If you’re a rosacea sufferer, there is no quick fix solution to your skincare woes. Unfortunately, rosacea skin is easily irritated and very sensitive. 

The so-called “Curse of the Celts”, rosacea is a chronic inflammatory skin condition prevalent in those with fair skin of Celtic origin, or northern and western European descent. However, people of all ethnicities can suffer from rosacea.  

As a chronic skin condition, rosacea presents most often in people between the ages of 30-50. Although it’s more common in women, it tends to be more severe in men. Despite remaining mysterious, it’s a common skin concern, affecting - 14 million people in the US, and as many as one in ten people in the UK population. 

The facial flushing and redness that characterizes rosacea creates discomfort and embarrassment, which ironically can lead to further flushing. Persistent redness is most commonly seen in the cheeks, forehead, nose and chin. Blood vessels may be visible, capillaries dilated and bumps can present that can be mistaken for acne. There may be swelling, and a burning or stinging sensation when experiencing a flare-up.  

The most common signs of rosacea include spider veins (broken capillaries), sensitive skin that is highly reactive to the sun or skincare products, visible blushing, large, inflamed pores, sensitivity around the eyes and bumpy skin texture. Many people with rosacea do not realise that these signs are a chronic skin condition. It can begin as a small patch of skin, before spreading to other parts of the face and becoming more intense.  

Rosacea Triggers 

Generally, the following stimulants are understood to be common triggers rosacea: 

• Extreme hot/cold weather or rapid change in temperature, including hot baths, hot tubs and saunas 
• Stress and negative emotions like anxiety and anger 
• Wind, sun or humidity exposure. 
• Eating spicy foods 
• Taking intense exercise 
• Caffeine 
• Alcohol 
• Tobacco 

 Feeling run-down, or allergies to certain foods are also potential triggers.  

Rosacea Causes 

There are several theories about the root cause of rosacea, but currently, scientists do not have a definitive answer for it. It’s thought both genetic and environmental factors are likely to play a role.  

Factors that are thought to influence the development of rosacea include: 

Demodex mites – these mites are microscopic and live on human skin in small numbers. However, in people with rosacea, it’s been observed that numbers of these mites are elevated, as much as 18 times higher in some cases. Although harmless, the mites release a bacterium when they die that may trigger an inflammatory response. 

Sun damage – researchers have found that exposure to radiation in UV light caused increase production of vascular endothelial growth factor, linked to the development of visible blood vessels. 

Genetics – rosacea appears to run in families which would suggest a genetic factor is at play. However, it’s also present in people where there is no known genetic link to the condition too – so this is probably not the only factor. 

H Pylori – these bacteria live in the digestive tract and there is a suspected link between them and rosacea, however there’s currently not enough research to support this theory. 

As you can see, there's quite a large amount of trial and error involved with figuring out what exactly your triggers are. When your skin flares up a red appearance occurs due to the expansion of capillary walls causing a rush of blood to your face. With rosacea, the compromised elasticity of the capillary walls means that the capillaries hold the blood, and your face maintains a red or ruddy appearance for longer. This is further aggravated by nervous or digestive disorders and where people have thinner skin, as the the blood vessels become more visible in the face. 

Types of Rosacea 

Different types of rosacea present different symptoms, or in some cases have a combination of more than one, or all the subtypes. There are four major subtypes of rosacea: 

Erythematotelangiectatic rosacea – It’s characterized by facial redness, flushing, and visible blood vessels. This is the most common type of rosacea. 

Papulopustular rosacea – It’s associated with acne-like breakouts and sensitivity (most common among middle-aged women); Persistent redness aside, bumps (papules) and/or pimples (pustules) also present with this subtype. It’s more commonly referred to as acne rosacea.  

Phymatous rosacea – There is swelling, fluid retention, thickening skin around the nose (known as rhinophyma), and redness. 

Ocular rosacea – This subtype is characterized by rosacea around the eyes. 

Rosacea Diagnosis 

To diagnose rosacea, your doctor or dermatologist will examine your skin and eyes. There is no one diagnostic “test” to diagnose rosacea. It’s important to get a professional diagnosis, to make sure that the condition isn’t a symptom of any other underlying illness, particularly if there is a sudden onset of rosacea. Early diagnosis is best as it means you can treat the rosacea most effectively by finding your triggers and what works best for you. It’s also best to treat rosacea as early as possible to best prevent the condition from worsening or becoming permanent, pronounced redness. 

Rosacea Treatment 

Unfortunately, if you're wondering how to get rid of rosacea permanently, there is no known rosacea cure. However, symptoms can be managed/eased with a tailored approach and avoidance of known stressors. This is a condition where patience with treatment measures is needed - it can take weeks or months of consistently implementing a treatment plan before results become visible. 

As rosacea appears to be triggered by an inflammatory response in the body – it makes sense that by avoiding triggers, you can reduce the inflammatory response and by extension your rosacea symptoms. The main suggestions to help alleviate and treat rosacea include both internal and external approaches. They include: 

• Sunscreen & limiting exposure to direct sunlight – the sun’s UV light aggravates rosacea symptoms. By limiting sun exposure and using SPF 50 sunscreen, you’re protecting yourself from harmful damage caused by the sun’s UV rays. 
  
  
• Sunscreen & limiting exposure to direct sunlight – the sun’s UV light aggravates rosacea symptoms. By limiting sun exposure and using SPF 50 sunscreen, you’re protecting yourself from harmful damage caused by the sun’s UV rays.
  
  
• Diet and food sensitivities – following an anti-inflammatory diet protocol may help reduce the symptoms of rosacea. A rosacea natural treatment diet could involve removing potential allergens like gluten, dairy, eggs to see if they’re contributing to skin redness using a method of elimination. Alcohol and caffeine have been known to increase skin redness. Refined vegetable oils, processed sugars and other highly processed foods can be pro-inflammatory in the body, resulting in a flushed or red appearance. 
  
  
• Diet and food sensitivities – following an anti-inflammatory diet protocol may help reduce the symptoms of rosacea. A rosacea natural treatment diet could involve removing potential allergens like gluten, dairy, eggs to see if they’re contributing to skin redness using a method of elimination. Alcohol and caffeine have been known to increase skin redness. Refined vegetable oils, processed sugars and other highly processed foods can be pro-inflammatory in the body, resulting in a flushed or red appearance.  
  
  
• Prescribed medicines – these are medicated treatments to treat rosacea, either applied topically on the skin or taken in antibiotic pill form. Your doctor may prescribe one of the following: 
  
  • Brimonidine (Mirvaso) - a gel that tightens blood vessels in the skin. 
  • Azelaic acid - a gel and foam that clears up bumps, swelling, and redness. 
  • Metronidazole (Flagyl) and doxycycline - antibiotics that kill bacteria on your skin and reduce redness and swelling. 
  • Ivermectin (Soolantra) and oxymetazoline - topical treatments that are used to treat rosacea. 
  • Results vary for each individual, and it can take you a number of weeks or months of use before you notice an improvement in your skin.

• Skin treatments – dermatologists provide treatments such as dermabrasion, laser therapy and light therapy can be used to help with rosacea. 

• Avoiding certain ingredients in skincare - The following ingredients could be a trigger for rosacea prone skin, and you should be hesitant of products containing these as they may cause a flare up: alcohol, camphor, fragrance, glycolic acid, lactic acid, menthol, sodium laurel sulfate (often found in shampoos and toothpaste), urea. 

Day to day however, you may be wondering if there’s a natural way to care for and protect red or sensitized skin. Some popular herbal ingredients include licorice, feverfew, green tea, oatmeal, lavender, chamomile, tea tree oil, and camphor oil. The purported efficacy of these herbal ingredients is often based on their anti-inflammatory properties. Some of these ingredients do have proven benefits, but some may aggravate rosacea, such as tea tree and camphor essential oils. 

However, one class of natural ingredients that is well studied, with proven efficacy by topical application, is plant oils. 

Natural Plant Oils & Rosacea 

Everyone’s skin is different, and what works for you might not have any effect on another. If you are looking for natural remedies for rosacea that you can implement into your rosacea care regimen, natural oils could be a good place to begin. Plant oils have a lot in common with the sebum produced by the skin and contain a lot less irritants than typical skin care products. With rosacea, it is important to know exactly what is being applied to your skin. As a rough rule of thumb, a lengthy list of indecipherable ingredients means the chances of something affecting hypersensitized skin is a lot higher. 

The first consideration when selecting any natural plant oil should be the oil's fatty acid composition. Choose an oil with high levels of essential fatty acids (Linoleic acid and Linolenic acid), ideally without fragrance. These essential fatty acids are well studied and have proven efficacy for improving skin health. For example, in one placebo-controlled study, "oils [rich in essential fatty acids] significantly improved all skin properties measured. Specifically, there was attenuated inflammatory response to a chemical skin irritant, decreased TEWL, and reduced skin roughness and scaling." Some examples of oils rich in essential fatty acids include:  

• Rosehip – very hydrating, rosehip can improve the texture of the skin while moisturizing. Anecdotally, rosehip oil is considered one of the best soothing natural treatments for rosacea.
• Evening primrose - high in gamma-linolenic acid, has anti-inflammatory properties, evening primrose can be used as a facial oil for rosacea. 
• Kalahari Melon oil - In a study where patients were being treated with Minocycline for rosacea, gamma Linolenic Acid, for which Linoleic Acid (70% of Kalahari Melon oil) is the primary natural precursor, was shown to significantly improve outcomes. It is also rich in vitamin E which means it remains stable for longer - making it a promising natural treatment for rosacea.

Precautions 

Plant oils containing essential fatty acids should not be confused with essential oils. Essential oils are distilled, aromatic compounds that are often irritating to skin, whereas essential fatty acids are key components of human cells that play an important role in skin barrier function. These essential fatty acids can be found in high concentrations in the plant oils mentioned above.

Skincare Tips for Rosacea Care 

If you suffer with rosacea, it’s best to follow a simplified skincare routine. This means:  

• Avoiding any harsh products (i.e. those designed for acne, they contain many irritants for sensitive skin). 
• Avoiding abrasive products (exfoliants in particular). 
• Washing the face with tepid water (not too hot, not too cold), avoid foaming cleansers and soaps that strip moisture from the skin barrier. 
• Always wearing sun protection – sunscreen containing zinc oxide is best for skin with rosacea as it is a mineral, not chemical, sunscreen. 
• Learning your skincare trigger ingredients and avoiding their use. 
• Moisturiser that helps rebuild the skin’s lipid barrier might help to ease sensitivity and the symptoms of rosacea. 

Lifestyle changes and implementing a consistent daily skin care routine that’s gentle and helps rebuild the skin’s lipid barrier, can help manage rosacea. You can help support your skin’s health, even if rosacea can’t be cured completely.  

Professional guidance and a longer-term maintenance  

This article’s intention is to educate, not to provide medical advice. Always speak to a medical professional or certified dermatologist first.