Rosacea affects millions of people worldwide and most are unaware that they have it. This condition is most commonly found in those of fair skin, between 30 – 60 years of age. It affects both sexes, but is almost three times more common in women than men. In the U.S. as many as 1 person in every 20 will develop Rosacea, often later in life and it can be hereditary. Sometimes called acne Rosacea because of its red inflammation of the cheeks and thick red or pink patches, it is a chronic form of dermatitis. In its severest form, it can cause semi-permanent redness, red gritty eyes, burning and stinging sensations and disfigurement of the nose (rhinophyma).
Rosacea can often look similar to sunburn or blushing and it involves inflammation of the cheeks, eyelids, nose and forehead. In less common cases it can also affect the neck, ears, scalp and chest. It can sometimes appear as spidery pink/red veins (telangectasiae) or as spots which look very similar to acne. This ailment is as yet un-curable and can be distressing due to its intermittent eruptions, which are thought to have a trigger factor.
Trigger factors thought to cause recurrent episodes of Rosacea:
• Exposure to sun/UV rays
• Assorted medications
• Bacteria helicobacter pylori
• Heavy exercise
• Hot baths
• Certain skin care products or cosmetics
• Some types of fruit, vegetables or dairy products
• Marinated meat
• Any strong emotions such as fear or embarrassment
• Hormone related conditions
• Weather or humidity changes
• Spicy food
• Foods high in histamine
• Stimulants such as coffee and tea
Causes and conventional treatments:
As to the causes of Rosacea, other than the trigger factors mentioned above, it has been noticed that patients with Rosacea had elevated levels of the peptide cathelicidin and higher than normal levels of stratum corneum tryptic enzymes. Antibiotics have been used to treat Rosacea but they probably only work because they inhibit some SCTE’s.
There has also been a study on intestinal bacteria being the cause of Rosacea. It seems patients with higher than normal levels of small intestinal bacterial overgrowth (SIBO) appear more prone to this condition.
When the patients of a study on SIBO were given a 10 day course of Rifaximin (a non-absorbable antibiotic which does not leave the digestive tract), 96% of patients experienced a complete remission of their symptoms, which lasted at least 9 months. In the 4% of patients that didn’t see their symptoms disappear, it was found that the SIBO had returned and a subsequent course of Rifaximin worked in all remaining cases.
Another study showed that patients who consumed fewer carbohydrates also saw a drop in recurrent episodes of Rosacea. It is possible that restricting carbohydrates can lessen intestinal fermentation and thus reduce intestinal bacteria.
Dermodex mites have been associated with the cause of Rosacea. Studies have shown that those suffering with Rosacea have increased numbers of the mite, particularly in the case of steroid induced Rosacea.
Common conventional treatment for Rosacea is often in the form of:
• Topical creams
• Isotretinoin (prescribed only in severe cases due to its side effects)
• Special soaps and cleaning aids
• Laser treatment
• Phytodynamic Treatment (PDT) (subjects the area affected to blue light)
• Glycolic acid peels (an exfoliant applied by a professional)
Is Laser treatment effective in controlling Rosacea?
Single wavelength dermatological vascular laser or intense pulsed light (broad spectrum) machines offer some of the best treatment with which to control Rosacea. They are particularly effective against skin redness (erythema). Light is used to penetrate and warm the skin. This damages the capillary walls and they are then absorbed by the body’s natural defence mechanisms. With several treatments, this has the ability to eliminate Rosacea altogether, although it is probable that periodic additional treatments will be needed to remove new capillaries.
Co² lasers can be used to remove enlarged tissue in the case of Phymatous Rosacea. This type of laser can vaporise skin tissue.
Single laser treatments for Rosacea can start at approximately $300 for small areas and can cost $500 plus for larger areas.
Treatment in the form of topical steroids has been shown to worsen the condition.
Holistic approaches to the treatment of Rosacea are as follows:
• Intense Pulse Light Therapy
• Managing your diet and trigger factors
• Chrysanthellum Indicum Cream (has been proved to significantly improve Rosacea symptoms including facial redness)
• Apple Cider Vinegar (thought to remove bacterial imbalance in the gut)
• Azelaic acid cream (appears to have antimicrobial action, effective at reducing skin redness and pustules)
• B Vitamins (inadequate riboflavin has been associated with Rosacea)
• Green Tea Cream (active ingredient polyphenone)
• Liquorice (this herb has proven effective when used in a topical cream)
• Digestive Enzymes (pancreatic enzyme supplements have been proven effective)
• Niacinamide Cream (thought to improve the skin’s barrier, reduce inflammation and improve the skin’s moisture level)
Make up for Rosacea
In milder cases of Rosacea, some women opt to cover the spider like veins and redness with make-up. It is advisable to use make-up suitable for delicate skin which has effective coverage properties. When applying make-up to the affected area, use gentle strokes and try not to rub or irritate the skin. The RosaceaGroup.org has many recommended brands of make-up to choose from, as well as cleansers, sunscreens, moisturisers and eye drops. It also has a Rosacea forum for all of your unanswered questions.
Types of Rosacea:
There are four identifiable types of Rosacea and it is not unknown for patients to have more than one form of this condition:
Erythematotelangiectatic Rosacea – This causes permanent redness of the affected areas and leaves the patient more susceptible to flushing/blushing episodes. There may possibly be burning or itching sensations and it is common to see spider like red blood vessels visible near the skin’s surface (telangectasiae).
Papulopustular Rosacea – A little permanent redness accompanied by red bumps (papules) which can be filled with pus (pustules). This type of Rosacea will last around 1 – 4 days and is very commonly confused with acne/pimples.
Phymatous Rosacea – This subtype is often associated with enlargement or disfigurement of the nose. It can cause thickening skin, irregular surface of the skin and enlargement. It is not limited to the nose and can affect the chin, ears, eyelids, forehead and cheeks. Spider like blood vessels may be visible.
Ocular Rosacea – Affecting the eyes, this type will cause redness, dryness and irritation. It may constantly feel as if the patient has something trapped in their eye, producing an itching and burning sensation.
Other variations of Rosacea include: conglobata, fulminans and Phymas in Rosaea.
Over 70% of sufferers said it lowered their self esteem and confidence and over 40% said it had caused them to cancel or postpone public engagements. Early consultation is highly recommended in the case of Rosacea as symptoms appear to worsen over time and if caught early, the condition is treatable.
Sources: http://en.wikipedia.org/wiki/Rosacea, http://altmedicine.about.com/cs/treatments/a/Rosacea.htm, http://rosaceagroup.org/review/r/Makeup.html