Rosacea : Causes & Solutions

What is rosacea?

Rosacea is a commonly occurring chronic disease of the skin. It affects more than 15 million people in the USA. The exact cause of rosacea remains unknown and there exists no cure for the disease. However, doctors have found methods of managing rosacea by minimizing the symptoms of the condition.

There are four types of rosacea. Each type has a different set of signs and symptoms. You may have more than one type of rosacea at the same time.

Rosacea often starts as a tendency to flush or blush more easily in comparison to other individuals. The redness may spread slowly beyond the cheeks and nose to the chin and forehead. Even the chest, ears and back may be red at times.

The trademark symptom of rosacea is small, red bumps on the skin that are filled with pus. These are usually present at the time when the rosacea flares up. Flare-ups of rosacea usually occur periodically. This implies that you may experience signs and symptoms of the condition for several weeks or even months, and then the symptoms will disappear, only to return.

woman with rosacea symptoms on her face

Types of rosacea

There are four types of rosacea:

Erythematotelangiectatic rosacea or ETR:

This type of rosacea is associated with symptoms of facial flushing, redness and the visible blood vessels on the face.

Signs and symptoms

  • Redness and flushing at the centre of the face
  • Presence of spider veins (blood vessels are broken and visible)
  • Swelling of the skin
  • Skin becomes very sensitive
  • Burning and stinging of the skin
  • Skin becomes dry, scaly and rough
  • A tendency to blush or flush easily in comparison to other individuals

Papulopustular rosacea or acne:

This type of rosacea is associated with redness and swelling of face and acne-like breakouts. It often occurs in middle-aged females.

Signs and symptoms

  • Breakouts similar to acne and the skin gets very red
  • These breakouts have to tendency to recur
  • Presence of oily skin
  • Burning and stinging of the skin
  • Skin becomes very sensitive
  • Presence of spider veins (blood vessels are broken and visible)
  • The appearance of raised skin patches called plaques

Phymatous rosacea:

This is a rare type of rosacea in which the skin gets thickened and acquires a bumpy texture. When the skin of your nose thickens it is referred to as rhinophyma. It often affects males and is usually associated with another type of rosacea.

Signs and symptoms

  • Occurs rarely. If it occurs, then initially the individual develops symptoms and signs of another type of rosacea
  • Skin acquires a bumpy texture
  • Skin starts to thicken, especially on the nose. Thickening of the skin on the nose is referred to as rhinophyma
  • Skin on the forehead, chin, ears and cheeks may also thicken.
  • The appearance of blood vessels that are broken
  • Skin pores appear large
  • Skin becomes oily

Ocular rosacea:

In this type, the eyes of a person are affected by the condition. You may develop irritated, red eyes, your eyelids may get swollen and you may have a lesion similar to a sty.

Signs and symptoms

  • Watery eyes
  • Red, swollen eyelids (the most common symptom of ocular rosacea)
  • Pink eye (conjunctivitis)
  • Swelling and redness around the eyes
  • Crusty eyelashes or eyelids
  • Bloodshot appearance of eyes
  • Eyes feel gritty. A feeling of sand in the eyes
  • Feeling of burning or stinging in the eyes
  • Eyes become very dry
  • Itching of eyes
  • Eyes become sensitive to light
  • Cysts may develop on your eyelids
  • Vision may become blurry
  • Blood vessels on the eyelids are broken and visible
  • Vision may be affected and become diminished

What are the causes of rosacea?

The causes of rosacea are yet to be determined. A combination of environmental and hereditary factors may play a role in the causation of rosacea.

By doing studies, researchers have found several important clues related to its cause:

    • Rosacea tends to run in families

Many individuals who suffer from rosacea have family members who also have the condition. It is quite possible that rosacea is a genetic condition and if you have a family history of rosacea, you may inherit a gene for it

    • Your immune system may play a role

Scientists have demonstrated that most individuals who have rosacea similar to acne react to the bacteria referred to as Bacillus oleronius. Due to this reaction, their immune systems overreact.

    • A role may be played by having an intestinal bacteria H. pylori

This bacterium is commonly present in individuals suffering from rosacea. However, it cannot be proved by scientists that rosacea can be caused by H. pylori.

    • The skin mite demodex may play a role

This mite often lives on the skin of cheeks and nose and these are the places where rosacea usually appears. It has been found in many studies that large numbers of the skin mite demodex are present on the skin of people who have rosacea.

    • A protein called cathelicidin may result in swelling and redness characteristic of rosacea.

This protein normally protects your skin from any type of infection. Whether you will get rosacea or not is determined by how your body processes the protein

What are the risk factors for rosacea?

Rosacea is a common condition. According to estimates by the U.S. government, more than 15 million individuals have the condition.

People who are more prone to get rosacea are:

  • In the age group of 30 to 50 years.
  • Fair-skinned, with blue eyes and blonde hair.
  • Have Scandinavian or Celtic ancestors.
  • Have a family history of severe acne or rosacea; or
  • A personal history of acne or acne nodules and/or cysts.

Females are more prone to suffer from rosacea than males. However, males who have the condition often suffer from more severe signs and symptoms.

Though some individuals are more prone to get the disease, it can occur in anyone. People of all sizes and colours get the disease. Even children may get rosacea.

General complications of rosacea

Rosacea affects more than just the eyes and skin. As it is a chronic skin disease, it may affect a person’s quality of life. Many sufferers report problems in their relationships and at work. According to studies and surveys, people who live with rosacea may suffer from the following:

    • Feelings of embarrassment and frustration

In surveys carried out by the National Rosacea Society, more than 40% of people said that due to their disease they avoided contact with people or cancelled social engagements.

    • Feelings of worry

People suffering from rosacea worry constantly that their disease may get worse or result in scars. They also worry about the adverse effects of medications that are used for treating rosacea.

    • Low self-confidence

In surveys carried out by the National Rosacea Society, about 70% of people living with the condition said that the disease has reduced their self-esteem and self-confidence.

    • Problems arising in work

In surveys, it has been found that when the disease is severe, 70% of people said that the way they interacted at work was affected by it. About 30% said that they sometimes had to miss work because of their rosacea.

    • Depression and anxiety

When a person lives with a disease of the skin that flares up unexpectedly, it may lead other individuals to believe that you are an alcoholic. This may cause symptoms of depression and anxiety.

Treatment of rosacea may improve the quality of life. According to studies, when people get fewer signs and symptoms of the disease, their quality of life improves.

How is rosacea diagnosed?

If a dermatologist suspects that you have rosacea, you will not require any medical tests. There are no medical tests to diagnose the condition.

To diagnose the condition, your dermatologist will do an examination of your skin and eyes. They may also ask certain questions. Before diagnosing your condition as rosacea, they may like to rule out all other possible medical conditions. Some other skin conditions look similar to rosacea.

Though medical tests are not required to diagnose rosacea, your dermatologist may order certain medical tests to rule out other conditions such as an allergic reaction of the skin and lupus.

Treatment of rosacea

If you have been diagnosed with rosacea, the dermatologist will discuss treatment options with you. Although treatment can’t cure the condition, it may:

• Decrease or eliminate the signs and symptoms of rosacea on your skin
• Relieve your discomfort due to the disease
• Prevent it from getting worse

For best results, your dermatologist will often start your treatment with some education. While laser treatment or medicine may help in reducing or clearing the signs and symptoms of rosacea, a flare-up may be caused by some of your regular habits.

You may help decrease flare-ups by learning to do the things mentioned below:

Find what your triggers for rosacea flare-ups are

Many things that you do may cause your disease to flare-up. Some common trigger factors for rosacea are becoming overheated, consuming spicy foods and having cold winds blowing on the face.

There are different triggers for different people. What’s important is to find out the triggers for your flare-ups of rosacea and to avoid them.

Some trigger factors for flare-ups of rosacea

Rosacea causes the skin to become extremely sensitive. Since the skin is very sensitive, many different things may cause the disease to flare. Anything which causes the condition to flare is referred to as a “trigger”. Hairspray and sunlight are common rosacea triggers. Other common trigger factors are stress, heat, spicy food and alcohol.

Here is a list of some of the common trigger factors of rosacea flare-ups:

Foods

  • Liver
  • Sour cream
  • Yoghurt
  • Chocolate
  • Vanilla
  • Cheese (the only exception is cottage cheese)
  • Soy sauce
  • Vinegar
  • Yeast extract (except bread)
  • Spinach
  • Avocados
  • Eggplant
  • Pods and beans with a broadleaf including pea, navy and lima
  • Tomatoes, bananas, citrus fruits, figs, raisins and red plums
  • Foods that have high amounts of histamine
  • Thermally hot and spicy foods

Beverages

  • Alcohol, particularly red wine, bourbon, beer, vodka, champagne and gin
  • Hot drinks such as hot cider, tea, coffee and hot chocolate

Temperature-related

  • Hot baths
  • Saunas
  • Extremely warm environments
  • Simple overheating

Weather

  • Strong winds
  • Sun
  • Humidity
  • Cold

Drugs

  • Topical steroids
  • Vasodilators

Medical conditions

  • Menopause
  • Frequent flushing
  • Caffeine withdrawal syndrome
  • Chronic cough

Emotional influences

  • Anxiety
  • Stress

Physical exertion

  • Jobs that require lifting and loading
  • Exercise

Skincare and cosmetic products

  • Acetone or hydro-alcoholic substances
  • Certain hair sprays and cosmetics, particularly those that contain witch hazel, alcohol or fragrances
  • Any substance which causes stinging or redness

Protect your skin from the sun 24/7

People suffering from rosacea often have skin that is very sensitive to the sun’s rays. Do the following to protect your skin from the sun:

  • Apply a sunblock (broad-spectrum) with SPF 30 (or more) daily before going outdoors.
  • Avoid the sun at midday.
  • When you are outdoors, it is better to be in the shade.
  • Wear a hat with a wide-brim when in the sun to protect the neck and face from the direct rays of the sun.
  • Wear sunglasses and sun-protective clothes.
  • If your skin gets irritated by sunblock, use one that is fragrance-free and which contains only zinc oxide and titanium oxide.
choosing fragrance free sunblock to avoid rosacea flare ups

Practice a skincare routine that is rosacea friendly

Many skincare and cosmetic products may cause irritation of skin suffering from rosacea. Certain skincare habits such as scrubbing to clean your skin may cause rosacea to flare up.

Using mild products on your skin and treating it gently may help in the prevention of flare-ups. If you can’t find mild skincare products, ask your dermatologist and they may recommend a product for you.

How to treat redness associated with rosacea

If you suffer from rosacea, it is very likely that you will develop redness on the face during the illness. Usually, the redness can appear as flushing and its duration increases each time it appears. If you don’t get treatment for your disease, this redness on the face may become permanent. The presence of spider veins or broken blood vessels that are visible on the face is another cause of redness on your face.

You can consult your dermatologist and get an appropriate treatment plan for the redness associated with rosacea. The treatment plan may include the following:

Protection from the sun

Sunlight is one of the most common causes of flare-ups of rosacea that results in redness. Sun protection is therefore essential throughout the year.

Even while treating the facial, you need to protect your skin from sunlight.

Do the following each day as recommended by the dermatologists:

  • Apply a sunblock (broad-spectrum) with SPF of 30 or more every day. You can try a sunblock, which contains only zinc oxide or titanium oxide or both.
  • Remain in the shade while outdoors.
  • Avoid the midday sun.
  • Wear a hat with a wide brim when going outdoors in the sun.

Manage your triggers

Even if you get treatment for the redness of your face, triggers can still make the face red. This can be prevented by having knowledge of your rosacea triggers and then avoiding them.

Skincare

The skin care and cosmetic products you use and the way in which you cleanse your face may contribute to the redness. If you have rosacea, your skin requires gentle care.

Skincare that is rosacea friendly involves:

  • Using a mild and gentle cleanser or face wash to wash your face.
  • Using your fingertips and applying the face wash or cleanser gently to the face.
  • Rinsing the face with cool or lukewarm water.
  • Drying the face by patting it gently using a clean, soft towel.

As a rule, you should avoid washcloths, astringents, deodorant soaps and toners on your skin if you have rosacea. All of these can worsen the redness.

If most products cause burning, redness or stinging, ask your dermatologist to recommend mild, gentle products for your skin.

Green-hued makeup

This may not decrease the redness; however, it may hide it. Certain companies manufacture green-hued makeup especially for persons suffering from rosacea.

Light or laser treatment

For individuals who have constant redness on their face or who have spider veins, laser treatment may be an effective therapy. The redness can be completely cleared in some patients and it may last for many years. Multiple sessions of laser treatment are required for visible results.

Laser treatment is expensive as the cost is rarely covered by insurance. Make sure you are treated by skilled professionals as there is a risk of serious adverse effects (such as burns, permanent scars, skin discolouration and blisters) if done by untrained persons.

Consult your dermatologist to find out whether you are a candidate for laser treatment or not.

Oxymetazoline hydrochloride cream and brimonidine gel

These are prescription medicines that can be used to reduce the facial redness of rosacea. Their effect last for a maximum of twelve hours. The redness reappears after the effect of the medicines has worn off. These medicines have been approved by the U.S. FDA (Food and Drug Administration) for the treatment of facial redness associated with rosacea.

Moreover, in clinical studies, these medicines have been found to effectively and safely treat facial redness when applied daily.

The common adverse effects of these medicines are mild and temporary. These side effects are increased redness of the face, flushing, contact dermatitis and a sensation of burning

How to treat eye problems associated with rosacea

People who suffer from rosacea are often not aware of the fact that it may also affect their eyes. Symptoms such as dry eyes or eye irritation are usually overlooked. In fact, most individuals mistakenly believe that some other problems such as contact lenses or allergies are the cause of their ocular problems.

A benefit of regularly visiting a dermatologist if you have rosacea is that your eye problems can be detected early. Symptoms of rosacea will develop in the eyes of more than 50% of all individuals who suffer from the disease at some time during their life.

Even when your skin rosacea is mild, you may develop serious eye problems. If you notice any kind of problem in your eyes, visit your ophthalmologist or dermatologist immediately. When your eyes are affected by rosacea, it then becomes essential to get treatment as without it your eyesight may be permanently affected.

Treatment plan

When detected early, the dermatologist can usually make a treatment plan to treat your ocular rosacea. Usually, you will be asked to do the following at home:

  • Apply warm compresses to the eyes.
  • Cleanse your eyes with a gentle, mild eye cleanser and warm water.
  • Use eye medicine and eye drops.
  • Avoid using makeup in case there is inflammation of the eyes. If you are wearing makeup, opt for non-oily and fragrance-free products.
  • Don’t wear contact lenses if you are having a flare-up, particularly if you have dry eyes.
  • Avoid triggers that cause flare-ups.
  • Relieve dryness of eyes by using artificial tears. Ask your dermatologist or ophthalmologist for guidance.

You may be prescribed oral antibiotics such as doxycycline, tetracycline, minocycline and erythromycin temporarily. If your disease is severe, you may require antibiotics for a longer duration.

dry eyes or eye irritation caused by rosacea

Follow your plan of treatment

When your eyes get affected by rosacea, it becomes important that you follow your plan of treatment. You may be required to wash and clean your eyelids gently several times in a day or put eye drops in your eyes. This may seem tedious; however, it is vital to follow the treatment plan as directed by your physician.

You should also keep all the follow-up visits with your dermatologist so that they can assess your response to treatment.

How to treat acne-like breakouts caused by rosacea

If you have breakouts similar to acne because of rosacea there are some very effective treatment options for you. Your treatment plan may include the following:

Topical medications

Azelaic acid

Apply this medicine twice daily – once in the morning and evening.

According to findings from six studies, about 70-80% of persons with rosacea reported a reduction in their symptoms after using azelaic acid. Some patients also began noticing complete healing. Some of the side effects of using this medicine are a sensation of burning or tingling and skin lightening. These are temporary side effects; however, if you continue to notice them, tell the dermatologist.

Metronidazole

This medicine is available as a cream or a gel and is an age-old treatment for rosacea acne breakouts. According to studies, it can effectively reduce both the breakouts and redness.

Some people even stop the medicine and don’t get a flare-up of rosacea. In a study, flare-ups of rosacea occurred in only 23% of individuals six months after they stopped applying metronidazole.

Some of the side effects of using the medicine are stinging, itching, dryness or irritation of the skin.

Sulfur and sodium sulfacetamide

These ingredients may be present in treatments which you purchase over-the-counter (OTC) like a cleanser or in a prescription medicine which you are applying to the skin.

For more than sixty years, these ingredients treated breakouts similar to acne in rosacea. They are considered safe to use; however, tell the dermatologist if you suffer from kidney disease or if you have a sensitivity to sulfur. You should also mention if you are pregnant or are planning to conceive.

According to studies, a 65-78% reduction in breakouts similar to acne began showing patients in around six to eight weeks with these ingredients. Redness is reduced by 66-83%.

Possible side effects of using sulfur and sodium sulfacetamide are dryness, itching, irritation of the skin and temporary redness. The side effects reduce as you continue using the medicine.

Retinoid

Retinoid is a type of vitamin A, which may irritate your skin if you have rosacea. Once the rosacea is under control, applying retinoid may help in preventing flare-ups of the disease. It may also help in reducing the signs of skin aging. However, retinoid doesn’t work for everybody. You should ask your dermatologist whether a retinoid is a right option for you or not.

Medicines that you ingest

Antibiotics

Dermatologists prescribe tetracycline to treat rosacea. It can reduce redness and breakouts quickly. In studies, the majority of patients reported fewer breakouts within a period of one month.

Your dermatologist may also prescribe certain other antibiotics including minocycline, erythromycin or doxycycline. Once the condition is under control, the majority of patients choose another treatment modality to maintain their results.

When you take antibiotics for a long duration or too frequently you may develop antibiotic resistance. In this condition, it becomes difficult to treat deadly bacteria as the antibiotics utilized for their treatment loses their efficacy.

To prevent antibiotic resistance, doxycycline may be given in low doses.

Low-dose doxycycline

When doxycycline is taken in low doses it can’t kill bacteria; hence, it no longer acts as an antibiotic. According to studies doxycycline, when given in low doses, can reduce the acne breakouts of rosacea. Hence, the U.S. FDA has approved low-dose doxycycline as a treatment modality for rosacea.

The low dose produces fewer side effects and is safe. However, avoid this medicine if you are lactating or pregnant.

Isotretinoin

This medicine has been approved for the treatment of severe cases of acne. It reduces the breakouts and redness. However, it may produce serious birth deformities; so it may be unsafe for some persons suffering from rosacea.

Procedures

Light or laser therapy

These may treat the breakouts and redness effectively. However, it is a costly procedure. The majority of patients require multiple sessions to achieve the best results. Moreover, to maintain their results, most people also require follow-up light or laser treatments.

To get the best results, have the procedure done by a board-certified physician with vast experience in treating rosacea using lights and lasers. “FAAD” after the name of a dermatologist shows that the physician is board certified.

Get the best results

Keep your follow-up visits with the dermatologist to get the best results. During the follow-up visits, the dermatologist may do an examination of your skin.

If your treatment results are good, your dermatologist may ask you to continue with the same treatment for longer. If not, you may receive a different treatment. The dermatologist may also change the treatment plan as required to reduce long-term adverse effects.

How to treat thickening of the skin associated with rosacea?

If you have rosacea, you should closely observe your skin. If you observe rounded, firm bumps or thickening of the skin on the face, then visit a dermatologist. Thickening of the skin typically occurs on the nose. They may also be present on chin, eyelids, ears or forehead. Medically, these changes are called phyma, and it can be treated in the earlier stages with medicines. The treatment becomes difficult in the later stages.

In the later stages, phyma may result in medical problems, such as trouble in breathing. Thick, swollen eyelids may cause vision problems.

To treat skin thickening, dermatologists use the following methods:

Medicines that you take

Isotretinoin

This medicine has been approved for the treatment of severe cases of acne. It can also prevent the worsening of phyma; however, it cannot treat thickened skin. It may result in serious birth deformities in pregnant females; so it is not the treatment for everyone suffering from rosacea.

Surgery

Surgery is the only choice for removing thickened skin. For this, you may be referred to a surgeon who performs this type of surgery (dermatologic surgeon). The surgical procedure to remove thickened skin is complex. It usually requires the use of different types of surgical procedure for removing excess skin and then reshaping the nose or another area of the face.

Post-surgery, to remove phyma you may be required to consume isotretinoin for some time to maintain the results.

Prevention of flare-ups of rosacea

Although no cure exists for rosacea, still you can keep it under control. By making certain changes in your lifestyle and treating your rosacea under a dermatologist’s care, you can help prevent flare-ups. This may also help to prevent it from getting worse.

Many people find that living with their disease becomes easier by making these changes and getting treatment. They also state that they look and feel a lot better.

Protect your skin from sunlight

Just a couple of minutes of being in sunlight can result in uncontrollable redness and flushing on your skin if you have rosacea. You should follow your dermatologist’s recommendations for sun protection.

Reduce your stress levels

If stress triggers your rosacea, you should learn stress management techniques so that a flare-up is not triggered by it. You can do the following:

  • Do stress relieving activities often. Common activities that relieve stress are meditation, tai chi or deep breathing. You may also join a rosacea support group.
  • While you are experiencing stress, inhale deeply, hold your breath and then exhale slowly.
  • Practice a hobby or do something which you enjoy every day. This can be reading a book, listening to music, gardening, going for a walk etc.

Don’t get overheated

To prevent flare-ups caused by getting overheated, dermatologists recommend that you plan ahead so as to avoid overheating. Additionally, you can also do the following:

  • Take warm showers and baths instead of hot ones.
  • If you are feeling overheated, drape a wet, cold cloth around the neck. Drink a cool drink. Sit in a room with an air-conditioner or fan on.
  • Dress in layers. You may remove the extra clothing if you feel overheated.
  • Sit far from heaters, fireplaces and other heat sources.

Avoid hot beverages

According to studies, in some people, their rosacea may flare up due to heat from a hot beverage. If that is the case with you, try doing the following:

  • Drink iced tea or coffee.
  • Let your beverage cool down so that when you drink it it’s lukewarm or warm.

Observe the effects of alcohol

The biggest alcoholic trigger seems to be red wine. To reduce your flare-ups due to alcohol do the following:

  • Drink white wine and skip red wine.
  • Add lemonade or soda to beer, white wine or other types of alcoholic beverages to reduce the quantity of alcohol.
  • Don’t take more than one or two drinks and drink a glass of water (cold) after every drink.
  • It’s best to avoid alcohol altogether.

Reduce your consumption of spicy foods

If spicy foods trigger your rosacea, do the following:

  • Try a milder version of your favourite food. Instead of choosing hot wings, choose mild wings. Choose a milder version of salsa instead of a hot one.
  • If you still get flare-ups of rosacea, refrain from eating spicy foods.

Select hair and skin care products carefully

Do you develop burning, stinging or itching of the face while using certain hair or skin care products? Does your face become scaly and dry after using these products?

This indicates that these products are causing irritation of your skin. Do the following to avoid rosacea flare-ups:

  • Visit a dermatologist to get a tailored rosacea skin care plan and some recommendations for products.
  • Don’t use toners and astringents.
  • Don’t use hair and skin care products that contain camphor, menthol and sodium lauryl sulfate as they trigger rosacea.
  • Sodium lauryl sulfate is commonly present in toothpaste and shampoos. If you must use a certain product around the face, avoid ones which contain this ingredient.
select skincare products to avoid triggers

Use makeup that is rosacea friendly

If your makeup irritates your rosacea, dermatologists recommend the following:

  • Apply a fragrance-free, mild emollient to the skin before applying makeup.
  • Use a liquid-based, light foundation which spreads easily as makeup. Set this type of makeup using powder.

You should avoid:

  • Makeup that is waterproof.
  • Heavy foundations, which are difficult to spread or need makeup remover.

Check your medicines

If a medicine you are taking is causing flare-ups of your rosacea, don’t stop the medicine on your own. First, consult with the physician who has prescribed that medicine to check whether it can be a trigger of rosacea or not.

Typically, medicines that may cause flare-ups of rosacea include those that can manage:

  • Hypertension
  • Anxiety
  • Migraine headaches
  • Glaucoma
  • Multiple heart problems

Vitamin B3 may also act as a trigger for rosacea.

If a vitamin or medicine is triggering your rosacea, ask your physician to change it.

Keep your face protected from cold and wind

Windburn is a common problem in people who have rosacea and can trigger a flare-up, particularly in winter. Cold climates or surroundings can trigger rosacea. Do the following to reduce flare-ups from cold and wind:

  • Cover up your face (up to beneath the eyes) with an acrylic or silk scarf. Avoid placing wool or other rough fabrics on your face as they may trigger a flare-up.
  • Wear sunblock (rosacea friendly) and emollient daily to protect the skin.
  • Remain outdoors for a limited time only, particularly in the sun.
  • Follow the treatment plan for rosacea.

Keep cool during exercise

Anything that increases your body temperature, including exercise, may trigger rosacea. However, you may still exercise. Do the following while working out to avoid a flare-up:

  • Reduce the intensity of your exercise.
  • Exercise in a cool environment. During summer, exercise in an air-conditioned or shaded area and at the coolest time of the day.
  • Try swimming or aqua aerobics in cool water. It helps in limiting flare-ups.
  • Keep things with you that help in cooling down. For instance, drape a towel dipped in cool water around the neck, or a bottle of cool water, or some ice cubes.

Discover your triggers

Take note of the common triggers mentioned in this article. Keep a diary or notebook and write down everything that triggers your flare-up. Describe your symptoms and their severity. When you keep track of the triggers for some weeks or months, you will be able to pinpoint the exact cause of your rosacea flare-ups. Once you know what triggers your rosacea you can act to help avoid these trigger factors.

Maintain a food diary

Maintain a food diary to determine the common trigger foods or allergens in your diet. Once you can identify them, remove them from your daily diet to prevent flare-ups.

Skincare routine tips for managing rosacea

Even if a person is already treating their rosacea, the correct skincare can make a huge difference.

A skin care routine that is rosacea friendly can:

  • Help with making your skin look better and feel more comfortable.
  • Improve your treatment results.
  • Boost the overall health of your skin.
  • Reduce flare-ups of rosacea.

To help people who suffer from rosacea with the right skincare, dermatologists offer the following tips:

Clean your face very gently twice daily

Cleansing after waking up and before going to bed helps in removing the dirt and oil which may cause skin irritation. To cleanse your face without causing skin irritation, do the following:

  • Choose a mild cleanser.
  • Apply this cleanser using your fingertips gently in a circular motion.
  • Rinse with cool or lukewarm water using fingertips. Make sure to remove the cleanser thoroughly because if it remains on the skin, it may cause irritation.
  • Gently pat face dry with a cotton towel.

Moisturize your skin daily

Whether your skin is oily or dry, it is imperative to moisturize as it helps to hydrate the skin by trapping moisture in it. This reduces irritation and your skin will feel and look more comfortable. Studies also demonstrate that applying a moisturizer that is rosacea friendly may also improve treatment results.

Protect the skin from sunlight throughout the year

Sunlight is the most common cause of a rosacea flare-up. Even dark-skinned people can get a flare-up with prolonged sun exposure. Apply sunblock every day before heading outdoors, even on cloudy days.

Choosing a sunblock that is rosacea friendly

Choose a sunblock with the following:

  • Titanium oxide, zinc oxide or both.
  • Silicone. Otherwise known as dimethicone or cyclomethicone.
  • No fragrance. The label should say “fragrance-free”, however, if it reads “unscented” look for another one.
  • SPF 30 or more
  • Broad-spectrum

Choose skin care and cosmetic products that are rosacea friendly

When you suffer from rosacea, many cosmetic and skin care products may cause irritation of your skin. When buying products, dermatologists recommend that you go through the ingredient list before buying. Avoid products that contain the following :

Opt for fragrance-free products instead of unscented products

To decrease irritation, you may also:

  • Opt for a cream rather than a gel or lotion
  • Never use a toner or an astringent

Test makeup, skin care and cosmetic products before applying to the face

If a product is new or every product you apply seems to cause stinging, it may help to test it beforehand. To test a product, apply a tiny amount of it near the skin area that’s prone to rosacea. If you get a strong irritation (there is stinging, burning etc.) within a period of 72 hours, then don’t use the product.

Treat your skin gently

Anything that causes irritation of your skin may worsen your rosacea. Avoid scrubbing or rubbing your face. This implies that you should not use facial sponges or washcloths and should not exfoliate your skin.

If you are not able to find non-irritating makeup, skincare or cosmetic products, your dermatologist may help you. They may examine of your skin and then recommend products according to your skin’s specific needs.

Natural remedies for rosacea

There are several natural remedies that may help to relieve your rosacea symptoms. Some of these natural remedies include:

1. Aloe vera

Gel obtained from the leaf of aloe vera is moisturizing and an emollient. It serves as an effective treatment for rosacea when used topically.

Many moisturizers available commercially contain aloe vera. You may use them or take a leaf of an aloe vera plant, take out the gel and apply it directly to the skin. However, it is advisable to perform a patch test before applying it to large areas.

2. Burdock

Burdock root is available commercially as an extract, food or supplement. Usually, it helps in purifying the liver and treating skin conditions including acne. In studies, the extract of burdock plant proves to be an effective remedy for rosacea.

3. Essential oils

Lavender, tea tree, eucalyptus, chamomile, geranium, rosemary, thyme, and rose essential oils have shown to fight skin inflammation and treat irritable and sensitive skin.

To treat an area, simply apply three drops of essential oil mixed with half a teaspoon of carrier oil (jojoba oil or coconut oil). Rub the oil on the area twice a day. Always make sure to do a patch test with a tiny amount of oil before you apply the oil to large areas of affected skin.

extracting essential oil using a dropper from a bottle

4. Chamomile

Apart from an essential oil, you can also consume chamomile as tea. After it has cooled down, you can use it as a skin-compress or wash.

5. Coconut Oil

Coconut oil is a popular antioxidant, moisturizer and anti-inflammatory agent. Apart from using it as a carrier oil, you can apply it directly in small quantities to the affected skin.

6. Comfrey

This is a plant which manufactures a compound known as allantoin. According to a study done in 2017, a product that contained allantoin improved symptoms of redness with no adverse effects. Allantoin can be effective in relieving skin reactions.

You can use creams containing natural allantoin or comfrey and apply it to the affected skin following the instructions on the label.

7. Green tea

Green is a rich source of antioxidants. Antioxidants help fight inflammation. According to research, it is an effective remedy for treating rosacea which is an inflammatory condition.

Green tea is present in many skin creams and products for rosacea. The application of topical products containing green tea is usually the best way to treat rosacea. Additionally, you may also use cool green tea as a compress.

8. Niacinamide

This is a type of B vitamin that is present in foods and incorporated into lotions and creams for topical application. It is particularly good for relieving and preventing the flushing of skin which occurs in rosacea.

9. Oatmeal

An age-old natural remedy used to treat rosacea, oatmeal helps in strengthening the skin and reducing the loss of water, which may worsen the disease. It also helps relieve the itching.

Mix a few tablespoons of it with water to make a paste. Apply this paste directly to the affected skin. There are skin products, such as face masks, containing oatmeal available on the market.

10. Raw Honey

Certain forms of honey, particularly raw honey, are an effective remedy to treat rosacea. It helps the skin retain moisture, else dryness will occur and worsen rosacea. In a 2015 study, manuka honey showed to be an effective remedy for rosacea.

You should buy raw honey of high quality, either manuka or kanuka honey. Apply the honey directly to the affected skin areas.

11. Turmeric

Turmeric has anti-inflammatory properties,  most commonly used for herbal anti-inflammatory remedies. Most recommendations associate inflammation and pain with rosacea.

You may use the herb in your cooking to get the health benefits. Additionally, you may also topically apply essential oil of turmeric after diluting it with a carrier oil. Try mixing powdered turmeric with some water and apply this paste to the affected skin. It will work as a poultice.

References
https://www.healthline.com/health/skin/rosacea
https://www.aad.org/public/diseases/acne-and-rosacea/rosacea
https://www.healthline.com/health/skin/rosacea#types
https://www.aad.org/public/diseases/acne-and-rosacea/rosacea#causes
https://www.healthline.com/health/skin/rosacea#risk-factors
https://www.aad.org/public/diseases/acne-and-rosacea/rosacea#symptoms
https://www.aad.org/public/diseases/acne-and-rosacea/rosacea#treatment
https://www.rosacea.org/patients/materials/triggers.php
https://www.aad.org/public/diseases/acne-and-rosacea/rosacea/how-to-treat-the-redness
https://www.mayoclinic.org/diseases-conditions/ocular-rosacea/diagnosis-treatment/drc-20375803
https://www.aad.org/public/diseases/acne-and-rosacea/rosacea/rosacea-treatment-eye-problems
https://www.aad.org/public/diseases/acne-and-rosacea/rosacea/rosacea-treatment-acne-like-breakouts
https://www.aad.org/public/diseases/acne-and-rosacea/rosacea/rosacea-treatment-thickening-skin
https://www.aad.org/public/diseases/acne-and-rosacea/rosacea/how-to-prevent-rosacea-flare-ups
https://www.aad.org/public/diseases/acne-and-rosacea/rosacea/6-rosacea-skin-care-tips-dermatologists-give-their-patients
https://www.researchgate.net/publication/320697152_An_Effective_yet_Gentle_Foaming_Facial_Cleanser_Specifically_Designed_for_Redness-Prone_Skin
http://europepmc.org/abstract/med/23346663
https://www.healthline.com/health/rosacea-natural-treatments#bottom-line
https://www.aad.org/public/diseases/acne-and-rosacea/rosacea/triggers-could-be-causing-your-rosacea-flare-ups