ROSACEA, AN EXPERT'S GUIDE

ROSACEA, AN EXPERT'S GUIDE

ROSACEA, AN EXPERT'S GUIDE

Rosacea or sensitive skin, afflicts 40% of the Irish population. Those most affected tend to be aged between 30 – 60, with a naturally paler complexion. Females are more likely to suffer from Rosacea, however, when rosacea does occur in males it is often more severe and advances more rapidly. The causes can be a genetic predisposition, stress, vascular dysfunction or inflammation.
Signs and symptoms
Rosacea refers to a range of symptoms that generally begin with ‘blushing & flushing’ and redness on the cheeks, nose, forehead and chin. As the condition progresses, symptoms typically worsen to include persistent redness of the nose and cheeks. Whichever the symptoms this condition is worsened by the breakdown of the acid mantle and the skins natural barrier.
Primary signs:
Burning and stinging, small blood vessels spring to the surface (Telangiectasia), and become increasingly visible. Diffused redness may become permanent, often worsening after exercise, drinking coffee or alcohol or other triggers. Redness is also an indicator of collagen loss, which leads to thinner skin and weakened support of the capillary network.
Secondary signs:
Rough and scaly skin, heat welts, pustules, papules or nodules may develop in these later stages; a factor which has led to the misdiagnosis of rosacea as “ acne rosacea ”. 
4 Sub types

  • Erythemato-telangiectasia, characterised by: transient flushing, central redness (erythema), stinging, burning, roughness or scaling, often seen in paler skin types

  • Papulopustular, characterised by: persistent flushing, central facial redness (erytherma), water or fluid filled vesicles, often in darker sin types

  • Ocular rosacea, characterised by: photosensitivity, watery eyes, burning, stinging, or the feeling of a foreign body within the eye

  • Phymatous rosacea, characterised by: thickened, course skin, enlarged pores and nodules present, often affects the nose (more present in male patients)


Aggravating Factors 

  • UV exposure

  • Overactive innate immune system

  • Perfumes and essential oils

  • Over use of lipid substances in topical skincare - sub type 2

  • Physical exercise

  • Menopause

  • Emotional & adrenal stress

  • Temperature changes (extreme), including hot showers

  • Chemicals (surfactants and preservatives) that can be found in many cleansers, toners and moisturisers

  • Some medications

  • Hormonal fluctuations such as menopause

  • Digestive disorders

  • Free radicals

  • Vitamin A & vitamin C and calcium deficiency

  • Diet e.g. alcohol, chocolate, acidic food & hot spicy foods and low fat diets 


Correct skin care and treatments to help manage symptoms
While there is currently no cure for rosacea, its symptoms can be managed quite effectively. Skin cell health and an intact and fully functioning defence barrier is very important to improving the condition.
In addition to the ingredients outlined below, a dietary intake of essential fatty acids such as Omega 3 & 6 is beneficial.
The stabilisation of the acid mantle and the repair of the skins barrier concentrates on mild cleansing, non irritating and anti inflammatory skin care and protection.
By addressing the primary and secondary factors we can directly treat the underlying causes. A home care regime is hugely important for maintenance and continual improvement for this condition.
The skin care products you use should be free of perfumes, preservatives, emulsifiers, mineral oils and silicones, as these substances have the ability to further aggravate a sensitive, inflamed skin condition such as rosacea.
The use of topical skin care ingredients with great supporting clinical evidence include;
Niacinamide (vitamin B3) increases ceramide and free fatty acid in the skin, which are key components in the protective lipid barrier. It also reduces redness, is anti-inflammatory and keeps the skin clam
Tetra-peptide-14- a redness relieving peptide
Gluththione- An anti-oxidant naturally produced in our bodies, glutathione helps to recycle vitamin C & E. It is shown in many rosacea studies that this peptide and vitamin c are reduced to extreme low levels due oxidative stress within the skin. 
Hinokitiol- extracted from the oils of the western red cedar tree this superpower ingredient with soothing, anti-irritant, anti-oxidant and brightening properties, these properties allow hinokitiol to target multi-factorial skin redness and blemishes more than 100 scientific articles exist on the biological effects
Marine Glycosaminogylcan: Glycosaminogylcans inhibit enzymes (MMPS)which are activated by uv rays, these enzymes are ‘upgraded’ with uv light increasing their numbers that inevitably leads to the breakdown of collagen and extracellular matrix which ultimately leads to redness and loss of collagen and elastin 
Vitamin A – Retinol
Stimulates collagen growth (neo collagenesis), regulates cell turn over & strengthens skin
AHAs
Regulates the ph of our skin, re-acidifies the acid mantle which preserves the micro flora of our skin, reducing trans epidermal water loss (evaporation of water from our skin) resulting in an increase free water within the epidermis and dermis
Vitamin C
Anti-oxidant, essential for optimal skin ‘performance’ drastically reduced in stressed skin. Neutralises ‘free radicals’ and gives UV protection.
SPF
Zinc- anti-inflammatory reduces redness and sensitivity. Decreases the stimulation of MMP activity (see above). 


***Treatment options***
A course of Intense Pulsed Light treatment is often the first port of call as it will visibly reduce red veins, improve background diffused redness and stimulate fibroblast activity resulting in a thicker healthier dermis.
Results may be seen in as little as 2-3 treatments.
A course of five consecutive treatments provide long term results. Maintenance sessions are required on a patient to patient basis.
In-clinic treatments such as Alumier MD enzyme re-activation treatment aims to stabilise the disordered skin barrier over the course of the long term. The skin barrier, when functioning well and intact, can prevent triggers such as environmental stress, chemicals and germs from causing a flare up.
As the skin barrier is stabilised, symptoms will gradually regress and you will notice visible improvements to the condition. In summary, a stronger skin with intact lipid bilayers (natural occurring oil created by our skin cells) will be better able to prepare itself to utilize anti-oxidants to scavenge free radicals. 
For further information regarding this condition or to book a free one-on-one consultation contact us on 01 6629106 or email [email protected]
References

  • Dr Hans. Lautenschläger, various publications Beauty Forum & Cosmetic Medicine

  • Florence Barrett-Hill; Skin Treatment Therapy for the Medical/ Therapeutic Professional, 2008

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