Many of us go red in the face when we are angry or when we are confronted by something embarrassing. Unfortunately, there are some people for whom facial redness is a manifestation of rosacea.

Rosacea is a chronic and progressive skin disease that causes redness and swelling in the face. This skin condition usually develops in the teenage years and becomes worse in the 30s and 40s.

It is common among the fair-skinned people, and it affects an estimated 14 million Americans. Although there is no real cure for this ailment in modern medicine, there are many ways to relieve the symptoms.

What is rosacea?

Rosacea (pronounced ‘roh-ZAY-sha’) is an inflammatory skin condition that causes redness, breakouts, and irritation of the face. It usually starts as a small rash and then spreads and becomes more intense over time.

This skin condition is not contagious and is often mistaken for acne, eczema and or a skin allergy. According to the American Academy of Dermatology, there are four main types of rosacea.

Subtype 1 (erythematotelangeictatic rosacea)

This type of rosacea is the most common and the least severe. It is characterized by visible blood vessels, facial redness, and flushing.

It is accompanied by enlarged sweat glands, oiliness or dry, flaky skin. The skin may become sensitive to make-up and sunscreens in this condition. It also may be sensitive to sun exposure or hot and spicy food.

Subtype 2 (papulopustular rosacea)

This rosacea is common among middle-aged women and is characterized by redness, swelling, and breakouts that resemble acne.

In this condition pimples without blackheads or whiteheads appear on or around the reddened area. These dome-shaped pimples may contain pus in some cases.

Subtype 3 (phymatous rosacea)

Also known as rhinophyma, this rosacea caused the skin to thicken and take on a bumpy texture. In this situation, the entire face including the eyelids can swell up.

More common in men, phymatous rosacea is characterized by a large bulbous nose and puffy cheeks.

Subtype 4 (ocular rosacea)

Ocular rosacea can cause irritation and redness in the eyes and swollen eyelids. Its symptoms also include crusting in the eyelashes, clear discharge and feeling of grit in the eyes. If ocular rosacea is not treated on time, it can cause corneal damage.

Not all the patients of rosacea have the same signs or symptoms. Some patients develop signs of more than one type of rosacea at a time. In mild cases, the symptoms can come and go on their own.

However, in more severe cases with symptoms like enlarged blood vessels, pimples, and thickened skin, it is essential to consult a dermatologist. Without treatment rosacea symptoms can become worse, so early diagnosis and treatment are vital.

Traditional treatments for rosacea

Though there is no cure for rosacea, doctors can prescribe different medications and lifestyle changes to relieve the signs and symptoms.

Medications

Doctors sometimes prescribe a combination of oral drugs and topical ointments to treat rosacea.

  • Topical medications like metronidazole, tretinoin, benzoyl peroxide, and azelaic acid are commonly prescribed. They help reduce redness and swelling.
  • Oral antibiotics like tetracycline, minocycline and erythromycin are prescribed for their anti-inflammatory properties. They are more effective than topical antibiotics.
  • Isotretinoin is prescribed in cases of severe inflammatory rosacea. This drug inhibits the production of oil by the sebaceous glands, but it can have some side effects.
  • Blephamide is a steroid that is prescribed for patients with ocular rosacea.
  • Tetracyclines are also prescribed for patients with ocular rosacea. They help improve dryness, itching, blurred vision and photosensitivity.

Laser treatment

Dermatologists sometimes use laser treatment for patients with visible blood vessels. The procedure may cause some tenderness, swelling, and bruising of the skin but these complications usually disappear within a few weeks of the treatment.

Plastic surgery

Patients of rhinophyma who develop enlarged nose and puffy cheeks are sometimes referred to a plastic surgeon. The treatment includes removal of excess tissue and remodeling of the nose through laser or scalpel surgery.

Causes of rosacea

Medical experts are not sure of what causes rosacea. However, heightened inflammation and an overactive immune system are known to trigger it. Here are some of the factors that cause rosacea:

1. Abnormal facial blood vessels

Specific abnormalities in the blood vessels in the facial skin could lead to flushing, persistent redness and visible blood vessels.

2. Sun damage

According to the researchers at the Boston University School of Medicine, exposure to UV light can spur the production of vascular endolethial growth factor, which can cause visible blood vessels (1).

3. Demodex folliculorum

Demodex folliculorum is a microscopic mite that lives on the human skin and usually causes no problem. However, some evidence seems to suggest that patients of rosacea have a much higher number of these mites on their skin, which may trigger an immune response and lead to inflammation (2).

4. H. pylori bacteria

This bacteria, which is found in the gut, stimulates the production of bradykinin, a small polypeptide which causes the dilation of blood vessels. This bacteria may play a role in the development of rosacea (3).

4. Side-effects of medication

Long-term use of corticosteroids, primarily when used to treat dermatitis or vitiligo, can also lead to rosacea. Beta blockers and niacin may also cause blood to rush to the face, which can lead to a rosacea flare-up (4).

5. Light skin

Rosacea is more common in people with pale skin and light eyes as compared to people with a darker complexion. While in Sweden almost 10 percent of the population is affected by rosacea, in people with African, Asian or Latino descent only 4 percent of people have rosacea (5).

6. Genetics

Studies suggest that people with rosacea are four times more likely to have a family history of that disorder (6). So, genetics also play a role in this skin condition.

Triggers

The National Rosacea Society surveyed 1066 rosacea patients. According to the survey the most common triggers for this skin condition are sun exposure (81%), emotional stress(79%), hot weather(75%),  heavy exercise(56%), alcohol consumption (52%), hot baths(51%), cold weather(46%), and spicy foods(45%) (7).

Natural remedies for rosacea

If your rosacea is not too extreme, you can manage its symptoms with some lifestyle changes and natural treatments. Here are some of the options:

1. Clean up your diet

Our gut regulates the inflammation in our body. Cleaning up the diet and adding health-promoting and anti-inflammatory foods can make a significant impact on skin problems.

Foods to eat: Organic foods and vegetables contain vitamins and minerals that help rebuild healthy skin cells. Foods that contain healthy fats like coconut oil, olive oil, avocado, nuts, and seeds help remove inflammation in the gut. Wild caught fish, cage-free eggs, grass-fed animal products, and legumes are good sources of high-quality healthy-proteins.

Turmeric, onion, ginger, garlic, tomatoes, carrots, cruciferous vegetables, and green tea are all anti-inflammatory foods. 

Foods to avoid: Added sugar and processed food increase oxidative stress and worsen inflammation. Caffeine and alcohol can also worsen the symptoms of rosacea.

For some people, removing dairy products like milk, cheese, yogurt and ice-cream from their diets is helpful in treating rosacea. Avoid refined oils that are rich in omega-6 fatty acids.

You should also avoid some common allergens like nuts, gluten, shellfish, and dairy products.

2. Reduce sun exposure

The UV rays from the sun tend to aggravate the symptoms of rosacea (8). Studies show that regular use of sunscreen offers significant benefits against flare-ups.

So, always wear a broad-spectrum sunscreen with SPF of at least 15 when going out in the sun. However, you must choose your sunscreen wisely as the chemicals in some sunscreens can make the matter worse.

3. Aloe vera

The gel from the leaf of the aloe vera plant has a moisturizing effect, and you can use it as a topical remedy for rosacea.  Many moisturizers and skin care products contain aloe vera.

However, you must do a patch test before you apply aloe gel on your affected skin.

4. Coconut oil

Coconut oil is used to treat a variety of skin related problems all around the world. This oil is known for its anti-inflammatory, antioxidant and moisturizing properties. Not only is it a natural remedy, but it is also cheap, safe, and easy to obtain.

5. Green tea

Green tea is a rich source of anti-oxidants which are helpful in reducing inflammation.  Research has shown that it is also useful in the treatment of rosacea.

You can drink green tea, use cooled green tea as a compress and also use skin care products that contain green tea.

6. Essential oils

Some essential oils can be used topically to improve rosacea. Diluted lavender essential oil can be applied on the skin to reduce the symptoms of rosacea.

Tea tree oil also helps in reducing inflammation and itching. It can be diluted with a carrier oil and used on the skin.

7. Lower stress

Stress is a common trigger of rosacea. It can lead to flare-ups. Staying calm helps lower the symptoms of rosacea. Exercise, meditation, and yoga are natural stress relievers.

Final thoughts

Rosacea is a progressive skin disease that causes redness and swelling in the face. Even though it is not life-threatening, its appearance often leads to embarrassment, anxiousness, and stress.

Abnormal facial blood vessels, sun damage, Demodex folliculorum, H. pylori bacteria, side effects of medications, light skin and genetics are some of the causes of this skin condition.

Doctors prescribe many oral and topical medications to treat the symptoms of rosacea. There are also many natural treatments and lifestyle changes that can help treat rosacea.

Rosacea is an inflammatory skin condition that causes redness, breakouts, & irritation of the face. It starts as a small rash & then spreads