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Rosacea

What is a Rosacea?

Rosacea is a chronic skin condition that causes the face to flush easily in reaction to certain triggers, causing redness accompanied with burning and itching sensations on the cheeks, nose, chin, ears and forehead. This flushing is caused by the dilation of blood vessels in the face, and can spread to the neck, chest, and even the scalp. Rosacea seems to most commonly affect biological females between the ages of 30-50 with fair complexions, but symptoms can can develop at any age and can affect either biological sex. It is a progressive condition; while symptoms may be sporadic and not very noticeable at first, they generally worsen and become more prominent and constant over time, especially without treatment. There is sometimes a delay in a rosacea diagnosis due to its gradual progression and pustules commonly being mistaken for acne, especially in younger age groups. 

Rosacea Symptoms

Rosacea can present with different symptoms depending on the subtype. One subtype involves persistent facial flushing, called erythematotelangiectatic rosacea. Someone with this type may have a permanent look of redness to the face, as well as visible blood vessels that look broken, usually around the cheeks and nose. If a person is unaware they have rosacea and/or it goes untreated, this redness may become irreversible. Rarely, the skin can also thicken and appear uneven and bumpy, and can even cause the nose to appear enlarged. Another type is papulopustular rosacea, which can resemble acne and causes the development of pustules on the cheeks, chin and forehead. These can vary in number and appearance, but are usually red and pus-filled. Unfortunately, if a dermatologist is not consulted, these bumps are commonly thought to be acne and not treated properly. These bumps can come and go, and can come along with the intermittent facial redness and flushing of rosacea. Lastly, ocular rosacea is a type of the condition that can cause perpetual dryness, sensitivity, and irritation to the eyes, usually causing a burning sensation and the appearance of red, bloodshot eyes. People’s symptoms may stick to one particular subtype, or they may have a combination. 

What causes Rosacea?

Doctors and researchers are still trying to determine the root cause of rosacea. It has been linked to potential hereditary factors commonly associated with the physical appearance of a fair complexion, such as light skin, eye and hair color. It has also been tied to external environmental factors such as an over infestation of the Demodex mite and poor gut health. While the cause is unknown, several factors have been linked to triggering the flares and symptoms of rosacea. These commonly identified triggers include stress, certain ingredients in makeup and skincare (such as witch hazel), spicy foods, foods high in niacin (such as chicken and mushrooms), and certain medications that cause vasodilation. Certain actions are also major causes of flares, such as alcohol consumption (mainly red wine), intense exercise (or in too hot of conditions), exposure to wind and sunlight, and smoking. These triggers cause facial flushing and/or the development of pustules, and flushes can last from minutes to hours. A flush can spread from the face down to the neck and chest area as well, and causes an intense feeling of heat, similar to that of a sunburn. Not everyone with rosacea is affected by the same triggers, and their rosacea may not be triggered every time they are exposed to a factor that usually affects their condition. For example, someone that usually experiences facial flushing from red wine may not if their rosacea is not in a flare-up period during that time.  

How do you treat Rosacea?

While there is no cure for rosacea, there are ways to treat the symptoms and manage flare-ups. Management of flare-ups is not only important for relieving physical comfort, but is vital in keeping the condition from worsening. As triggers differ from person to person, it is crucial for a person with rosacea to determine their unique triggers and attempt to avoid them on a daily basis. There are also certain dermatological treatments that have been effective in reducing the physical appearance of rosacea, including topical medications or laser therapy to shrink expanded blood vessels. If rosacea is left untreated, the blood vessels causing the flushing may remain enlarged even without triggers and cause permanent facial redness. 

Is Rosacea tied to your gut health?

The connection between skin and gut health is a hot topic of research. Gut dysbiosis is commonly linked with widespread inflammation, which is the root cause of many chronic conditions, including rosacea. Several studies have correlated higher incidences of rosacea in patients that also have gastrointestinal disorders such as IBS and IBD, with one study even finding that patients with rosacea were 13 times more likely to have SIBO. Common triggers of rosacea can be tied to gut health, such as stress and certain foods.  Stress is consistently linked as a potential indication that the gut is out of balance, which in turn could be causing rosacea flares. Similarly, specific foods causing flushing may be an indication that they aren’t being digested properly or are in some way harmful to a person’s unique microbiome. So while more research is needed on the gut-skin connection, it makes sense that focusing on a healthy gut might end up also being advantageous in dealing with the management of rosacea. 

Can probiotics help with Rosacea?

More research is needed, but studies have shown that probiotics might positively impact the gut and skin barrier function by inducing the growth of beneficial bacteria. This may help reduce inflammation, and thus potentially be extremely helpful in alleviating skin disorders such as rosacea. However, it is important to note that not all probiotic strains may be favorable for each person, only certain strains may help balance the gut while others may have the opposite effect. Therefore, using personalized probiotics unique to a person’s gut microbiome, is the smart option to make sure you are only consuming helpful probiotics that may have a positive effect on overall your gut health and skin health. 

Are there supplements to help with Rosacea?

While there is some encouraging research on the potential benefits of zinc and omega-3 supplements, there is just not enough clinical evidence yet to support their aid in rosacea management and treatment.