Tuesday, 6 October 2020

Rosacea

A common chronic disease of unknown cause, characterised by redness with inflamed spots and pustules. Though it may be under control it is a relapsing condition. The skin appears tense and shiny (though it's not an oily skin condition) and on close inspection often reveals spider or thread veins. Rosacea is usually confined to the face, though it may spread onto bald scalps and, rarely, even onto the upper arms.

It used to be associated with acne but it's actually a very different condition. There is no oil present and the spots don't usually leave any scarring or pits. Symptoms include flushing, heat and stinging, spots, visible blood vessels, skin sensitivity, sometimes skin thickening. It effects about 1 in 10 people and 1 in 600 people are diagnosed with it in the UK every year. It's most common in fair skin (used to be called 'the curse of the Celts'). Occurs in men and women but more common in women between 30 & 50 and though it's three times more common in women it tends to be worse in men.

4_subtypes_of_rosacea

The exact cause is unknown though could be abnormalities in the blood vessels on the face or a reaction to mites. Recent research shows that UV light, alcohol and other triggers activate peptides in the skin. These in turn effect the immune system which causes the dilation of blood vessels. Rosacea can be genetic and was originally thought of to be linked to acne but it's not and for some it can be related for hormonal changes often the menopause. An allergy to Demodex mites is the cause for some whilst for other it's related to a gastrointestinal disease - including excessive growth of the bacterial populations in the small intestine (SIBO - small-intestinal-bacterial-overgrowth) which can be treated with antibiotics.
Some ingredients in your skin care can cause a flair up: alcohol, fragrance, salicylic, glycolic and witchazel - alcohol denat is a definite trigger for me  If you have a flair up check the common ingredients and avoid waterproof base makeup as removal is hard.

Everyone with rosacea will find they have different triggers - UV, alcohol, stress, temperature, wind, 
exercise, spicy food, dairy and hot drinks as well as the ingredients in your skincare can all be triggers. For me it used to be alcohol and hormonal changes. Now it's really just ingredients in skincare.

Before you start thinking about the best way to treat rosacea it's good to identify which subtype you have. 

1. Erythematotelangiectatic - permanent redness with a tendency to flush and blush easily. Possible intense burning, visible blood vessels.
2. Papulopustuar - some permanent redness, bumps and pustules. Easily confused with acne
3. Phymatous - most commonly associated with an enlarged nose, thickening skin, irregular surface nodules. Can affect chin, eyelids and forehead.
4. Ocular - eyes and eyelids appear red and may feel itchy and dry. Blurring, sensitivity to light and higher susceptibility to eye infections.

Though there is no known cure for rosacea you can absolutely do things to keep it under control. If it's really bothering you it's worth going to your GP to see what they recommend and in some instances getting blood tests to check thyroid function. Things you can do at home are: avoid known triggers (as mentioned above), laser treatment helps some cases. Medications such as ivermectin (prescription) and azelaic acid (this is the one to use) can help. Sometimes antibiotics can help though it will probably only be temporary. It's important for everyone to use sunscreen every day but if you have rosacea and good physical sunscreen is a must (chemical sunscreens convert UV into heat in the skin and therefore raises the skins temperature). Omega 3 fatty acids are good to take to help improve general skin health. 

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