Rosacea is a chronic skin condition characterised by the random formation of red patches, bumps and pustules on the face, neck and in some severe cases chest, of the afflicted. It can affect any part of the head, face and neck area, though usually it is the face that is affected most. In some people it is hardly felt and in others the sensation of stinging and burning in affected areas can cause considerable discomfort. Recent estimates have revealed that it affects between 5 and 20% of the world’s population. As such it is considered a pretty big health concern.
The area afflicted can also get really dry and flaky and eventually skin will start peeling off if left untreated.
In some unfortunate people, the rosacea can also affect the nose to such an extent that it causes a large, bulbous red-coloured nose also referred to as ‘rhinophyma’. But this is a very rare occurrence.
More women than men
Rosacea affects more women than men (by a factor of 3) and its onset is most prevalent between the ages of 30 and 60. Heavily superstitious medieval British folk used to refer to it as the “curse of the Celts” – though historically it was actually recorded in Britain way before it appeared in Scotland or Ireland – so that ‘accusation’ is somewhat misleading. The condition does appear to affect a disproportionately larger number of fair skinned people than people with darker skin tones.
Research has shown that certain inflammatory pathways play a key role in the development of rosacea. So curbing inflammation is an important step in taking control and treating this condition.
Inflammation at fault
If left untreated, rosacea will get worse over time. The consensus of modern medicine is to use topical corticosteroids to curb the inflammation. Corticosteroids are the purported panacea for any inflammatory condition but it comes at a cost, essentially corticosteroids knock out the entire immune system leaving the rest of the body at risk for infection. When applied topically, this risk is minimised but it still isn’t the best thing for our bodies. Especially not when used over longer periods of time.
Though we mentioned before that rosacea affects mainly women over the age of 30, rosacea can affect all ages and genders. Another possible cause of rosacea is unmitigated, continuous exposure to the sun. So if you are at risk of getting rosacea, try to minimise your time in the sun – and definitely avoid sun burns at all cost!
Another one is food intolerance. Gluten, lactose and other triggers have been related to the development of rosacea – especially in the elderly. Certain food groups are known to stimulate the release of prostaglandins which end up dilating blood vessels in the face.
Foods that decrease inflammatory response
Since certain foods are thought to trigger the release of chemicals that dilate superficial blood vessels on the face and cause flushing, some practitioners of alternative medicine recommend avoiding these foods in order to reduce the symptoms of rosacea.
Identify foods that you may be allergic to. This is a trial process that everyone has to do individually as we are all different and our digestive tracts and immune system are primed to different allergens and foods. Begin by eliminating the obvious triggers; gluten, lactose, alcohol and others. A great way to start avoiding gluten products is to try and only eat gluten-free bread and then spread this out to other areas such as pasta, cakes and biscuits.
Some people are highly sensitive to the neurotransmitter histamine (whose presence is increased during allergic reactions). Histamine also increases capillary permeability and superficial blood vessel dilation. Some foods such as cheese (especially aged varieties), beer, red wine, yoghurt and certain pork products (most notably bacon as it’s highly processed) are high in histamine. So try to avoid these where possible if you have been identified as histamine sensitive (a simple blood test can reveal you histamine levels).
To reduce the risk for inflammatory conditions such as rosacea, research appears to suggest a diet high in nuts, seeds, fruit, whole grains, vegetables, polyunsaturated oils (olive, corn, soy, sesame, avocado oil) and oily fish (like mackerel). People with such a diet may have a decreased risk for other inflammation-related diseases. Furthermore foods high in antioxidants and omega-3 fatty acids seem to decrease inflammatory effects by promoting the body’s own anti-inflammatory response.
Cherries, artichokes, beans, broccoli, apples and (you’ll be happy to hear) dark chocolate are all high in antioxidants. So try to focus on eating these. The essential amino acid lysine affects the gut and in turn the gut affects our skin, so supplementing with lysine has worked for some people with rosacea. Because of its anti-inflammatory effects, some people have shown a reduction in rosacea blemishes after supplementing with turmeric root extract.
Sun, temperature and stress may trigger rosacea
As mentioned, increased sun exposure can promote rosacea – especially sunburn. Also being in an environment where temperatures fluctuate greatly, can cause flushing and red patches (going from hot to cold and vice versa). In some people hot baths and saunas are definite triggers.
Emotional stress is also believed to be a major contributor to rosacea. Trying to create an environment that reduces stress will help minimise the signs and symptoms.
Bacterial overgrowth in the gut and mites living on the face, at fault?
Recent clinical studies appear to suggest that the overgrowth of harmful bacteria in the gut might be linked to rosacea and other inflammatory conditions. It appears that this pro-inflammatory effect is most prevalent in the small intestine. Supplementing with beneficial bacteria in the form of probiotics may help reconstitute a healthy bacterial population in the small intestines.
Also, it may be shocking for you to read that there are mites that live in the pores of the skin that covers our faces. These mites come out at night, reproduce and then go back into the pores to lay their eggs and die. Healthy people have between 1 – 2 mites per square centimetre of skin (most notably nose, cheeks and forehead). Recent research has shown that people with rosacea have around 10 – 20 mites per square centimetre.
The problem isn't the mites per se, it is a bacteria that grows in their guts. Most species of mite don’t have an anus so they can’t go number 2, as such their abdomens just swell over their life time and eventually burst. This is how the bacteria get released on to the skin and then certain cells of the immune system recognise these bacteria and cross react with them – causing an inflammatory response that results in tissue damage and skin conditions like rosacea.
Further evidence of the mite/rosacea connection are clinical studies that have shown that 80% of people living with the most common forms of rosacea have immune cells that are primed react strongly against these mite bacteria whereas ‘only’ 40% of ‘healthy’ individuals appear to have these cells.
Natural health products that help with rosacea
Antibacterial skin products will eliminate some of these mites, but some do so at a cost. Be sure to check for organic facial cleansing products, many industrial versions of facial soaps and creams have other additives that will promote inflammatory responses.
There are some great natural products (creams, cleansers, oils) available to help treat the facial flushing associated with rosacea – products that are designed specifically for people with sensitive, rosacea-prone, skin. Moroccan Argan oil has long been touted as an excellent treatment for rosacea (because of its anti-inflammatory effect), as well as colloidal silver water and products made from rose water (roses for rosacea!).
Good luck with finding out what is triggering your rosacea. And remember it is possible to treat the condition and it is not with you for life. Stay positive and experiment, especially with your food. Please do this in consultation with a qualified healthcare practitioner.
by Christopher von Roy BSc, MSc, DCP Immunology
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