acne-like flare-ups on the cheeks, chin, forehead and nose. Technically it is known as acne rosacea.

It generally occurs when the blood vessels close to the skin’s surface expand, swell and cause the skin to become red. It is also often associated with broken capillaries on the surface of the skin, and in its most aggressive form, can cause ruddiness and a swollen, bulbous appearance on the nose, forehead or chin, commonly known as “whiskey nose”, or “gin blossoms”.  Facial burning, stinging and itchiness are also some of the common symptoms reported by many rosacea sufferers.

The eyes can also be affected. “This is known as ocular rosacea, and it gives the eyes a bloodshot appearance, as well as affecting the eye lids and lash line, making them red and itchy,” says Associate Professor Greg Goodman from Monash University and the Skin and Cancer Foundation of Victoria. Sufferers may also experience a dry, gritty feeling with burning, itching and stinging. Individuals with ocular rosacea may also be prone to styes, light sensitivity and blurred vision.

In determing whether your own condition is acne or rosacea, consider the following – but get a doctor’s diagnosis before following any course of treatments:

Acne is not associated with  flushed skin and breakouts can occur anywhere on the face. It is also connected to blackheads and whiteheads.

Unlike acne, rosacea does not manifest in whiteheads or blackheads but  small, pustule-like bumps. The breakouts are usually limited to the cheeks, chin and nose. Whereas acne can be cured, rosacea cannot. It can be kept under control to a point where it is no longer visible, but it will always exist to some degree.

Causes and triggers of rosacea
“It’s what we call a typology, in that we don’t know what causes it or why people get it,” explains Goodman. “The disease is characterised as a cluster of symptoms and patterns, but we don’t know the cause.”

In some cases, it does tend to be hereditary, with recent research indicating that those of English, Irish or German descent are more vulnerable to the condition. Adult women are more commonly affetced than men.

What is known is that it produces activity including the aforementioned symptoms, together with “acne, pimples and pustules and red, slightly itchy bumps on the forehead, cheeks chin and nose,” says Goodman. “People with rosacea have blood vessel instability, so they will flush easily and produce a tendency towards standing redness, broken blood vessels and easier flushing.”

“Triggers, rather than the actual cause, are better known and include heat, certain foods such as citrus fruits, dates, nuts and figs, and alcohol, although strangely enough, whiskey seems not to be a trigger,” says Goodman, adding that weather can also cause a flare up. “Hot and humid conditions will make [rosacea] worse.”

Spicy food and hot drinks like tea and coffee are culprits too. “It’s not the caffeine that sets off the condition as we once thought,” explains Goodman, “rather, the heat from the hot liquid.”

Stages of Rosacea
Rosacea occurs in varying severity. In some people, it may simply appear as mild flushing, but in others, it can be quite severe and ever present.

In its mildest form, pre-rosacea, it occurs as a slight flushing that comes and goes, possibly with a few pimple-like bumps and some fine broken capillaries. If mild rosacea is left untreated, it can advance to a more severe form of the condition.

Inflammatory rosacea is most severe and appears as constant redness accompanied by pustules, cysts and red bumps, which cover much of the face and possibly even the décolletage.

Vascular rosacea is a state of constant redness where the cheeks and nose may become swollen and enlarged blood vessels are very visible.

What Can Help?
While there is currently no cure for rosacea, clearly, avoiding triggers is paramount. There are also many solutions that can relieve the condition, however “the approach must be holistic,” stresses Dr. Garry Cussell from the Facial Rejuvenation Clinic in Sydney. This includes diet, reducing stress levels, topical and internal solutions and advanced light therapy and laser techniques.

Topical and Internal Antibiotics
”We don’t quite know why antibiotics work, as rosacea is not an infective condition, but they do,” says Goodman. It is widely thought that it might be due to their anti-inflammatory action, rather than their anti-bacterial action.

Intense Pulsed Light (IPL) is effective on milder forms of rosacea. “IPL targets the red cells and reduces the redness in the area. The light is drawn to the redness and it destroys the red cells. Depending on the severity of the rosacea it will be combined with internal and external antibiotics and skin care,” says registered Lisa Sullivan-Smith from The Clinic in Sydney. Expect to pay approximately $220 to $440 per treatment, with a minimum of three treatments required.

The Gemini 532 Laser is a powerful vascular laser which has two wavelengths; one that targets superficial blood vessels and another that addresses deeper ones. “It’s a nice way of closing broken capillaries and calming general redness of the skin,” says Dr Cussell. Downtime is minimal and depending on the extent of the condition being treated can be up to three days. Expect to pay approximately $440 per treatment, depending on the severity of your condition.

Fractioned lasers (under such brands names as Fraxel and Cutera) can help by smoothing the skin where acne and pustules have been present. “Rosacea is usually associated with acne and congestion of pores,” says Dr Cussell. ”Most people with rosacea have bacteria and yeast mites [known as Dermodex] trapped in the skin. Both of these add to the inflammation and redness. Fraxel will destroy oil glands, get rid of acne and bumps and help smooth skin texture that has been affected by acne rosacea. We usually use this in conjunction with a special serum that kills the yeast and bacteria.” Expect to pay upwards of $400 per treatment for T-zone area, depending on severity of condition.

Omnilux Light Therapy is a specialised LED light therapy used in conjunction with the aforementioned solutions can help calm the condition. It directs blue and red light wavelengths onto the skin. The blue light helps to kill the bacteria, while the red light aids in cellular healing. Blue kills the bacteria causing the problem, while red promotes cellular healing. Expect to pay approximately $100 per treatment.

Skin Care
Look for skin care that is calming, strengthening and healing, and that targets weakened blood vessels. “Avoid anything with active ingredients such as acids or vitamin A,” advises Goodman.

“Ingredients including Azulaic acid, green tea and other antioxidants are ideal. Always use non-irritating cleansers and moisturisers and a water-based or light liquid sunscreen applied daily is essential.” Goodman adds that any product used on the skin should be able to be easily removed. “You don’t want to apply anything that is too claggy, or thick, that requires a lot of rubbing when cleansing.”

Products to try:

• Decleor Cleansing Milk, $60, Aromessence Rose D’Orient, $130, Harmonie Gentle Soothing Cream, $110
• Dermalogica Soothing Eye Make-up Remover, $48.50
• Eau Thermal Avene Diorseal Treatment Cream for Localised redness, $33.95
• La Prairie Cellular Nurturing Cream Anti-Redness, $320
• Clinique Redness Solutions Soothing Cleanser, $38, Urgent Relief Cream, $68, Daily Relief Cream, $90.
• Dr. Spiller Aloe Sensitive Cleansing Milk, $62, Anti-Couperose Crème, $93, Azulen Cream Mask, $74.
• Pevonia Botanica Ligne Rose RS2 Gentle Cleanser, $66.95, RS2 Gentle Lotion, $63.95, RS2 Concentrate, $119.50, RS2 Care Cream, $119.50.
• A’Kin Rose & Geranium Cleanser and Toner in One, $27.95, Rosehip Oil, $24.95, Unscented 24 Hour Pure Moisture, $24.95.
• L’Oreal Paris UV Perfect SPF30+, $24.95

Make up
To begin with, look at colour correction. A green tinted primer will help counteract the redness in the skin. “Apply with caution and choose a quality product,” warns L’Oreal Paris make up artist Rae Morris. “You don’t want a film of green over your skin, you simply want the primer to counteract and negate any redness.”

Products to try:

• L’Oreal Paris Studio Secrets Professional Anti-Redness Primer, $37.95
• Dermalogica Sheer Tint Redness Relief, $77

Choosing a gentle-to-the-skin, healing and nurturing make-up is paramount, which is where mineral formulations can step in. Most mineral formulas contain natural sunscreens that won’t clog the skin, as well as zinc oxide, which is very healing. ”Mineral formulations are very easy to remove too,” adds Goodman, “which means they are less irritating. You really want to avoid anything thick or pancake-like.”

Products to try:

• Jane Iredale Amazing Base Loose Minerals SPF20, $79
• Bare Minerals Loose Foundation SPF15, $79

by Shonagh Walker

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