It has a rather lovely name but for those who have rosacea (say “rose-say-sha”) – the inflammatory skin condition that makes them look like they have a drinking problem or are constantly sunburned – it is less than a desired experience.
The skin flush can begin on the nose and cheeks, and spread to the forehead and chin, according to the American Academy Of Dermatology (AAD).
Sometimes, the ears, chest and back can be affected, and look red all the time. Think back to the blush on Bill Clinton’s and Princess Diana’s faces and you’ll have an idea what rosacea looks like.
Rosacea isn’t confined to just flushed cheeks either. It is also characterised by broken capillaries, complaints of sensitivity, stinging and burning, as well as bumps that resemble acne that can be hard or pus-filled, said Dr Calvin Chan of Calvin Chan Aesthetic & Laser Clinic.
"In severe or advanced cases, the redness can affect even the eyes and thicken the skin on the nose, creating a characteristic, bumpy nose appearance," he said.
YOU MITE WANT TO KNOW
Although the experts aren’t sure what exactly causes rosacea, some studies have found that skin mites living in and around hair follicles on the face, including the eyelashes and eyelids, could be a link.
The Demodex folliculorum mite is found on everyone’s face and actually provides waste management by feeding on your dead skin cells and facial oils. But in large quantities, the mites may create problems such as rosacea, according to Dr Frank Powell, consultant dermatologist at Mater Misericordiae Hospital in Dublin.
In fact, rosacea patients have four times more mites than those who don’t have the skin condition, he said, suggesting that those with rosacea may be genetically inclined to produce a certain type of lipid that allows the mite to flourish.
That’s where it starts a cascade of events on the microscopic level, said Dr James Del Rosso, adjunct clinical professor of dermatology at Touro University College Of Osteopathic Medicine.
Rosacea patients have four times more mites than those who don’t have the skin condition.
When there are too many mites in a follicle, their sheer number can cause the wall of the follicle to degrade. In response, the body activates an enzyme, which leads to inflammation and signs of rosacea, including bumps and pimples, said Dr Del Rosso.
Rosacea is more common in women than men, according to the Mayo Clinic’s website, and in those over the age of 30.
KEEPING ROSACEA AT BAY
While medicated gels and oral antibiotics can be prescribed to reduce the redness and swelling (unfortunately, there is no known cure for rosacea), there are also ways for you to temper a flare-up.
Here’s a look at what the common triggers are and how you can minimise an attack that can leave you red in the face:
- THINK UV PROTECTION
The sun is the commonest trigger of rosacea, said Dr Eileen Tan, dermatologist at Mount Elizabeth Novena Hospital. "It is not fully understood but it is thought that sun exposure increases your Vitamin D level, which in turn, raises the cathelicidin level in the body. Patients with rosacea are known to have elevated levels of cathelicidin."
But there’s no need to return from your lunch break looking like you’ve had a few beers when you haven’t. Thirty minutes before stepping out of the building, apply a broad-spectrum sunblock of at least SPF30, said Dr Tan, who recommended one that contains zinc oxide or titanium dioxide.
When walking to your lunch spot, keep out of the sun as much as possible. This is also the chance to whip out that broad-rimmed hat that you see so many Instagrammers wearing.
- STAY COOL
Make air-conditioning and fan your BFFs as over-heating is another trigger of rosacea. For that matter, try to exercise in an air-conditioned place and during the cooler parts of the day if you can, and avoid workouts done in heated environments such as Bikram yoga or heated pools.
Instead of nipping into the steam room or jacuzzi after your workout, opt for a lukewarm shower (skip the hot water). Then, head to the gym’s wellness cafe for a frozen smoothie, rather than a hot coffee or tea to keep cool.
When you’re out in a cafe having a cuppa, order an iced coffee or tea instead. Or let your drink cool to lukewarm temperatures before drinking to avoid over-heating your body.
- LIMIT ALCOHOL'S EFFECT
A study published in the Journal Of The American Academy Of Dermatology noted that women who drink had a higher risk of developing rosacea than those who don’t. And no, it’s not the Asian flush we’re talking about here.
The study found that red wine (that includes rose wines) and hard liquor increase women’s risk more than other drinks. The flush-inducing culprits could be the inflammatory factors such as histamines and resveratrol.
READ: Major study debunks myth that moderate drinking can be healthy
In another study on more than 700 rosacea patients by the National Rosacea Society (NRS) in the US, beer caused 41 per cent of the patients to be red in the face, while an additional 15 per cent were affected by malt liquor or other malt-based drinks. Among the hard liquors, vodka was the leading aggravator (33 per cent), followed by tequila, bourbon, gin, rum, and scotch.
The moral of the story: Explore the wonderful world of white wines instead. To minimise your intake of alcohol further, you could add soda or lemonade to white wine, beer and other drinks to lessen the amount of alcohol in each drink.
- PASS THE MALA AND CHOCOLATE
Sorry, but the oddly satisfying sensation of feeling your mouth burn is not good news for your looks. Capsaicin, which is the chemical that causes the pain receptors in your skin to feel warm, can affect rosacea, according to a study published in Dermatology Practical And Conceptual.
It noted that 75 per cent of the respondents cited spices as a trigger. If you must have spicy food at mealtime, choose a milder version of the dish instead, suggested the AAD.
It’s not only chilli that can trigger rosacea symptoms. Foods that contain cinnamaldehyde, the compound that gives cinnamon its familiar fragrance, can also make you blush. In the same study, cinnamaldehyde-containing foods that have been cited to induce rosacea include tomatoes (30 per cent), chocolate (23 per cent), and citrus (22 per cent).
"Avoid the food that triggers your rosacea during an active episode and as much as possible, two to three weeks after a flare-up," advised Dr Tan.
Also, eat fresh produce and avoid preservative-rich foods. "I have patients who observed that their skin is stable with the consumption of fresh prawns but they develop itchy skin with frozen ones," she said.
- SHOW SKIN SOME TLC
Give harsh cleansers and scrubs a wide berth as they’re invitations to a rosacea flare-up, said Dr Joshua Schneider, director of cosmetic and clinical research and assistant professor of dermatology at Mount Sinai in New York City.
Your best bets are gentle, soap-free cleansers that don’t wreak havoc on your skin’s protective barrier, said Dr Tan. When shopping for one, choose options that do not contain alcohol, witch hazel, fragrance, menthol, peppermint and eucalyptus oil.
You should still wash your face twice a day even if you have rosacea, said Dr Tan. Then, follow up with a gentle, fragrance-free moisturiser.
"Adopt gentle tapping or circular motions, and avoid rubbing skin vigorously," she said. "Rinse off the cleanser with lukewarm water and pat your face gently with a cotton towel."
For men, it is a better idea to use an electric shaver than a blade, suggested the NRS. “The idea is to create as little trauma and inflammation as possible so you do not provoke a rosacea flare,” said Dr Schneider. For shaving and post-shaving products, opt for gentle, unscented ones.
- USE SKIN-FRIENDLY MAKEUP
In addition to the skin, rosacea can also affect the eyes, making them look bloodshot. So, be kind to your peepers by choosing allergy-tested and fragrance-free formulas such as mineral powder eyeshadow and mascara that can be removed with warm water instead of makeup remover.
The NRS also suggested using eyeshadows and eye pencils in neutral colours as jewel tones have more pigment that can irritate the eyes.