Rosacea is a chronic inflammatory skin condition that affects millions.
It is a skin condition that the Estheticians at The Summit see on a regular basis. Although as Estheticians we cannot diagnose this skin condition, we assist our clients through treatments and home care in managing this often distressing and frustrating skin condition. Working with clients with rosacea has become one of our specialties!
WHAT IS ROSACEA?
This is a chronic non-contagious inflammatory skin condition that has a slow progression. It is a disorder of the pilo-sebaceous unit (hair follicle/pore/oil gland) whose cause has several aspects that are still being understood and researched. It has 4 recognized stages as well as a "pre-rosacea" stage. The stages range from mild flushing and blushing, to intense and sudden flushing and blushing, visible veins, redness, itching, swelling, red bumps, acne-like breakouts and skin thickening. The name Rosacea comes from the latin word "like roses" but as anyone suffering from this skin condition will tell you - it is not all rose-y! It is a condition that cannot be cured but lessening of the symptoms, flare-ups and redness can be dramatically improved with the correct treatments, patience and a steady and guided home care regimen.
Here are some of the stats:
- Affects more women than men
- Fair skin more prone
- English, German and Irish are genetically more prone.
- Appears from 30-50 years of age and peaks in 40's-50's
- In a recent survey of people with rosacea 41% avoid public contact when in a flare-up and 51% miss work due to their condition
STAGES- if the condition is allowed to progress untreated these are the stages
- Pre -Rosacea - in this early stage you will have a tendency to blush, flush easily and often with no swelling, irritation or visible veins (telangiectasia - often referred to as couprose)
- Subtype I - flushing of the skin persists for abnormal lengths of time, increased telaniectasia, can have tiny bumps/pustules, dry appearance, increased sensitivity
- Subtype II - moderate rosacea will have persistent and deep erythema (redness), flushing is intense and frequent, the visible veins are dense, some swelling, inflamed, bumps and pustules
- Subtype III - severe rosacea will also have intense bouts of facial swelling and burning and skin thickening and disfigurement
- Subtype IV - occular rosacea or rosacea of the eyes will have red, dry irritated eyes and eyelids, watery and bloodshot for long periods, stys are common, sensitive to light
The bumps and pustules with rosacea can resemble acne but are usually not accompanied with blackheads. Rosacea will also have burning and itching that acne does not have. Rosacea also appears mostly on the cheeks, chin, nose and between the eyebrows.
CAUSES - the cause of rosacea is multi-faceted but the main root cause is sun damage or solar elastosis. This is the reason that fair skin individuals are more prone. Other causes found through continuing research are
- demodex mites - these microscopic parasites live in and around the hair follicles in pairs creating no symptoms for most individuals. They feed on dead skin and are hosts to staphylococcus bacteria. For unknown reasons those with rosacea have 5-15 X's more demodex mites.
- lipase - this is an enzyme produced by demodex mites. In higher quantities in rosacea sufferers lipase breaks down sebum on the skin surface which is the skins protect barrier. The skin then becomes very vulnerable and inflammation and pustules increase.
- vascular endothelial growth factor - this is the latest in developing research. For more info http://www.rosacea.org/grants/research.php
TRIGGERS - there are many triggers for rosacea and each person with rosacea can be triggered by different things. This creates important and necessary detective work for both the client and the esthetician in order to reduce and manage rosacea effectively. When you look at the list don't be discouraged - you may only be triggered by one or two! Some things you can't avoid but instead over time can work at limiting.
- Increased Heat - this can include warmer climates and exposure to UV (both natural and tanning beds), exercise, hot tubs, saunas & steam rooms. The reason is that parasites love moist heat and skin heat increases lipase therefore redness and acne. The increased capillary activity also weakens the blood vessels causing more breakdown (telangiectasia) over time.
- Cold & Wind - going from cold and wind outdoors to warm indoors causes an intense constricting and dilating of the blood vessels which over time weakens the walls of the blood vessels causing leaking and redness.
- Allergic Reaction & Topical Irritants - an allergic reaction or constant allergic stimuli will increase histamines in the body/skin and increase redness.
- Medications/Drugs - vaso-dilating drugs can trigger and make rosacea worse. Here are a few: nitroglycerin, calcium channel blockers, topical steriods, nifedipine
- Alcohol & Hot Beverages - these are both vaso-dilators that in many will create an instant and intense flushing.
- Stress - an imbalance of too much stress on the body lowers our immunity, increases the activity of the demodex mites and effects our hormones. This creates a loss of ceramides , lipids, hylaronic acid and amino acids in the skin's protective barrier.
- Foods/Histamine Rich - too many histamines in the body creates an inflammatory response as we know with allergies. Certain foods are high in histamines. For most people this would not be a problem. For those with rosacea they act as triggers for a flare-up. Not all foods will bother all people. Here are a few: spicy food, cheese, meats and salami, chicken, spinach, raisins and figs, bananas, avocados, tomatoes, peas, lima & navy beans, red plums, soya sauce, yogurt, sour cream, chocolate and vanilla, yeast extract.
TREATMENTS in our Clinic - we have several treatments for managing the symptoms of rosacea that are highly effective. For each individual the course of treatments can be different. For this reason we recommend first our Clinical Skin Care Consultation with one of our Clinical Estheticians who specialize in rosacea. The consultation is 45 minutes and $38.00 plus HST (the cost of which is redeemable on some of our clinical treatment series/programs.Here is a list of professional treatments that address Rosacea and its symptoms:
- 8 Week Skin Transformation Program - an 8 week treatment series of weekly treatments that combine the effective use of AHA's and BHA's to smooth the skin surface, reduce the demodex mites, decrease lipase and control pustules. It also includes the use of an LED light device to reduce inflammation as well as ceramides and anti-oxidants to repair the skin barrier.
- Laser Vein Removal - from a few visible veins around the nose to many all over the face - this is a highly effective treatment for the immediate and progressive diminishing of telangiectasia. For more info click here: https://summitspa.ca/blogs/early-bird-specials/harnessing-light-to-heal-repair-the-skin-part-1
- Thermo-coagulation – excellent for fine facial vein removal.
- Dermasound Treatment Series – a series of 4 weekly or bi-weekly treatments to gently improve, repair, control and maintain rosacea-prone skin. Click here for more info - https://summitspa.ca/blogs/early-bird-specials/dermasound-elite-treatment-for-sensitive-acne-prone-and-aging-skin
- Signature Skin Transformation Treatment or Series – this mutli stepped treatment combines the use of mild chemical peels, LED Light Therapy and our Dermasound Treatment.
- Rejuvenating Facial Treatments - these 1 hour treatments immediately soothing and repairing with the use of gentle enzymes, AHA's or BHA's to decrease thickening, reduce demodex mites, control pustules and inflammation. A re-hydrating and anti-inflammatory complex and mask are used to soothe and repair.
TREATMENTS at Home - a successful home care regime is critical to the success of controlling the symptoms and flare-ups of rosacea. An effective program needs to have 5 components: gentle cleansing, exfoliating with AHA's, BHA's or enzymes, sunscreen and anti-oxidants, anti-inflammatories and hydrators. Here is the most successful at home treatments that we have found and have been recommending with great success. There are several in each category for client skin type and preference:
- Gentle Cleansers - To be used morning and night. Avoid soap and harsh cleansers that disrupt the skins protective barrier as it is already compromised.
- Yonka Cleansing Milk
- GM Collin Sensiderm Cleansing Milk
- GMC Medical Soothing Cleanser
- Glymed Gentle Facial Wash - use at night after a first cleansing with either of the above cleansers. This cleanser contains AHA's which are effective exfoliators for the treatment of rosacea.
- Skinceuticals Soothing Cleanser
- Seaflora Sea Foam Cleansing Concentrate-Ocean Authentic
- Exfolating with AHA's, BHA's and Enzymes - These treatments reduce inflammation, promote strenghtening of blood vessels, control the demodex mites and decrease skin thickening. Choose one.
- Phytomer Vegetal Peel - an enzyme exfoliant to be used 1-2 times a week. Excellent in the beginning of treatments when the skin is more imbalanced.
- Yonka Alpha Peel - 8% AHA & BHA gel to be used nightly on recommendation of Esthetician
- GM Collin Derm Renewal Cream - 10% AHA gel/cream to be used nightly on recommendation of Esthetician
- GM Collin Derm Renewal Booster – 10% AHA gel to be used nightly on recommendation of Esthetician.
- Glymed Youth Firm Peel – an enzyme and lactic acid exfoliant to use once every week or two based on the recommendation of an Esthetician.
- Glymed Plus Facial Hydrator - 10% AHA gel to be used on recommendation of Esthetician
- Sunscreens and Anti-Oxidants - Due to the fact the rosacea's cause is sun damage wearing a sunscreen daily is critical. An effective anti-oxidant will repair sun damage, reduce redness and uneven skin tone associated with sun damage. All sunscreens listed are natural, mineral-based sunscreens for their soothing anti-inflammatory qualities.
- Anti- Oxidant - Skinceuticals Serum 10 or GMC Medical Antioxidant 10 Serum(to start), Skinceuticals CE Ferulic, Skinceuticals Phloretin CF or GMC Medical Antioxidant 20 serums. Applied daily prior to sunscreen.
- GMC Medical Sun Protection Cream SPF 60
- Skinceuticals Physical Fusion SPF 50
- Skinceuticals Sheer Physical SPF 50
- Anti-Inflammatories - This important step reduces redness and strengthens the blood vessels making the skin less prone to intense flare-ups. Most are used morning and night during a flare-up and then just once a day to control.
- Hydrators - Most of these hydrators are also anti-inflamatories. They are important for protecting and repairing the skin barrier to reduce irritation and skin sensitivity.
- Phytomer Soothing Skin Cream for normal to dry skin types
- GM Collin Rosa Sea Cream - for all skin types particularly combination
- Phytomer Neutralizing Cream - for combination skin types
- Yonka Elastin Day or Night - for normal to dry skin types
- Skinceuticals Redness Neutralizer – for normal to dry skin types
Things to avoid: soap, products with essential oils, toners, retinols, micro dermabrasion, scrubs and scrubbing.
For more info on rosacea visit http://www.rosacea.org/
Once results are achieved don’t stop! Due to the natural of the condition it can be treated and maintained but not cured. If you go back to your old routine the condition will slowly return. Patience is the key!