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Rosacea is a chronic skin disorder that affects more than ten million Americans, with almost half of the sufferers aged between 30 and 50 years old. The disease has been called “the Celtic curse” because it affects people of Northern European descent more often. Women are more likely to suffer rosacea of the milder form, and men more frequently have the severe form, which involves deformity of the nose. Rosacea nearly always appears on sun damaged skin.

Except for cases precipitated by use of steroids, the causes of rosacea are not known, but there are several discredited theories, including those involving skin mites (Demodex folliculorum and Demodex brevis) and the bacterium Helicobacter pylori. Because we do not know what causes the disease, there are no good treatments, and all that can be done is to prevent irritation and inflammation.

Rosacea develops in stages and is characterized by “twitchy” blood vessels, i.e. subcutaneous blood vessels that are too sensitive. Almost anything will start flushing and blushing episodes, followed by redness of the skin caused by congestion of the capillaries and chronic dilation of capillaries causing elevated dark red blotches on the skin. Rosacea patients may develop severe sebaceous gland growth that is accompanied by papules, pustules, cysts, and nodules. Inflammatory lesions develop in the areas of erythema and may look like acne, but in rosacea there are no comedones, the primary event in acne.

It can be difficult to distinguish acne, eczema, and other skin affections from rosacea, but it is very important to recognize rosacea because, although it cannot be cured right now, early recognition and treatment can prevent progression to disfigurement.

There are several medical treatments used to attenuate the effects of rosacea rather than cure it, and laser treatment can help with telangiectasia, or deformation of the nose.

Azelaic acid is effective in the treatment of rosacea, particularly at the stage when there are papules and pustules. Glycolic acid is beneficial for all stages of rosacea, both in the higher concentrations of glycolic peels used by professionals, and at the lower concentrations for home use (3-10%).

What can you do about rosacea? It is important to avoid precipitating factors such as exposure to sun, stress (easier said than done!), cold weather, hot beverages, cigarette smoke, alcohol consumption, and any foods that you have noticed exacerbate your rosacea. Any cosmetics used must be non-comedogenic and nonirritating. Use sunblock and avoid sun exposure, because sun damage is one of the factors that precipitate rosacea. Protect your skin from infection and weakening of the skin barrier as well.

Steroids are not an option, so to control inflammation try our Olive Anti-Inflammatory Cream or other anti-inflammatory ingredients, like niacinamide. Try soothing actives, like licorice, or green tea with caffeine, which would work as a vasoconstrictor. Centella asiatica and horse chestnut extracts are well known for their capillary strengthening properties. Many clients have found relief using 4-ethoxybenzaldehyde mixed with a base cream. Azeloyl glycine and magnesium ascorbyl phosphate are other options. You could also try our glycan-7 booster, which may help with strengthening the skin barrier and enhancing the immune response against Demodex. Our clients have also reported excellent results with sea kelp bioferment used on its own (please see our forum). Our Redness Reduction Serum with epidermal growth factor works for others.

I usually ask clients to try these products one by one and see whether one of them helps. With such a complicated condition as rosacea, we should expect that at different stages the skin will respond in different ways to the same treatment.