Rosacea: The ultimate guide to the causes and treatment of the inflammatory skin condition affecting millions

The chronic inflammatory skin disease affects 1 in 20 people in the UK* – and it’s more common for women. If you’re experiencing redness, burning or tightness across your face, you might have the condition. Leading skincare expert Dr Ian Strawford shares everything you need to know about rosacea.

“Rosacea is very common – it can affect up to 50% of people of the people I see to some varying degree”

He explains. “It is an inflammatory skin condition, which tends to affect Caucasian women more than other – but anyone, of any gender or race can have rosacea.”

“Rosacea used to be called acne rosacea, and skincare experts used to think it was a form of acne, which we now know isn’t correct. However, there are similarities between acne and rosacea. They are both caused by a dysfunction of pilosebaceous units in the skin. These are the oil glands that produce sebum. Healthy skin will produce oil to protect the skin, keeping it hydrated. If you have rosacea, these pilosebaceous units get blocked, and don’t allow oil to get onto your skin. This can cause white, acne-style spots, which is why the two skin conditions can be mixed-up. When the sebum is trapped, microbes will often go into the skin to feed on the oil, releasing fatty acids, which are inflammatory. This sets off an immunological response, which our immune system reacts to. This is why people with rosacea experience inflammation in the skin. When we have inflammation, our blood vessels will vasodilate, or open up. This is what causes rosacea’s signature redness.”

Flushed away

One of the main symptoms of rosacea is skin flushing. “Redness can be caused by variations in temperature, or it could be hormonal, or due to lifestyle choices like alcohol or caffeine”, Dr Strawford, Clinical Director of Skin Excellence Clinics, explains. “Over time, people with rosacea may have permanently open blood vessels, which can lead to little red veins on the face. You can try laser treatments to get rid of the blood vessels, but the most important thing is to tackle the cause, otherwise they can come back if your skin is still inflamed. The body’s response is often to open up even more blood vessels if you have chronic inflammation. This chronic inflammatory process can denature collagen, breaking down the collagen you are producing. This can lead to textural changes in the skin, and over time you can end up with irregular open pores and ageing skin. Inflamed skin is more vulnerable to pollutants, UV light and heavy metals in the air.” “Many people have mild inflammatory skin changes, meaning your skin may be more sensitive to the sun or you experience some redness. However, rosacea can lead to quite chronic, severe changes to the skin. A classic example is a big, bulbous nose, called rhinophyma. Extreme cases can also result in chronic styes too.”

Dos and don’ts

Dr Ian Strawford outlines how to treat rosacea – by looking at the root cause. “Rosacea has been poorly treated in the past”, he says. “We would tell people to cleanse their skin, which is important, but over cleaning can actually exacerbate the issue. Laser treatments were often too aggressive for people with rosacea. The redness might reduce, but it would always come back.” Instead, Dr Strawford has adopted a new technology in the treatment of the chronic skin condition. “LED phototherapy has been a game changer in the treatment of rosacea. I use Dermalux’s new Tri-Wave MD device to treat my patients’ skin. Dermalux uses unique, clinically proven wavelengths to gently penetrate the skin. For people with rosacea, I use Near Infrared (NIR) 830nm light and red 633nm light to reduce the inflammatory pathways and de-stress the skin. With weekly treatments it can take as little as a month to get the skin under control, after which we can maintain the skin’s condition with skincare, and less frequent LED treatments. It’s critical to reduce oil production with careful cleansing, before moisturising and using sun protection, with products that don’t block the skin.”

Images courtesy of Sur Medispa, Glasgow

Can we combat rosacea at home?

While at-home skincare is key to maintaining healthy skin, Dr Strawford recommends doctorled, in clinic treatments for maximum and highly effective results. “The Dermalux devices we have in-clinic deliver high-intensity light energy, ensuring your skin gets the sufficient dose at the right time to stimulate real biological changes. Doctor-led care is key, as so many things can cause issues in rosacea prone skin, like retinol.” LED pioneer Dermalux has launched the Tri-Wave MD, the most powerful phototherapy device in the world. LED Phototherapy is the application of clinically proven, therapeutic wavelengths of light, which energise the cells to accelerate natural regeneration and repair processes, without any discomfort or downtime.