Rosacea: Is It Really Rosacea

Understanding Your Skin From the Outside In

One of the things I find myself talking about more and more in my treatment room is rosacea.

I have had several clients come to me believing that they have rosacea because their skin is red, flushed, warm, irritated or sometimes bumpy. But redness does not automatically mean rosacea.

And this is something I think is really important to understand.

Not every red face is rosacea.

Rosacea is a genuine, chronic inflammatory skin condition. It can involve flushing, persistent facial redness, visible blood vessels, sensitivity, burning or stinging and, in some people, acne-like breakouts or eye symptoms. It can be managed very successfully, but at present there isn't a simple cure. Management is usually about understanding the individual skin, reducing triggers, protecting the skin barrier and using appropriate treatment when needed.

So before we put a label on the skin, I believe we should ask a much bigger question:

Why is the skin behaving this way?

Your skin is communicating with you

I have always believed that skin health is much bigger than the products we put on our face.

The skin is an organ, and it is constantly responding to what is happening around us and within us.

That doesn't mean that every skin problem is caused by diet or that you can simply “cure” rosacea by changing what you eat. It is much more complicated than that.

But I do believe there is enormous value in learning to listen to your body.

When I see a client with a very reactive, flushed or irritated complexion, I want to know more.

Do they flush after exercise?

Does their face become hot in the evening?

Do certain foods seem to coincide with a flare?

Do they feel bloated?

Are they experiencing itching or irritation elsewhere?

Does their skin become puffy around the eyes?

Are they using lots of active skincare products?

Has their skin suddenly become much more sensitive?

Are they stressed, run down or sleeping poorly?

These observations don't diagnose rosacea — that is something that needs proper medical assessment — but they can give us useful information about patterns and possible triggers.

In fact, dermatologists commonly recommend keeping a diary of foods, products, environmental exposures and symptoms to help identify individual rosacea triggers. Common triggers can include heat, sunlight, stress, alcohol, spicy foods, wind, cold and exercise, although everyone's triggers are different.

Looking at the whole picture

I have recently had clients referred to me by nutritionists.

I actually love this approach because it recognises that skin health doesn't exist in isolation.

The nutritionist can work with the client on nutrition and overall wellbeing, while I can concentrate on the skin itself — its barrier, sensitivity, hydration, inflammation, product choices and appropriate treatments.

It becomes much more of a team approach.

And when someone isn't already receiving guidance elsewhere, I often encourage them to start simply by becoming more aware of their own patterns.

Sometimes I suggest keeping a little diary for a couple of weeks.

Not a complicated one.

Just:

What did I eat?How did I feel?Did I feel bloated?Did my skin feel hot?Did I flush?Did my face feel itchy or irritated?Did I notice puffiness?What products did I use?What was happening emotionally or physically that day?

You may start seeing connections that you hadn't noticed before.

But it's important not to jump to conclusions. A food diary can help identify patterns, but it doesn't prove that a particular food causes rosacea or another skin condition.

And then there is flushing…

This is something I understand personally.

I am someone who flushes very easily. I can “pink up” when I exercise, when I become warm or when my body temperature rises.

That doesn't mean that I have rosacea.

Flushing can happen in perfectly healthy skin. In fact, rosacea often begins with a tendency to flush, but ordinary flushing and rosacea are not the same thing. With rosacea, redness can become more persistent and increasingly reactive over time.

Part of this comes down to our individual vascular response.

When we become hot, blood vessels in the skin dilate — vasodilation — allowing more blood flow to the skin and helping the body release heat.

Some people simply have a much more noticeable vascular response than others.

I see this in my treatment room all the time.

I can perform the same treatment on two clients and see completely different reactions.

One person may become very flushed after microneedling, while another barely changes colour.

That doesn't necessarily mean one person's skin is healthier than the other's.

Our skin is individual.

Our vascular response is individual.

Our genetics, skin barrier, sensitivity and inflammatory response are individual.

And this is why I don't believe in treating every red face in exactly the same way.

What about skincare?

This is where things can become complicated.

Sometimes someone has been told they have rosacea and has then started treating their skin very aggressively.

They may be exfoliating, using acids, scrubs or multiple active ingredients because they are trying to “clear” the redness or congestion.

And sometimes the skin becomes even more irritated.

More treatment isn't always better treatment.

For genuinely rosacea-prone skin, gentle cleansing, moisturising, barrier support and daily sun protection are important parts of management, especially Identifying and reducing individual triggers.

Avoid using strong vitamin A products like Tretinoin.

Rosacea is about management, not perfection

If you genuinely have rosacea, I don't want you to feel that your skin is something you have to fight against forever.

There is a great deal that can be done.

Personalised Skin Care Management Plan

A tailored skin care management plan for an individual can encompass various elements, including:

• Skincare Routine: Implementing a suitable daily skincare regimen that addresses specific skin needs.

• Trigger Management: Identifying and managing factors that may aggravate skin conditions.

• Sun Protection: Using sunscreen and protective measures to shield the skin from harmful UV rays.

• Professional Treatments: Considering in-office skin treatments that can enhance skin health and appearance.

Topical products or oral treatments tailored to the individual's symptoms can be prescibed by medical professionals. For ongoing issues such as redness or visible blood vessels, advanced options like laser or light therapies might be explored to achieve optimal results.

But I think the word management is important.

You learn your skin.

You learn your triggers.

You learn what it likes.

You learn what it doesn't like.

And you become consistent.

Because good skin health isn't usually created by one miracle treatment.

It is created by what you do repeatedly.

So, do you really have rosacea?

If you have facial redness, flushing, sensitivity or irritation, don't automatically diagnose yourself.

It could be rosacea.

But it could also be another skin condition, irritation, sensitivity, environmental exposure or simply a tendency to flush easily.

Rosacea can resemble other conditions, which is one reason professional assessment is important when the diagnosis isn't clear.

For me, the starting point is always understanding the skin in front of me.

I want to know what it looks like, how it behaves, what the client is experiencing and what their current skincare routine looks like.

And then, where appropriate, I want to look at the bigger picture too.

Because your skin doesn't exist separately from you.

It is part of you.

And sometimes, rather than asking:

“What product will get rid of this?”

the better question is:

“What is my skin trying to tell me?”

Your face is the window to your physical health, if you have any questions or I can help with your skin health concerns, get in touch.

Denise x