Rosacea is a chronic inflammatory skin condition. It is characterized by a flushing on the cheeks, nose, forehead, and chin sometimes accompanied by small, red, pus-filled bumps. This condition most commonly affects those with fair skin over the age of 30 that have a tendency to blush easily. More women are diagnosed with rosacea but the symptoms in men tend to be more severe; rosacea will get worse over time if not treated. It is estimated that 1 in every 20 Americans are affected with rosacea.
The cause of rosacea is unknown but it is thought that hereditary, environmental, and lifestyle factors all play a part. Anything that dilates blood vessels can trigger or aggravate rosacea such as: hot foods or beverages, spicy foods, alcohol, temperature extremes, sunlight, stress, strenuous exercise, hot baths or saunas, corticosteroids, and some blood pressure medications. Experts suggest that abnormalities in the blood vessels of the face cause the persistent redness but do not know what causes inflammation. Demodex folliculorum are microscopic mites that live on human skin and usually do not cause problems. However, patients with rosacea have much higher numbers of these mites; but it is unknown if these mites are the cause or the effect of rosacea. H. pylori, a bacteria found in the stomach, stimulates the production of a protein that dilates blood vessels and may cause the development of rosacea.
Rosacea symptoms vary from person to person with flare ups lasting weeks to months. Rosacea can often be misdiagnosed as acne, eczema, or an allergic reaction. According to a panel of 17 medical experts worldwide, rosacea always includes at least one of the following primary signs: Flushing, persistent redness, bumps and pimples, and visible blood vessels. Secondary signs and symptoms can include eye irritation, burning or stinging, dry appearance, plaques (raised red patches), skin thickening (especially on the nose), and swelling. Rosacea can even affect skin on the neck, scalp, chest, and ears.
There is no known cure for rosacea but a combination of medical treatment, lifestyle changes, and proper skin care can help relieve the signs and symptoms. As a skin care therapist it is essential to know if your client has been diagnosed by a medical doctor and what medications have been prescribed to treat their rosacea. Examples of commonly prescribed topical medications include: antibiotics (metronidazole), tretinoin, benzoyl peroxide, sulfur, and azelaic acid. Oral antibiotics, often combined with topical medications include: tetracycline, minocycline and erythromycin. Another aspect of medical therapy can include laser (IPL) treatments for visible blood vessels (telangiectasia) and plastic surgery options for severe cases of rosacea.
The goal to treating a rosacea client is keeping the skin calm and cool. Avoid steam and keep towels at cool temperatures. Avoid overstimulating the skin and use a gentle pressure when massaging the face. Keep the following guidelines in mind during a facial service with a rosacea client:
Cleanse – use non-foaming cleansers; unless the skin is oily.
Exfoliate – use enzyme based exfoliators; avoid scrubs and chemical peels.
Correct – Hyaluronic acid to helps repair the lipid barrier. Antioxidants, such as green tea, neutralize oxygen stealing free radicals.
Protect – use oil free moisturizers and daily UVA/UVB sun protection containing zinc and titanium dioxide.
Makeup – Clean formulated mineral makeup is best because of their simple ingredients and full coverage. Look for an oil-free, green-tinted base or a yellow-toned mineral powder applied with a soft, antibacterial brush.
Some ingredients to avoid can include alcohol, witch hazel, fragrance, menthol, peppermint, and eucalyptus oil. Steer clear of stimulating AHA’s, BHA’s, and some Vitamin C products.
Rosacea is a complex skin condition that leaves a lot to the unknown. This makes some clients nervous about receiving skin care treatments. Ease these concerns by offering a complimentary skin analysis and ask them to bring in the products they currently use so you can look for irritating ingredients and make recommendations to help them control the symptoms of rosacea.