Rosacea is an inflammatory skin disorder of unknown cause, usually beginning at middle age or later. It begins as flushing and redness on the central face and across the cheeks, nose, or forehead but can also less commonly affect the neck, chest, scalp or ears. The disorder can be confused and co-exist with acne vulgaris and/or seborrheic dermatitis. The precise biological mechanism behind rosacea still remains unknown, but it is thought that rosacea is a disorder where the blood vessels become damaged when repeatedly dilated by stimuli, causing the vessels to readily dilate and remain dilated for longer periods of time or permanently, resulting in flushing and redness.
Papulopustular rosacea occurs as immune cells and inflammatory mediators leak from the microvascular bed causing inflammatory pustules and papules. Helicobacter pylori infection is implicated as a causative factor.
Causes / Risk Factors
Major causative factors and risk factors that can contribute to the incidence of rosacea include the following:
- High fat diet
- High sugar diet
- Bowel toxicity
- Low fibre diet
- Food sensitivities
- Impaired glucose tolerance
- Long term antibiotic therapy
- Female hormone therapy
- People that are fair-skinned
- Rosacea affects both men and women of all ages, but middle-aged women are more susceptible
- Persisting redness due to exercise, changes in temperature and/or cleansing
- Certain medications and topical irritants can quickly progress rosacea – e.g., corticosteroids, microdermabrasion, chemical peels, high doses of isotretinoin, benzoyl peroxide and tretinoin.
- It has also been suggested that rosacea might be due to hypersensitisation of sensory neurons following exposure to dysbiotic intestinal bacteria in the digestive tract.
Symptoms & Signs
Common signs and symptoms of rosacea include
- Flushing and easy blushing
- Permanent redness
- Red pustules
- Red gritty eyes
- Burning and stinging sensations on the skin
- Small blood vessels visible near the surface of the skin
- Bulbous nose, with thickening of the skin and nodules (Rhinophyma, in phymatous rosacea)
- Increased Demodex mite count
- Exposure to temperature extremes can cause the face to become flushed as well as strenuous exercise, heat from sunlight, severe sunburn, stress, cold wind, moving to a warm or hot environment from a cold one such as heated shops and offices during the winter. There are also some foods and drinks that can trigger flushing, these include alcohol, foods high in histamine and spicy food.
- Depression stemming from cosmetic disfigurement, painful burning sensations, etc
Diet and Lifestyle Considerations for Acne-Rosacea
Dietary and lifestyle guidelines that may assist in the management of rosacea:
- Dietary guidelines which are low reactive, low glycaemic load and support healthy detoxification are recommended.
- The Wellness Lifestyle Program is designed to regulate blood sugar levels, beneficially influence fat metabolism, and reduce inflammatory signalling whilst balancing hormone activity. This diet is rich in soluble fibre, antioxidants, phytonutrients, essential fatty acids from nuts and fish, and quality protein.
- Elimination Diet – The National Rosacea Society recommends keeping a food diary to help identify and reduce potential food and drink irritants.
Employ a gentle skin cleansing regimen using non-irritating cleansers. Protection from the sun is important with regular use of a physical blocker sunscreen is advised.
Integrative Treatments Overview
In order to obtain optimal results, the patient might consider a holistic approach that integrates several treatments to address biochemical, physiological, energetic, emotional and/or spiritual imbalances. These treatments can include Allopathic Medicine, Complementary Medicine, Biomedicine, Nutritional & Environmental Medicine, Functional Medicine, Orthomolecular Medicine, Energy Medicine, Traditional Chinese Medicine, Naturopathy, Ayurvedic, muscular-skeletal support, Psychology and more. It’s important that treatments are overseen by experienced and certified practitioners who are able to work in teams (see below for where to find one).
For Treatment options see Treatments menu at mindd.org
Nutritional & Environmental Medicine Overview
Nutritional & Environmental practitioners focus on cellular health by optimising nutrient uptake while minimising toxic exposure. Biomedicine, Functional Medicine and Orthomolecular Medicine are all subsets. The overall goal is to reduce inflammation and oxidative stress which are key drivers in chronic modern disease (e.g. asthma is inflammation of the lungs, arthritis is inflammation of the joints, eczema is inflammation of the skin, IBS involves inflammation of the gut and ADHD and Autism include inflammation of the brain). A combined approach of diet, lifestyle and natural therapies supports the body’s innate ability to heal and prevent disease by maintaining homeostasis (balance).
It is recommended that a patient consult a certified practitioner to assess their symptoms and case history and explore their individual need to:
- Screen for food sensitivities and allergies
- Implement dietary intervention geared to the individual (e.g. GAPS, Gluten-Free, Dairy-Free, Soy-Free, FodMAPS, Evolutionary, low oxalate/salicylate, Ketogenic)
- Supplement with vitamins, minerals, amino acids and probiotics
- Improve gastro-intestinal health to support the vagus nerve and brain and immune function
- Support neurotransmitter function
- Supply fat soluble nutrients for brain structure and function
- Reduce toxicity and heavy metal accumulation
- Minimise infections (e.g. bacteria, yeast, virus, parasites) to reduce immune response and nutritional deficiencies that can impact on mental and physical health
- Regulate blood glucose and establish healthy eating habits
- Use energy healing (acupuncture, homeopathy, kinesiology, Emotional Freedom Technique)
Where can I find a certified practitioner?
Finding a well-trained Integrative practitioner requires research. You can reference the lists below for one in your area and should consider checking references and interviewing several before you select one.
The World Anti-Aging Academy of Medicine can help you find Integrative practitioners throughout the world.
The American Academy of Anti-Aging has a directory of doctors, spas, clinics and products that support Integrative treatments for all disease.
The American College for the Advancement in Medicine (ACAM) trains practitioners in Complementary and Integrative Medicine.
Generation Rescue has a list of Integrative practitioners who specialise in childhood neurobiological disorders (Autism, ADHD, allergies). If they do not treat adults or your condition, they might be able to refer you to someone in your area who can.
Australia & New Zealand
Mindd Foundation trains Integrative practitioners in Australia and New Zealand and is partnered with the Medical Academy of Paediatric Special Needs (MAPS).
The Australian College of Nutritional & Environmental Medicine (ACNEM) trains in Australia and New Zealand.
The British Society for Ecological Medicine has a list of practitioners in the UK
Mindd Foundation gratefully acknowledges the contribution of Metagenics in supplying the Definition, Causes and Diet & Lifestyle Considerations for this page.