Rosacea: Triggers, Treatment, and Advice

Rosacea is a chronic and inflammatory skin condition that affects millions of people worldwide. Although it is not a life-threatening condition, it can significantly impact one's quality of life and self-esteem. We want to help those of us with rosacea understand the various types of rosacea, including its triggers, highlight certain factors that can be impacting their rosacea more than they are aware of and explore all possible treatments from skincare to clinical treatment. This is so we can help you feel momentous in your skin, confident in yourself and to simplify your skincare journey. 

Rosacea Triggers: Identifying and Managing Flare-ups

There are four types of rosacea [1]:

• Subtype one: known as erythematotelangiectatic rosacea (ETR), is associated with facial redness, flushing, and visible blood vessels.

• Subtype two: papulopustular (or acne) rosacea, is associated with acne-like breakouts, and usually develops in our 30s 

• Subtype three: known as rhinophyma, is a rare form associated with the thickening of the skin on your nose. It usually affects men and is often accompanied by another subtype of rosacea.

• Subtype four: is known as ocular rosacea, and its symptoms are centred on the eye area.

Rosacea is characterised by redness, visible blood vessels, and small, pus-filled bumps on the face [2]. The condition can be exacerbated by certain triggers, making it important to identify and manage them effectively. Common triggers include: 

• Exposure to sunlight

• Hot weather

• Stress

• Spicy foods

• Alcohol

• Caffeine

By limiting or avoiding these triggers, individuals with rosacea can reduce the frequency and severity of flare-ups. One way you can narrow down your triggers is by keeping a skin diary including your symptoms as well as your daily meals and other habits. This approach is similar to that of a food diary for identifying food sensitivities.

It’s helpful to write down:

• all the foods you eat

• what types of beverages you drink

• the weather and any environmental changes

• what types of personal care and skin products you’re using

• your daily activities and exercise routine

• your current stress levels

• any new life changes

You can also use this checklist from the National Rosacea Society instead of a notebook.

Additionally, gentle skincare practices and using products designed for sensitive skin can also help in managing the condition, as the skin barrier is more fragile with rosacea. Moisturising regularly and protecting the skin from harsh weather conditions can be beneficial for individuals with rosacea.

The Role of Diet in Rosacea Management

Research suggests that diet can play a role in managing rosacea symptoms. While there isn't a one-size-fits-all approach, some dietary adjustments may help control flare-ups. Foods that are often associated with triggering rosacea include spicy foods, hot beverages, alcohol, and foods high in histamines, such as fermented or aged products [3]. Rosacea is an inflammatory skin condition, so limiting foods that increase inflammation, e.g. simple sugars and refined carbohydrates, or combining these foods with fat and protein to reduce sugar spikes can help reduce overall inflammation in the body. Keeping a food diary and noting any flare-ups after specific meals can help individuals identify their personal triggers.

On the other hand, some foods have been shown to have potential anti-inflammatory properties that could benefit rosacea-prone skin. These may include foods rich in omega-3 fatty acids, and antioxidants, and those with a low glycemic index [4]. A consultation with a registered dietitian or healthcare professional can help individuals develop a personalised diet plan that aligns with their specific needs and triggers.

The Role of UV in Rosacea Management 

You may notice redness and skin flushing right after your skin is exposed to the sun. Sunburn can make your flare-ups even worse. The heat can also increase your body temperature, which dilates blood vessels and triggers inflammation [5]. 

Limiting sun exposure, especially during the midday hours, can help prevent these types of rosacea flare-ups. Practising overall sun safety, such as wearing a wide-brimmed hat and sunglasses during the summer months is also advised. Most importantly, Renude recommends wearing broad-spectrum sunscreen every day, and topping this up every 2 hours in accordance with advice from the British Association of Dermatologists; you can see our guide on sunscreens for Eczema and Rosacea for more help.

Skincare Tips for Rosacea Management

Maintaining a consistent and gentle skincare routine is crucial for individuals with rosacea [6]. Using mild, fragrance-free, and non-comedogenic products can help avoid irritation and flare-ups. 

Some key skincare tips for rosacea management include:

1. Cleansing: Use a gentle, non-abrasive cleanser to wash the face twice a day, avoiding hot water. Avoid oil-based cleansers as these can increase inflammation within the skin, opt for cream or gel-based instead. Pat the skin dry instead of rubbing.

2. Moisturising: Apply a simple non-comedogenic moisturiser twice daily to keep the skin hydrated and protected.

3. Sun Protection: Use a broad-spectrum sunscreen with an SPF of at least 30 every day, even on cloudy days. Physical sunscreens with zinc oxide or titanium dioxide are preferable but are generally best suited to those with light-medium skin tones. Those with medium - deep skin tones should look for a hypoallergenic formula, which has been specifically tested on sensitive skin

4. Makeup: Choose makeup products specifically formulated for sensitive skin and avoid heavy or oil-based products. We recommend mineral-based makeup where possible. 

5. Avoid Over-Exfoliation: Exfoliating the skin should be done sparingly and gently to prevent irritation. We would always recommend speaking with a professional before adding any exfoliating products into your skincare routine.

Clinic Treatments for Rosacea 

Laser Treatment

For individuals with moderate to severe rosacea symptoms, laser treatment can be an effective therapeutic option [7]. Laser therapy works by targeting blood vessels and reducing redness and visible blood vessels on the face. Different types of lasers, such as pulsed dye lasers and intense pulsed light (IPL), can be used depending on the severity and type of rosacea [8].

It's essential to consult an aesthetician or dermatologist at a registered clinic before undergoing any laser treatment. They will assess the individual's specific condition and recommend the most suitable laser approach. Laser treatment can significantly improve the appearance of rosacea and boost confidence. We would typically recommend opting for a CQC-registered clinic for this type of aesthetic treatment. CQC stands for Care Quality Commission and is an independent regulator which monitors and inspects healthcare providers to ensure the highest level of service and quality.

Rosacea is a complex condition, but identifying and avoiding triggers, adopting a suitable diet, and incorporating effective skincare practices can go a long way in reducing flare-ups and managing symptoms. 

Consulting healthcare professionals will ensure personalised and effective treatment plans tailored to each individual's needs. With the right approach, those with rosacea can achieve better control over their condition and enjoy a more comfortable and confident life. Take our skin quiz if you’d like to speak to one of our aestheticians about your skin and get helpful advice. 

Resources: 

Rosacea: Understanding the 4 Types & Treatment (usdermatologypartners.com)

Rosacea - NHS (www.nhs.uk)

Diet and rosacea: the role of dietary change in the management of rosacea - PubMed (nih.gov)

Rosacea Diet: Foods to Eat and Foods to Avoid for Calmer Skin (healthline.com)

Impact of ultraviolet radiation and exposome on rosacea: Key role of photoprotection in optimizing treatment - PubMed (nih.gov)

Skin care routine for rosacea: Tips and more (medicalnewstoday.com)

Rosacea | NHS inform

Laser Treatment for Rosacea: Types, Efficacy, Side Effects, and More (healthline.com)