Conseils rosacée quotidien.

How to better live with rosacea?

Characterized by redness, dilated blood vessels, inflamed skin, and more, rosacea goes well beyond simple physical manifestations. It can have a significant impact on the self-confidence, quality of life, and mental health of those who suffer from it. However, it is possible to learn to live better with these visible skin changes that can be bothersome and discouraging. Discover in this article our lifestyle tips to limit rosacea flare-ups.

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Advice #1: Consult a dermatologist.

Although it is an incurable chronic skin disease, there are several types of treatments available to alleviate symptoms and thus improve quality of life, depending on the form of rosacea in question. The metronidazole, azelaic acid in topical application, or even the doxycycline in oral form are the most frequently prescribed. For more severe forms of rosacea, treatments involving mechanical destruction, the use of lasers, or the recourse to cryosurgery are possible.

Therefore, consider consulting a dermatologist as soon as you notice the first symptoms to make a diagnosis of rosacea, discuss your feelings and implement a treatment plan tailored to your situation. Early treatment can prevent symptoms from worsening. The doctor may also prescribe soothing and repairing care in parallel to alleviate symptoms and improve the skin's appearance.

Similarly, regular visits to a dermatologist can also help manage rosacea, by providing personalized advice and adjusting treatments as necessary.

Advice #2: Understand your own rosacea triggers.

The identification of triggering factors and understanding their impact on the disease incidence are paramount. By knowing them, the patient can gradually adjust their lifestyle habits to move towards a more balanced management of the disease and their daily life. It's not necessarily about completely stopping all of their habits, but rather modifying certain behaviors to limit their impact.

Common triggers for rosacea flare-ups include sun exposure, temperature, stress, spicy food, intense physical exercise, alcohol consumption, and certain skincare products.

Advice #3: Prioritize a balanced diet.

Diet's role in the pathogenesis of rosacea is significant. Adopting a balanced diet, including the consumption of certain types of foods, can be beneficial and alleviate the symptoms of rosacea.

A study by SHEN conducted in 2023 assessed the role of diet on rosacea, and more specifically the relationship between adherence to a Mediterranean-style diet (consumption of whole grain products, vegetables, legumes, fish, olive oil, and nuts are recommended, due to their omega-3 content) and the risk of incident rosacea. This study took place from January 2018 to December 2021 on a prospective cohort. Several skin examinations were performed and a Mediterranean Diet Score (MDS) was generated.

Out of 83 patients suffering from rosacea, the MDS was associated with a decrease in the risk of rosacea among the patients. Adopting the Mediterranean diet helps to reduce the production of inflammatory cytokines and aids in reducing skin inflammation.

Advice No. 4: Manage stress.

Stress can exacerbate rosacea. Indeed, it is responsible for the activation of the NALP3, TLR-2, and TRPV1 pathways, thus inducing an increase in inflammation accompanied by a vasodilation of the blood vessels. However, this latter will lead to a strengthening of the symptoms of rosacea with more intense redness manifesting in the form of flare-ups.

In order to minimize discomfort as much as possible, it is recommended to engage in activities that promote mental and physical relaxation such as yoga, meditation, or even Schultz's autogenic training, in your daily routine. Autogenic training, developed by psychiatrist Johannes SCHULTZ, is a relaxation method based on the use of self-concentration techniques. Moreover, it is important to maintain a good sleep pattern. Indeed, lack of sleep is also a significant stress factor for the body.

Advice #5: Reduce your consumption of alcohol and tobacco.

Alcohol is one of the triggers of rosacea. Its consumption will induce an increased release of catecholamines which cause dilation of the vessels. In addition, inflammation will increase and cause the intensification of erythema. In order to preserve your health and avoid harmful effects, it is preferable to limit your alcohol consumption to two or three glasses per week .

The effects of smoking on rosacea are more abstract, and the scientific data on this subject is still somewhat unclear. Overall, tobacco remains a harmful element, due to the numerous toxic compounds it contains. The nicotine found in tobacco could particularly contribute to the development of the disease. Moreover, the degradation of elastin and collagen fibers contributes to the damage of the skin barrier.

Advice #6: Protect yourself from sun exposure all year round.

As with many inflammatory diseases, sun exposure, through the UV radiation it emits, is one of the most common triggers of rosacea flare-ups. UV rays induce the formation of free radicals which lead to an oxidation process resulting in the deterioration of skin tissues. This process occurs as a result of the stimulation of NALP3, TLR-2, and TRPV-4 activation pathways, which amplifies inflammation and the release of pro-inflammatory cytokines.

To reduce rosacea flare-ups caused by the sun, it is recommended to apply a broad-spectrum sunscreen (UVA/UVB) providing a SPF of 30 or more daily to ensure optimal protection, regardless of the season or weather, to wear sun-protective clothing (hat and sunglasses with UV protection), to seek shade as much as possible, and to limit direct sun exposure.

It is suggested to increasingly turn towards solar care products based on mineral filters (zinc oxide and titanium dioxide) and without artificial fragrance.

Advice #7: After cleansing, prioritize daily hydration of the skin.

It is recommended that skin prone to rosacea should wash the face with a gentle cleanser designed for sensitive skin, soap-free and with a pH of 5.5 at a frequency of once to twice a day only.

As inflammation impairs the barrier function, skin prone to rosacea becomes particularly sensitive and dry. Indeed, the skin barrier undergoes damage, increasing water loss and making it less capable of fulfilling its protective function. This dysfunction can cause significant discomfort for the patient, accompanied by intense feelings of tightness.

Thedaily use of a non-greasy cream with occlusive and moisturizing functions is necessary to counteract the harmful effects caused by inflammation. It should preferably contain emollients (ceramides, vegetable oils, squalane, niacinamide), humectants (hyaluronic acid, glycerin, allantoin), occlusives (butters, waxes, silicones, etc.), as well as anti-inflammatory agents (azelaic acid, bisabolol, etc.) in order to best restore the epidermal barrier, while reducing the accompanying sensations of tingling or burning.

If you are using medications to treat rosacea, first apply your topical treatment, then follow up with a moisturizer that is gentle on rosacea.

Advice #8: Choose skin care products wisely.

Skin prone to rosacea is particularly sensitive and can react strongly to certain components found in cosmetic products. These reactions often manifest as feelings of irritation, itching, and the appearance of red patches.

It is recommended for them to select gentle and non-irritating formulas, free from synthetic fragrance, alcohol, menthol, camphor, sodium lauryl sulfate or other potentially harsh ingredients.

Before applying any treatment to the face, always remember to test the products beforehand.

Advice #9: Pay more attention to exfoliation.

In theory, rosacea makes the skin more sensitive and prone to irritation. However, it is a highly individual condition. Therefore, while exfoliation may be "beneficial" for some people's rosacea, it can conversely worsen it for others.

However, in cases of active redness or rosacea flare-ups, it is preferable to avoid exfoliation until the skin has calmed down.

retinoids , AHAs (glycolic acid, lactic acid, etc.) and BHAs (salicylic acid, etc.) due to their potential to irritate sensitive skin.

Similarly, the use of accessories (exfoliating gloves, konjac sponges, dry brushes, exfoliating straps, etc.) and grainy mechanical scrubs can be abrasive and irritating. However, gentle exfoliants such as poly-hydroxy acids (PHA) can be suitable for sensitive skin prone to rosacea. They are much less irritating.

Be gentle with your skin and avoid over-exfoliating. Individuals with rosacea should exfoliate less frequently than those without the condition. Once a week, or even less frequently, may be sufficient. Of course, this can vary depending on individual tolerance.

Advice #10: Use makeup to diminish mild redness.

If redness becomes too bothersome on a daily basis, the use of makeup can be helpful. Once again, it is essential to choose gentle and non-irritating products. For instance, when it comes to foundations, it is better to use fluid cosmetics or medical foundations, which provide coverage without being occlusive. Care should be taken to avoid thick and greasy textures, as they can clog the pores on the skin's surface and lead to an exacerbation of inflammation and symptoms.

Furthermore, the application of a green anti-redness concealer can be beneficial and allow to neutralize the red color of the skin, while maintaining a natural effect. Green and red are considered complementary colors, they cancel each other out when combined. The green concealer can be used in various ways depending on the extent of the redness.

Advice #11: Resort to psychological support.

Living with rosacea can pose a psychological challenge as the visible and bothersome symptoms often lead to self-consciousness in patients. Addressing the psychological aspect of the disease can have a real impact on the progression of the disease and most importantly, on the quality of life of the patients.

This care can be provided through a psychological support by the patient's surroundings or by a specialist, the joining of a support group or a online community. These groups are spaces where individuals share their experiences and tips for better managing the disease. This allows the patient to obtain advice and emotional support regarding the experience they are going through. These discussion groups can be recommended by the doctor or easily found on social networks and on the internet.

Sources

  • STEINHOFF M. & al. Recent advances in understanding and managing rosacea. F1000Research (2018).

  • BAGATIN E. & al. Consensus on the therapeutic management of rosacea - Brazilian Society of Dermatology. Brazilian Annals of Dermatology (2020).

  • ALI F. & et al. Rosacea. British Journal of Hospital Medicine.(2021).

  • YIN D. & al. Association between rosacea and smoking: A systematic review and meta-analysis. Dermatologic Therapy (2021).

  • REINHOLZ M. & others. Dietary patterns in acne and rosacea patients—A controlled study and comprehensive analysis. Multidisciplinary Digital Publishing Institute (2023).

  • VEIGA F. & al. Topical Treatment and Care for Rosacea: From Traditional to New Drug Delivery Systems. Molecular Pharmaceutics (2023).

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