Rosacea is the most misdiagnosed skin condition. We see so many clients that have been given treatment, advice, and products that are not indicated and have in fact worsened their condition.

The following blog is written by Ijlal, during Rosacea Awareness Month, 2022.

What is Rosacea?

Rosacea is a chronic inflammatory, non-contagious skin condition. The condition primarily affects the central focus of the face (cheeks, nose and in some cases the eyes). Often described as a “permanent flush”, it may also present with other known symptoms such as,

  • ‘Permanent’ or persistent facial flushing across the nose and cheeks
  • Enlarged or broken facial capillaries (telangiectasis)
  • Frequent blushing
  • Swollen nose or cheeks (hyperplasia)
  • Lumps under skin (non-tender)
  • Pimples on forehead, cheeks & chin (yellow-headed)
  • Facial burning, itching, stinging sensation
  • Eye complaints, including red, swollen, itchy, irritated eyes and/or swollen eyelids
  • Enlarged nose, thickening of nose skin (more common in men than women)

Rosacea can also be classified into four sub-types:

  • Subtype 1: Erythematotelangiectatic rosacea (sensitivity, redness, flushing)
  • Subtype 2: Papulopustular rosacea (red papules, pus-filled pimples, alongside facial redness)
  • Subtype 3: Phymatous rosacea (skin thickening, bumpy on nose)
  • Subtype 4: Ocular rosacea (eye &/or eyelid inflammation, sometimes no skin symptoms are noticeable)

It is important to note that symptoms can fluctuate depending on the individual and the listed subtypes are just a guide to support treatment.

Due to the physical and visual nature of rosacea, sufferers can experience frustration, embarrassment and low self-esteem. Husk Naturopathy prioritises finding the root cause and an individualised approach to each client. With thorough treatment, patients can have improvements in symptoms and management of rosacea.

The Root Cause of Rosacea from a Functional Naturopathic Perspective

Rosacea is a multifactorial skin condition, and the exact causation remains unknown. Research has highlighted certain factors possibly contributing to rosacea.

Diet and Food Sensitivities

Some foods and drinks may exacerbate rosacea. These may include, spicy food, aged food high in histamine (e.g. processed meats, wine, aged cheese), alcohol, cinnamaldehyde containing foods (e.g. cinnamon, citrus, chocolate, tomatoes). These foods are known to increase vasodilation, which may aggravate rosacea symptoms.

Impaired Digestive Health

The role of the gut microbiome is considered a significant factor in skin health. Gut microbiota plays a role in regulating inflammatory responses in the body, therefore intestinal dysbiosis can activate neurogenic inflammation resulting in skin inflammation. Studies suggest specific microbiome alterations (dysbiotic strains in microbiota) have a link with rosacea patients and rosacea progression. Rosacea patients may experience gut-associated conditions, such as h.pylori infection, small intestinal bacterial overgrowth [SIBO], Crohn’s disease, celiac disease, ulcerative colitis, gastritis and gastroesophageal reflux disease [GERD]. The connection between digestive conditions suggests a strong correlation between the gut microbiome and rosacea.

Skin Microbiome

The gut microbiota has shown ability to impact skin function and health, via immune system modulation (regulating inflammation) and/or the intestinal barrier. Studies have shown that chemicals can be released via gut bacteria, entering the bloodstream and reaching the skin. One study found that free phenol and p-cresol chemicals can enter the bloodstream and contribute to skin symptoms. Rosacea patients are believed to have an over-growth of skin microorganisms called Demodex folliculorum, contributing to skin hypersensitivity.

Intestinal Permeability

Studies have demonstrated the link between skin conditions and intestinal permeability. The gastrointestinal epithelium works as a protection against external pathogens from entering the blood stream via the gut microbiota and the gastrointestinal lining as physical barriers. Intestinal permeability can contribute to pathogens and other substances entering the bloodstream, leading to inflammation which can reach the skin.

Some other factors may include:

  • Consuming hot foods/beverages
  • Genetic predisposition
  • Sunlight overexposure
  • Emotional stress
  • Autoimmunity
  • Overheating
  • Vitamin D status
  • Zinc levels
  • Anxiety

Rosacea in Skin of Colour

Inaccurately, there can be the common misconception that darker skin tones do not present with rosacea. Misdiagnosis, lack of awareness and underreporting of rosacea in skin of colour are barriers to accurate management and effective treatments. A lack of education, information and research into the way rosacea presents in darker skin tones is also hindering accurate diagnosis and support.

How rosacea may present in skin of colour:

  • Warm feeling of face (warm sensation)
  • Persistent facial flushing
  • Stinging/burning feeling of face
  • Unidentified facial discolouration
  • Dry skin patches that look swollen
  • Acne and/or breakouts that do not clear up
  • Thickened, swollen or rough skin on cheeks, forehead, nose
  • Hardened bumps, yellow or brown in colour, around eyes and/or mouth
  • Dilated blood vessels visible on cheeks
  • Sunlight sensitivity
  • Reactive skin to products (skincare and/or make-up)
  • Noticing triggers that cause warm sensations, facial bumps and redness

Naturopathic Treatment Aims To,

  • Avoid known and unique triggers
  • Reduce inflammation
  • Modulate immune response
  • Reduce stress response
  • Strengthen the vascular system
  • Investigate and treat gut terrain + pathogens

Our Favourite Supplements for Rosacea

  • Zinc
  • Vitamin A
  • Omega 3.
  • Vitamin C
  • NAC/ liposomal glutathione
  • Omega 3s
  • Curcumin
  • Boswelia

Our Favourite Herbs for Rosacea

  • Withania
  • Holy Basil
  • Bilberry
  • Gotu Kola
  • Echinacea
  • Hemidesmus
  • Reishi
  • Cordyceps
  • Green Tea

5 Things You can do Right Now

  • Avoid direct and reflected sunlight
  • Avoid caffeine, alcohol, sugar, gluten
  • Avoid spicy foods and curries
  • Avoid consuming your drinks and meals when they are too hot
  • Avoid heated environments or activities such as hot yoga, saunas, baths, HIIT