Life is full of simple pleasures: a day at the
beach, a glass of wine with friends, a spicy bowl of curry. But these
pleasures can become problems when they trigger rosacea, a condition
marked by facial flushing and roughness estimated to affect more than 16
Rosacea’s visible nature can lead to feelings of awkwardness. “Rosacea affects a person’s self-esteem and may lead to social withdrawal,” says Jeanette Jacknin, MD, holistic dermatologist and author of Smart Medicine for Your Skin (Avery/Penguin, www.drjacknin.com). In a survey by the National Rosacea Society (NRS, www.rosacea.org), nearly 76% of the respondents said that rosacea hurt their self-confidence.
Rosacea’s emotional impact is heightened
by the fact that it affects the nose and central face. (The chest, ears,
neck or scalp can also be affected.) Persistent redness and bumps may
be accompanied by the appearance of fine blood vessels and the skin may
itch, swell or feel dry. “A bulbous red nose may develop slowly if the
condition is untreated,” says Jacknin; the prominent nose of W.C. Fields
was caused by this condition, called rhinophyma.
Up to 50% of patients develop ocular
rosacea, marked by burning, gritty eyes and recurring styes, infections
that cause red bumps to form on the eyelids. Jacknin says eye problems
can come before or after skin symptoms develop, or occur on their own.
Ocular rosacea can damage the cornea, causing blurry vision.
Rosacea, which runs in families, occurs
most often in fair-skinned people. “I don’t think I’ve ever see people
with real dark skin having rosacea,” says Alan Dattner, MD, founder of www.holisticdermatology.com in New Rochelle, New York and a founding member of the American Academy
of Dermatology’s Task Force for Nutrition and the Evaluation of
Rosacea tends to occur in cycles of
remissions and flareups sparked by triggers such as heat and sun
exposure. Hot drinks and spicy foods can also set off an outbreak; other
common triggers include alcohol, tomatoes, citrus fruits and chocolate.
“Anything that stimulates blood coming to the face is a possible
trigger,” explains Dattner. “It’s a vicious cycle: Someone gets
embarrassed, they flush, they become embarrassed about their rosacea,
they flush some more.”
Scientists are studying why rosacea
develops. Microbes, food allergies, an over-reactive immune system and
glitches in the interaction between nerves and blood vessels have all
been implicated. Studies have found a potential link between ocular
rosacea and bacteria associated with Demodex mites, normal skin
inhabitants that are more abundant in rosacea patients (Ophthalmology
The number of factors helps explain why
each patient experiences rosacea differently. “It’s like a lock and key.
The same substance may cause a reaction in one person and not another,”
says Dattner. He tells people to check their facial reactions with a
hand mirror “so they can figure out ways to avoid making the rosacea
Cooling the Burn
The first step in controlling rosacea is
to avoid anything that triggers a flareup. Jacknin suggests wearing
sunscreen with a sun protection factor (SPF) of at least 15 every day,
even when indoors, and a hat when outside. Avoid extremes of heat and
humidity; this means no hot baths or showers and avoiding hot tubs,
steam rooms and saunas.
Exercise is as important for people with
rosacea as for anyone else but “take care not to become overheated or
flushed, or to sweat profusely,” Jacknin cautions. Early morning or late
evening workouts can help you avoid the worst heat of the day.
Proper skin care is crucial. Use lukewarm
water and a very mild soap or cleanser, and don’t scrub; blot the skin
dry with a soft towel. Jacknin says to use only fragrance-free,
hypoallergenic, water-based cosmetics. If you have ocular rosacea, take
particular care of your eyelids. The NRS recommends cleaning them twice a
day with either plain water or baby shampoo on a wet washcloth.
Jacknin says that some people with
rosacea report good results with either horse chestnut cream or rose-wax
cream applied twice a day. For visible blood vessels, Jacknin suggests
diluting essential oils of borage, rose, cypress, neroli or lemon in
evening primrose or jojoba oil and applying the mixture sparingly to
affected areas. (All topical therapies should be tested on small patches
of skin first to check for irritation.)
Caring for rosacea from the outside isn’t enough; it’s essential to understand what’s going on inside. “You need to determine what’s off in your digestive system,” says Dattner. “If you have a lot of allergies to specific foods, eating those foods over and over again is going to keep producing inflammation.” This can lead to leaky gut syndrome, in which a damaged bowel lining allows irritants such as undigested food particles to pass into the bloodstream.
Finding a diet that’s less likely to set
off your rosacea means determining which foods cause your symptoms and
cutting them out of your diet. Jacknin also recommends avoiding animal
and hydrogenated fats, junk food, refined sugars and artificial
flavorings and preservatives.
Instead, Jacknin suggests eating more
vegetables—especially the vitamin B12-rich dark-green varieties—fruits,
whole grains and such lean sources of protein as fish and skinless
chicken. Drinking at least eight glasses of filtered water daily helps
flush toxins out of the body.
Jacknin recommends a number of
supplements for rosacea including a high-quality multivitamin,
preferably one based on whole foods; beta-carotene, 25,000 IU twice a
day; vitamin B complex; vitamin C, 500 mg with bioflavonoids, three
times a day; zinc, 25 mg twice a day; flaxseed oil, 1,000 mg three times
a day; acidophilus- and bifidus-based probiotics twice a day; and
digestive enzymes. (Tailor a supplementation plan to your needs in
consultation with a trained practitioner.)
Jacknin also suggests homeopathic
remedies depending on your particular symptoms. For example Arsenicum
album, 30x or 15c, is appropriate if the rash is dry, burning, flaky and
scaly. A trained homeopath can help you in your search; find one
through the National Center for Homeopathy: www.nationalcenterforhomeopathy.org, 703-548-7790.
The best way to keep rosacea from limiting your life is to keep looking for solutions. “Rosacea is a manifestation,” says Dattner. “It’s not just one cause, one problem.”