Having been diagnosed with acne rosacea at 30 years old (some 25 years ago, yikes!) and researching this skin disorder, I knew I was in for a long haul of trying to control this chronic condition that was bestowed on me. Acne rosacea is characterized by intense and frequent flushing, and the appearance of broken blood vessels on the cheeks, chin and nose. I also had acne-like pimples in these areas as well. Firstly, I needed to discover my triggers. What were the internal and environmental factors that made my skin blush to the colour purple, and break out in hundreds of tiny pustules that seemed to produce and multiply daily? It’s important to note that once you have been diagnosed with rosacea it is essential that you find the triggers that make you flush. They can be different for each individual. The common triggers are sun exposure, red wine – and for me red plums – and heat, such as hot or steam baths, saunas, hot yoga, hot drinks and warm environments. Cosmetics and skincare containing high levels of alcohol or acetone, as well as fragranced products can also be culprits.
Even emotional/physiological triggers, such as anxiety, embarrassment, stress, menopause and physical exertion can inflame the skin. Early on, I was given the timely advice that I needed to control the inflammation, i.e., the flushing, in order to control the disorder or rosacea could wreak havoc on my skin! I was given oral antibiotics, along with the topical antibiotic metronidazole, to help get my skin under control while I did my investigative work to find my triggers. I then needed to find skincare products that could help alleviate this condition from the outside. Not an easy task! Rich emollients were a problem for the acne component of my rosacea. Cleanser selection became particularly important, as I needed to remove my makeup and sunscreen thoroughly without over sensitizing my skin. Physical sunscreen containing zinc oxide is comfortable on my skin. I like that they reflect UV rays off the skin rather than absorbing the UV and turning it into heat energy as the chemical sunscreens do.
Also, I find it helpful to change my skincare products slightly in different climates. Warm dry climates affect my rosacea as do warm moist climates. The right consistency of products makes a difference in these environments. I could tell you exactly what I use for skincare but I may do you a disservice, as what works for my rosacea will not necessarily work for you. I will, however, tell you my skincare staples that I would not be without. Topical vitamin C serum composed of pure L ascorbic acid. My dermatologist advised that I apply vitamin C serum every day without exception 20 years ago. I have stuck with it all these years. For rosacea skin, vitamin C serum is very instrumental in helping control the inflammation of the disorder. It also helps ward off free radicals in the environment that penetrate through our already compromised skin barrier. I apply this serum in the morning after my metronidazole gel that I mentioned earlier. Lastly, I apply a physical sunscreen and makeup.
At night I use a low dose retinol .05% to keep the rosacea pimples at bay. Before and after Laser Genesis treatment for rosacea. As far as cosmetic treatment options are concerned, I must say that the vascular lasers for facial redness have been very instrumental in controlling my disorder. These cutting-edge lasers have dramatically reduced the persistent redness in my skin. A series of 5 to 6 treatments spaced at 4 to 6 weeks apart is advised for inflammatory rosacea. I would advise to start on the vascular treatments as soon as possible after your diagnosis. Remember, we need to control the inflammation in order to control the disorder. Rosacea is a chronic disorder so you may need maintenance treatments a few times a year. Skincare products help control ours skin’s outer environment, while vascular lasers help control the inflammation from within by shutting down the flushing, blushing vessels. Lastly, I have to give the Fraxel® re:store DUAL non-ablative fractionated laser a lions’ share of credit for literally transforming my skin.
Although it does not treat redness per se, I am much less red after having just two treatments! The laser heat and light may have killed the demodex folliculorum mite, which is theorized as an infectious component living in rosacea skin. This is my theory as my skin is much more resilient to flushing than before the treatments. The Fraxel® re:store DUAL also removed a thick layer of dead skin cells and sun damage, which allows my skincare products to penetrate to the fullest extent. I hope this information has been helpful to you. if you would like any more information. Remember, find those rosacea triggers!Vitamins A,C, E & B3 are found naturally in the skin and have been shown to have potent anti-inflammatory and anti-oxidant properties. They can be depleted by sunlight, smoking, pollution and other free radical stress. The number of products containing these vitamins has ballooned in recent years. Read on to see how the theory and background of these Vitamins might be good for you.
Also known as alpha-tocopherol, Vitamin E is found in fresh vegetables, vegetable oils, cereals and nuts. The term Vitamin E is used to describe 8 naturally occurring molecules. The activity of these compounds is measured in terms of alpha-tocopherol equivalents. Vitamin E has been shown to be useful in photoprotection, atopic dermatitis and skin protection. There is evidence to suggest that vitamin E is the most important physiologic barrier anti-oxidant in the stratum corneum – i.e. in the part of the skin that protects you from the elements, Vitamin E is thought to be the critical anti-oxidant agent. Topical Vitamin E can restore the levels in the skin that can become depleted due to the oxidative stress of the sun and other environmental insults. This page from Paula Begoun seems to be pretty comprehensive about Vitamin E. “A sampling of its substantiated capabilities when applied topically includes: Because humans lack the enzyme to produce Vitamin C (L-ascorbic acid), we need dietary sources to obtain it.
Citrus fruits and leafy green vegetables are good sources. Topically, Vitamin C has potent anti-inflammatory and antioxidant properties and indeed acts synergistically to restore the regenerative effects of Vitamin E. Thus Vitamin E and Vitamin C are often combined in topical preparations. Vitamin C is used to as a treatment and to prevent photodamage, photoagine, hyperpigmentation and redness. Studies have shown that Vitamin C and Vitamin E together have greater benefits compare to when used alone. Adding ferulic acid was also found to further double the photoprotective effect of the two Vitamins. Retinol is the naturally occuring form of Vitamin A and can easily penetrate the epidermis. The biologic properties of retinoids include “antioxidant activity (via free radical scavenging), increased fibroblast proliferation, modulation of cellular differentiation and proliferation, increased collagen and hyaluronate, and decreased matrix metalloproteinase-mediated extracellular matrix degradation”.
Topical retinol has been found to be effect for treating photoaging – showing improvements in facial wrinkles and fine lines. Unfortunately some rosacea sufferers have found topical Vitamin A derivatives to be too harsh for their sensitive skin. Cherie Detrie, M.D., director of cosmetic dermatology at the University of Pennsylvania in Radnor, has said “retinaldehyde offers rosacea patients who may have sensitive skin the benefits of retinoids with fewer side effects.”. A 1999 study found that that “retinaldehyde has beneficial effects on the vascular component of rosacea.” The term Vitamin B3 is used to describe both niacinamide and nicotinic acid (niacin). Niacinamide is found in meat, fish and wheat. Niacinamide has anti-inflammatory and skin-lightening properties and can decrease the production of sebum. Topical niacinamide can be used to treat dry skin, acne, photoaging, blistering, pigment disorders and would healing. One study looked at the topical usage of 1-methylnicotinamide (MNA) 0.25% in treating rosacea.
The response was good in 26% of patients and moderate in 50% of patients. Varying results have been discovered when assessing the effect of topical 2% niacinamide on sebum excretion and sebum levels in Japanese and white subjects. A 2005 study found that Niacinamide – Containing Facial Moisturizer Improves Skin Barrier and Benefits Subjects With Rosacea. Also note that the formulation of 1% metrogel also contains niacinamide. A 2007 study also found that niacinamide and kinetin in combination worked well to provide anti-aging effects for asian skin. If you are considering taking a B complex vitamin supplement, Dr. Sy warns us to avoid one that contains Niacin as that can cause flushing. Following is the abstract and summary that motivated this article. Topical vitamins, J Drugs Dermatol. 2008 Jul;7(7 Suppl):s2-6., Burgess C. ,The Center for Dermatology and Dermatologic Surgery, Washington, DC, USA. Vitamins are a natural constituent of human skin and are part of a system of antioxidants that protect the skin from oxidative stress.
There has been an increased interest in the use of natural antioxidants such as vitamins to help restore dermal antioxidant activity. Vitamins A, C, E, and B3 have been shown to have potent antioxidant and anti-inflammatory properties, but to achieve optimal effectiveness, products must be delivered in appropriate formulations. Products containing alpha-tocopherol (vitamin E), L-ascorbic acid (vitamin C), retinol (vitamin A), and niacinamide (vitamin B3), are effective for the treatment of photoaging. These compounds have also shown effectiveness in the treatment of inflammatory dermatoses, acne, and pigmentation disorders and wound healing. There is emerging evidence that combinations of vitamins have additive effects that provide enhanced efficacy compared with individual compounds. Summary: Substantial data suggest that topical vitamins such as vitamin E, vitamin C, retinol, and niacinamide have beneficial effects on the skin including photoprotection, and protection from photoaging and inflammatory dermatoses.