What is Rosacea?
Rosacea is a relatively common skin problem that is often confused with acne vulgaris, but it has no relation to this condition. It is a chronic skin disorder that most often affects the forehead, nose, cheeks and chin areas of the face; in rare cases, it can affect other parts of the body.
When Rosacea first starts it usually occurs as intense blushing, the redness which may come and go, but eventually if this continues to happen, groups of capillaries close to the surface of the skin become permanently dilated, resulting in blotchy red areas with small bumps and sometimes pimples. This is a phenomenon known as telangiectasia (Gk, telos, end, angeion, vessel, ektasis, swelling).
The skin tissue can swell and thicken, and may become tender and sensitive to touch; if this happens around the nose, it may become bulbous in what is known as rhinophyma (Gk, rhis, nose, phyma, tumour); this is more common in men. It can also cause persistent burning and feeling of grittiness in the eyes or inflamed and swollen eyelids. In severe cases, vision can be impaired. Rosacea can cause a great deal of discomfort and because it affects the face, it can be very distressing for cosmetic reasons.
Who is at risk for developing Rosacea?
Researchers have been unable to pinpoint the cause of Rosacea, but they have found that it affects certain people more than others. Susceptibility factors appear to be:
- White women between the ages of thirty and fifty
- Fair-skinned individuals
- People who blush easily
- Use of skincare and make-up products that contain alcohol
- People who carry the Helicobacter Pylori bacteria. This can cause stomach ulcers, but not always; it is a common infection of the digestive system.
- A microscopic mite on human skin has been found in significantly higher numbers than usual on the skin of people who suffer Rosacea.
- Rosacea has been linked to free radical damage due to the antioxidant system not functioning optimally.
- Digestive insufficiency is common. E.g. low stomach acid production results in a low output of digestive enzymes that break down food enabling uptake of nutrients.
- Poor liver function and an excess of toxic burden. The liver performs some 3,000 functions daily. Due to these functions (chemical reactions) the liver is the greatest source of internal heat.
Nutritional factors linked to Rosacea:
- High consumption of alcoholic beverages
- High consumption of spicy foods
- Drinking liquids that are too hot
- Vitamin/mineral deficiencies
- Digestive insufficiency
- Food allergies or intolerances
Factors are known to aggravate the condition (called tripwires or triggers):
- Exposure to sunlight
- Emotional stress
- Adrenal exhaustion
- Wind exposure
- Physical exercise
- Washing the face
- Humidity
- Extremes of temperatures – cold and hot
- Rapid temperature changes
- Topical skincare products including steroid creams
Treatment Strategy for Rosacea
Lifestyle:
- Identify your tripwires and change your lifestyle in order to avoid them where possible. If you have no idea what your tripwires are, try keeping a diary of flushing episodes and note down any foods that you ate, unusual temperatures, and how you felt emotionally just before the episode and what the weather has been like.
- Avoid extremes of temperature; especially heat (including steam baths, saunas, and hot tubs).
- Avoid wearing make-up as much as possible; if you do use cosmetics choose all-natural, water-based products.
- Avoid touching the skin except when cleansing.
- If you use a humidifier at home, use a cool-mist humidifier only.
- Keep your skin scrupulously clean, but treat it gently. Use a mild all-natural wash, and lukewarm to cool water; never use cold or hot water. Pat the skin dry after washing, do not rub it.
- Do not use topical steroid creams, these make the condition worse.
- Avoid wearing tight clothing such as polo necks; friction can be irritating.
- Do not hold anything close to your face for any length of time, such as a telephone receiver; this can raise the local temperature.
- Investigate a Pulse-Light therapist with experience in Rosacea. I strongly recommend The Pulse Light Clinic London, for their wealth of experience.
- Ensure adequate sun protection on a daily basis (ultraviolet rays still reach earth on cloudy days). You should choose a broad-spectrum sunscreen (it should be non-irritating, and hypo-allergenic) such as COOLA MineralBaby Moisturizer Suncare Unscented SPF45 available on amazon. This is especially important for those whose Rosacea flares up when exposed to the sun, and for those undergoing IPL therapy. Always check a small area of skin on your face first when trying a new product.
Diet:
- Investigate the possibility of food allergies/sensitivities.
- Investigate digestive sufficiency and liver health.
- Eat a diet that emphasizes organically grown, raw fruits & vegetables, nuts, seeds, oily fish and whole grains.
- Eat sprouted seeds often (but ONLY organically grown as these are very concentrated in nutrients and also in chemical pollutants if not organic) – for their excellent nutrient content with low calories.
- Drink green tea for its antioxidant, antibacterial, & fat-burning properties.
- Allow your food and drinks to cool to room temperature before eating/drinking.
- Maintain healthy Blood Sugar levels by including a protein in all meals and snacks and by avoiding refined carbohydrates.
- Avoid fats as much as possible, especially saturated fats, which include: dairy products, fatty cuts of red meat, and ready-made meals (if you have to eat these check labels). Lean poultry and lean red meat should play a complementary role only in the overall diet.
- Avoid processed foods, preservatives and sugar as they can suppress immunity (inflammation is produced by the immune system).
- Avoid Gluten grains gluten is difficult for many to digest and acts as ‘glue’ in the intestines as the name suggests, or those with digestive issues avoiding gluten is essential.
- Avoid alcohol, caffeine, chocolate, cocoa, dairy products, salt, and sugar.
- Avoid spiced foods; to add flavour to foods use fresh herbs such as parsley, garlic, ginger, lemon-grass, oregano, and dried turmeric.
- Once a month follow a 2-day mono-fast (but NOT if you have blood sugar imbalance). Speak to your Nutritional Therapist for guidance with this.
Nutrients That Are Particularly Helpful In Rosacea:
Vitamin A is necessary for healing and for the construction of new skin. Some good food sources: liver, eggs & tuna; the body can make vitamin A from pro-vitamin A (beta-carotene). Food sources: dark green leafy veg, most yellow, orange and red fruits and vegetables. CAUTION: tomatoes and spinach are often triggers.
Vitamin C has antioxidant properties and is required for the production of new collagen in skin and capillaries. Good food sources: broccoli, cauliflower, Brussels sprouts, cress, red & green peppers, berry fruits, strawberries, kiwi fruit, papaya, guava, citrus fruits and tomato purée. CAUTION: citrus fruits may be a trigger.
Vitamin E is a potent antioxidant and protects collagen from damage; it has anti-inflammatory properties, helps in the healing process and in preventing easy bruising. Some good food sources: extra virgin olive oil (as a dressing, not in cooking), avocado, fresh nuts & seeds.
Zinc is required for tissue repair, immunity, stress management, and digestive sufficiency. Some good food sources: shellfish, whole grains, pumpkin seeds, green leafy vegetables & peas.
Selenium plays a major role in the antioxidant system & detoxification pathways. Good food sources: garlic, asparagus, sesame & sunflower seeds, whole grains, Brazil nuts and seafood.
Chlorophyll helps to cleanse the blood and prevent infections; it also supplies a balance of required minerals. Some good food sources: dark green leafy vegetables, whole grains, alfalfa, sprouted seeds, and all other green vegetables.
Essential fatty acids are required for healthy skin, healing, and they provide anti-inflammatory compounds called Prostaglandins. Some good food sources: flax seeds (soaked overnight and added to your breakfast or ground flax-seeds), pumpkin, sunflower & sesame seeds, fresh nuts. These foods should be eaten in small amounts ONLY as they provide pro-inflammatory omega 6 fats. Omega 3 is far more important for prostaglandins that have anti-inflammatory effects. Sources: oily fish such as organic salmon, mackerel, herring, sardines, and pilchards, with a lesser amount in tuna.
Sulphur is required in the detoxification processes; it helps the body to resist bacteria and has been found to be helpful with all skin conditions. Some good food sources are garlic, onions, eggs, fish, turnips and Brussels sprouts.
Other Considerations:
Rosacea is an inflammatory condition with an increased requirement for or deficiency of antioxidant activity. The result is a condition of ‘excessive heat’. Introducing ‘cooling’ foods, and foods high in antioxidants nutrients can be of benefit. The best way to do that is to eat fresh, raw, organic fruits & vegetables at least twice per day. Avoidance of foods that produce excess heat is essential: rich, greasy, highly seasoned foods; highly processed foods, denatured foods (microwave cooking), chemical ingredients (additives & preservatives), excessive meat, fried foods, very sweet foods, refined flours and rancid oils.
Some lifestyle factors increase the production of heat (and so should be avoided) these are over-eating, eating when stressed or in a hurry, and an imbalance between activity and relaxation, favouring activity with little or no true relaxation. Good quality sleep (preferably 8 hours every night) is essential to overall health and well-being. For instance, the liver performs some 3,000 functions, including detoxification processes, and is most active when we are in the deeper stages of sleep, around 3 am.
In order that balance results, and not a condition of ‘coldness’ (heat deficiency) one must also have some cooked foods on a daily basis. How you cook food is important, I recommend quick stir-fry on medium heat, short duration steaming of vegetables so as they are crisp in texture, and retain their nutrients, and low heat cooking methods (e.g. simmering). Avoid pressure cooking, microwave cooking, baking, high-temperature boiling, and deep-frying.
References:
- Clayton A. Immune and Lymphatic System BCNH 2001-02 Y1/Mod6 Pt 2.
- Kendall SN. 2004 Remission of rosacea induced by reduction of gut transit time. Clinical & Experimental Dermatology. May:29(3_ 297-9
- Millikan L 2003. The proposed inflammatory pathophysiology of rosacea: implications for treatment. Skinmed 2(1): 43-7
- Oztas et al. 2003. The role of free oxygen radicals in the aetiopathogenesis of rosacea. Clinical & Experimental Dermatology. 28(2):188-92.
Bibliography:
Balch & Balch Prescription for Nutritional Healing 3rd Edition Avery 2000.
Pitchford P. Healing With Whole Foods, Oriental Traditions and Modern Nutrition North Atlantic Books 1993. Savona & Holford Solve Your Skin Problems Judy Piatkus Ltd 2001.
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