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8 Facts about Acne Rosacea You Should Know 


What Is Acne Rosacea

Acne rosacea is a symptom of rosacea, a chronic inflammatory skin condition marked by profuse flushing, diffused redness, visible blood vessels, and inflamed lesions that are often referred to as acne rosacea. There are four verified sub-types, erythematotelangiectatic, papulopustular, phymatous, and ocular rosacea. However, papulopustular, which is the sub-type associated with acne rosacea is the most misdiagnosed.

The term acne rosacea is a misnomer. Unlike acne vulgaris, acne rosacea is marked by raised pus-filled papules and pustules. There are no sebum plugs (whiteheads) or comedones (blackheads) associated with common acne. 


What are the Types of Rosacea (Four Subtypes)?

Erythematotelangiectatic – marked by facial redness, flushing, and visible blood vessels.


Papulopustular - associated with acne-like breakouts, often affects women over 35


Phymatous rosacea - a condition that is marked by rhinophyma and an overall thickening of the skin on the forehead, nose, and chin. 


Ocular Rosacea - symptoms are centered in the eye area.


How to Identify Acne Rosacea?

infor graphic to teach you how to identify acne rosacea

It is widely known that acne rosacea predominantly affects people of European descent. However, approximately 415 million people suffer from it worldwide. Recent studies prove that many other ethnicities deal with acne rosacea as well. Since first described by French surgeon Dr. Guy de Chauliac in the 14th century, rosacea has been identified by its color.

The visible flushing and distended (stretched) capillaries known as telangiectasia are simply easier to identify in lighter skin types. Due to a high concentration of melanin, the typical markers may be more difficult to spot. In addition to that, the acne lesions themselves may appear more purple rather than red.

So, an inexperienced dermatologist may not properly identify the condition in darker skin types. For example, since genetic acne is common in Afro-Latin American communities, acne rosacea cases are often misdiagnosed. 

Very few studies have looked at the prevalence of rosacea in people with deep skin tones. Doctors must become more aware of how symptoms appear in richly pigmented skin to ensure the diagnosis of the condition. Even if dilated blood vessels aren’t visible, the skin may be warm to the touch.

There may be acne or dry patches that never seem to clear up. Finally, the skin of the forehead, nose, cheeks, and chin will begin to thicken and develop an orange peel-like texture. So, even without visible cues, the trained professional can pinpoint the issue.


What Causes Acne Rosacea?

man with acne rosacea and mites on his face

While the actual cause of Rosacea is still unknown, many variables may contribute to its occurrence. Impaired barrier function, skin mites, and a weakened immune system initiate the cascade of symptoms.

The uppermost layer of the skin, the stratum corneum, prevents foreign matter from entering the body while regulating transepidermal water loss (TEWL). It is covered with a slightly acidic mixture is made up of water, lactic acid, and lipids. Those who suffer from rosacea often have extremely sensitive skin because its barrier is compromised. Also, many skincare products trigger inflammation, thereby further sensitizing the skin. 

One cause that often goes unmentioned is an overgrowth of a common parasite that is normally the skin’s friend. The Demodex mite (Demodex folliculorum) lives on sebum and dead skin. They do most of their work at night, while the host is resting. However, when the barrier is impaired, these mites overpopulate the skin, and their excess excrement causes additional irritation which triggers inflammation.

To understand acne rosacea, you must look at the digestive process. The gut microbiome, the collection of microorganisms that live in the digestive tract, plays a huge role in defending the body against pathogens. Put simply, when “bad” bacteria take over, the entire system is thrown out of whack. This disruption in what is known as the gut-skin axis is the initial trigger of the inflammation cascade that marks the onset of Rosacea. Since a large part of the immune system resides in the gut, maintaining a balanced digestive system is the first step in controlling inflammatory skin conditions like acne rosacea.


What are the Symptoms of Acne Rosacea?

infographic showing Acne rosacea symptoms like enlarged nose, pus filled papules, red burning itchy eyes, and lax capilaries

Flare-ups often start with red, burning, itchy eyes. As the condition progresses the characteristic pus-filled papules of acne rosacea begin to appear. Many times, episodes occur in cycles, meaning that symptoms will return for weeks or months at a time, then disappear for just as long. The concern here is that eventually, the eruptions may progress into more severe forms of Rosacea.

In advanced stages, patients develop rhinophyma, a condition characterized by an enlarged, disfigured nose with thickened skin, acne-like papules, pustules, and lax capillaries. Identifying the triggers that exacerbate rosacea symptoms is the key to controlling the condition.


What Triggers Acne Rosacea?

Stress - Most rosacea sufferers experience a great deal of stress in some areas of their lives. This alone can slow down stomach acid production and impair digestion.


Spices - Simply ingesting spicy foods can trigger an acne rosacea episode. 


Wine – The tannins in wine (and some say even the caffeine in coffee) cause profuse flushing and disrupt the digestive system.


Climate - Heat and humidity can worsen acne rosacea. Ultraviolet (UV) radiation is the primary cause of skin flushing which initiates an entire cascade of rosacea symptoms.


How to Treat Acne Rosacea?

Green fruits and vegetables for good alkaline diet to treat Acne rosacea

While there is no known cure for Acne Rosacea, symptoms can be managed by making small changes in lifestyle and nutrition.

Changing the diet to a greener more alkaline meal plan that includes prebiotic and probiotic foods supports the growth of good bacteria in the gut. 

Other Treatment solutions range from at-home care options, spa facials, to medical solutions. Self-care takes on new meaning when attempting to manage acne rosacea at home. 

What’s more, developing a daily rosacea-friendly skincare regimen with products that soothe irritation, yet balance oil production is the key to minimizing flare-ups.

Natural, plant-based products are gentle on rosacea. Certain ancient herbal remedies have stood the test of time because they are proven to work. Essential oils contain antimicrobial, antifungal, and anti-inflammatory properties that may tingle a bit, but they are extremely effective at reducing redness and calming the oil glands. Since they should never be used directly on the skin full strength, select products that list essential oils as their active ingredients.


What are the Top 10 Tips for Treating Acne Rosacea?

some botanical ingredients and herbs used to treat Acne rosacea
  • Invest in botanical skincare: First, not harm! Select botanical ingredients that won't irritate the skin. Daily skincare regimens that include products with plant-based ingredients support skin structures with their high antioxidant properties. Also, plants provide phytonutrients that are like supplements for the skin. One school of thought advises rosacea sufferers to avoid active botanicals. However, there are numerous reports from those who found relief by incorporating essential oils, like lavender, tea tree, and lemongrass into their self-care. In addition to being antimicrobial, they are also very effective at calming the skin. Essential oils should never be used at full strength. So, rather than simply adding them to your current cleanser or moisturizer, purchase products that are formulated to specifically address acne rosacea symptoms.
    • Wash your face:  Cleansing the skin daily removes pollutants and environmental debris. Plus, it preps the skin for additional products. Creamy cleansers are great for dry skin. When balancing oily skin, look for a foaming face wash with low suds that does not contain SLS (sodium lauryl sulfate).
    • Moisturize: Whether the skin feels oily or dry, select a cream or lotion with humectants to draw in moisture and emollients to seal in hydration. These are the properties that reinforce the skin’s barrier. 
    • Reapply SPF: Select a mineral-based sunscreen that doesn’t trigger an acne rosacea break-out. It can be challenging but applying (and reapplying) sunscreen throughout the day is shown to reduce UV-induced flare-ups. No matter what, try to avoid synthetic SPF ingredients. Since they are quite oily and occlusive, they may potentially irritate acne rosacea. Look out for chemicals like oxybenzone, octinoxate, octisalate, and avobenzone on the ingredient list.
    • Use red light therapy devices that can be used at home: They radiate at the level of near-infrared light to increase microcirculation. This means more blood and healing nutrients are delivered to the affected area, bringing more oxygen which accelerates the cellular repair process. Improvements in the skin’s condition, color, and texture can be noticed with only a few treatments.
    • Use facials and other types of professional skin treatments offered at wellness centers or medical spas: These facials are aimed at finding balance. Services may range from a gentle touch such as cream cleansers and hydrating masks to a more aggressive protocol that introduces a chemical peel series to resurface the skin and flush the capillaries. Both approaches have merit. Either way, scheduling regular skincare services can be effective at keeping rosacea symptoms at bay. Adhering to professional recommendations for home care products will help maintain the results seen from treatment.
    • Follow Doctors' recommendations: for use of antibiotics, topical creams, and laser or light therapy. Although oral antibiotics have proven to be successful, using this type of medication long-term carries adverse reactions. Therefore, for mild to moderate inflammatory rosacea, dermatologists turn to topical treatments to reduce the redness and number of acne lesions. Their first-line of therapy usually includes metronidazole, a topical antibiotic that controls the overgrowth of certain bacteria and parasites. A dermatologist may also incorporate azelaic acid, a potent antibacterial, and a free-radical scavenger. Only Phymatous rosacea is commonly treated with laser or IPL (intense pulsed light) therapy. However, this type of treatment is only approved for fairer skin types.
    • Change your lifestyle: To get the best results out of treatment, making a few lifestyle changes will help manage acne rosacea. Making small changes will reduce systemic inflammation thereby soothing inflammatory skin conditions like acne rosacea. So try to rest and restore to manager stress, minimize outdoor exercise, and avoid overheating.
    • Control your Diet: Attempt an elimination diet to weed out rosacea offenders by avoiding triggers like spicy food, wine, and coffee. Add supplements like essential fatty acids (EFAs), particularly Omega 3.
    • Maintain Proper Hydration 


    Overview of Acne Rosacea

    Ultimately, acne rosacea can devolve into a disfiguring skin disorder that may trigger emotional stress. Also, the onset of stress can worsen an already unmanageable condition. That’s why it is so important to identify symptoms early. Since there is no known cure, long-term treatment is the only option. Developing daily habits like eating probiotic foods and adhering to a skincare ritual, applying Botanical and natural essential oils products is the best way to ensure episodes no longer occur.



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