Rosacea Case Studies

I have several clients with rosacea, and their skin couldn’t be more dissimilar. Blood vessels right under the surface of the skin become enlarged, triggered by temperature changes, strenuous exercise, UVA & UVB, harsh facial scrubs and spicy foods. Whilst there is no cure for rosacea, there are ways of controlling it, especially if it is caught young; otherwise a tendancy towards flushing can exacerbate dry skin (leading to flaking and redness) or an oily skin can thicken and develop lumps.

The first stage in an anti-redness skincare routine is to avoid irritants such as glycolic acid, synthetic fragrances, alcohol, witch hazel, fragrant plants/essential oils e.g. cedar, cinnamon, lavender, lemon, lime, menthol. I also advise against abrasive facial scrubs.

There are two main aims:

1)Ease inflammation by swapping irritating ingredients for calming ingredients

2)Repair protective layer which has become damaged and vulnerable.

The dermatologist Leslie Baumann recommends the following calming ingredients:

aloe vera

basil

chamomile

vitamin b5

ginger

niacinamide

salicylic acid

sulphur

tea tree oil

zinc

Everyone needs a sunblock as UV light is one of main causes of rosacea.

Florence

Florence is a young beauty therapist with a pink toned Celtic complexion who unfortunately suffers from acne, rosacea and occasional eczema, but refuses treatment and her skin looks angry. Rosacea is more common in delicate pink toned skins and I worry that unless she addresses the redness, it will be become permanent as she gets older. She is also unlucky to have acne as well (quite different from the lumpiness that accompanies rosacea in a mature skin), commonly misdiagnosed as acne rosacea; hers is true acne with congestion and blackheads.

Her dehydrated, combination skin feels tight around the edge, with a shine on the t -zone and spots on the chin. She was wary about getting medication from the GP because she was worried that retinoids would thin and dry out her skin. Of course I am a long term retinoid user so I am slightly biased. Her skin felt tight after using her Elemis cleanser, (which as a therapist she knew was a sign that the product was not right for her skin), but it helped heal the breakouts temporarily, and her skin felt better the next day. She was looking for a range using entirely natural ingredients.

I advise all my clients to treat their skin conditions from the inside out with an anti-inflammatory diet, but particularly in Florence’s case because she was adamant that she didn’t want any medical treatment.

Fruit/veg x 5 daily

Good fats e.g. oily fish such as mackerel

supplements: ginger, turmeric

An acid/alkaline diet combined with the GI (low sugar glycaemic index) diet because high blood sugar levels cause inflammation at a cellular level

500mg of evening primrose oil x 2 daily

Avoid coffee which causes stress which prompts the release of sugar

Over the counter acne treatments will be too irritating

Susie

Susie’s skin was dry/combination although now she had hardly any shine and found that make up goes patchy. Susie is so distressed by her facial redness that she had sought the help of a cosmetic doctor who injected the red veins, but unfortunately they came back within six months. She spends a lot of time outside, and seeing as environmental factors are a main cause, I devised an environmental protection routine.

1) Cleanse – gentle cleanser with anti-inflammatories

2)Anti redness serum – I recommend a vitamin c serum (at least 10% l-ascorbic acid) which protects skin from both pollution and UV rays which stimulate nerve endings,contributing to redness.

3) A redness cream – although Susie has a bit of shine down the centre of the face, the rest of her skin dry.

Cortisone creams are best avoided because they make the condition worse despite seeming to narrow the blood vessels at first..

IPL, gentle facial lasers (ND Yag) and pulsed dye laser all reduce enlarged blood vessels and help with reactive redness but they can recur. This happened to my client: her expensive laser treatment lasted only a year and left her with open pores around nose and chin.

Alicia

Alicia’s skin was previously oily with localised spots on her face and she developed rosacea in her fifties, but had found a way of dealing with it. I have adopted her dermatologist’s approach to treating rosacea: either gently with kid gloves, or harshly. Alicia chose harshly and it has worked for her oily skin.

Routine:

AM: tea tree wash

Elizabeth Arden sensitive toner

PM: Clinique 7 day scrub mixed with a pea size blob of Dr Organics tea tree facial wash

Alicia didn’t use a particular product for rosacea and wouldn’t take the long-term antibiotics recommended by her GP (none of my clients would consider medication). This is a shame because bacteria is one of the main causes of inflammation and antibiotics are anti-inflammatory. A low dose for three months (either tablets or gel) can really help reduce the lumpiness. This lumpiness is often misdiagnosed as acne rosacea but ironically similar treatments can help e.g. low doses of the powerful acne drug roacctuane can help stubborn cases because it has an anti-inflammatory action.

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