We all want our skin to look perfect at Christmas and red cheeks competing with Santa Claus’ outfit for attention certainly do not fit into this dream. However, this is a sad reality for many rosacea sufferers, as December can take its toll on rosacea skin. Cold weather and central heating combined with increased consumption of alcohol and indulgent party food as well often upgrading skincare to richer formulations can wreak havoc on rosacea complexions, leaving skin red, breakout prone and irritated.
Rosacea is a common facial skin problem in adults that is often mistaken for acne by patients. It’s more common in women than men and fair skin types are particularly susceptible – which is why it’s also known as the ’curse of the Celts'. Rosacea often appears in mid-life – patients often tell me they never had acne as a teenager, but now they’re in their forties they’ve started getting breakouts (as well as lines and wrinkles…). Not fair!
Rosacea can show up as vascular changes, typically redness, flushing and broken capillaries and/or as inflamed lesions (‘bumps’, spotty breakouts with papules and pustules or red ‘blotches’).
Happily, there is a range of effective treatments for rosacea and certain lifestyle changes can also help avoid a ‘bad skin month’. I can certainly sympathise with you, as I am a rosacea sufferer myself, so here are my seven top tips...
Dr Stefanie Williams
1. Don't just soldier on - see your doctor for a rosacea prescription
Seek help! Your doctor can give you prescription creams, which are much more effective than any over-the-counter solutions.
You will need different types of treatment for the inflamed and the vascular symptoms. Any inflamed lesions such as spots, bumps and blotches should be treated with anti-inflammatory prescription creams containing, for example, Metronidazole, Ivermectin or Azelaic Acid.
For temporary relief of rosacea-related redness, we can prescribe a cream called Mirvaso, which greatly reduces redness for up to 12 hours. I like to prescribe it as an emergency ‘skin saver’ for special occasions (such as Christmas!), but I don’t recommend using it daily.
For longer-lasting effects on redness, vascular rosacea with facial redness and broken vessels (teleangiectasias) benefits from laser or IPL treatment. However, any inflamed lesions must be cleared first, so don’t even think about having a laser or IPL treatment if you’re still getting breakouts.
2. Skip the red wine and spicy foods and pack mineral SPF if you are skiing
Check your lifestyle habits. Beware of potentially aggravating factors such as cold wind, spicy food, alcohol (particularly red wine which also includes mulled wine) and hot beverages.
Different patients react to different triggers, but overall red wine makes more people flare compared to white wine, so it may be worth considering this when you decide which wine to have with your Christmas dinner. But even within the group of red wines, there are huge differences and I often hear from patients that organic red wine without added sulphites is better tolerated than most others. And from personal experience, I can say that mulled wine seems to be (sadly…) one of the worst triggers of all (maybe it’s the combination of cheap red wine, sugar and heat), so be mindful of this.
If you are planning to go skiing over the holidays, be aware that the sun often makes rosacea flare-up, so you will need to be prepared. Your skincare regime should include a sun protection product with SPF30-50 . My preference for rosacea skin are pure mineral filter products, but make sure they come in a light-weight base such as Jan Marini’s Physical Protectant, £53 .
3. Avoid rich creams and use a light moisturiser such as hyaluronic acid
Your daily skincare regime is crucial, since the wrong products can be the sole cause for flare-ups. It can be very tricky for rosacea sufferers to find the perfect skincare regime for their skin (and in my experience most high street brands get it wrong!), as they may feel temporary relief from rich, soothing skincare, which however is contraindicated, as it will flare up the condition shortly after.
That’s because most rosacea patients report that they suffer with “ dry, sensitive skin ” that at times feels tight and uncomfortable and is often reactive. With this in mind, sufferers attempt to soothe their skin with rich creams or oils which then, however, aggravate rosacea breakouts.
The reason is that perceived “dry skin” in rosacea is not true dryness, but a sign of micro-inflammation in the skin. That’s why it’s crucial to treat the micro-inflammation of rosacea with anti-inflammatory prescription creams rather than ‘numbing’ the sensation by plastering on rich skincare. Treating the micro-inflammation will also lessen the perceived need for heavy moisturisers, a win-win situation.
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In the meantime, adding a light-weight hyaluronic acid serum is more suitable to help counteract the cold weather, compared to over-moisturising with heavy emollients, which will not do rosacea skin any favours and may leave you more breakout prone over the holidays.
4. Use a gentle cleanser and avoid harsh cloths
Daily cleansing with a rosacea suitable cleanser is of utmost importance, so even if you are coming home late after a Christmas party, make sure to remove your makeup and cleanse your face properly. Falling into bed without cleansing your face is an absolute no-no for any rosacea sufferer! Cleansing wipes also a no-go for rosacea. My recommendation is to use a gentle, yet pore-cleansing facial gel cleanser. Needless to say, that mesh sponges, abrasive scrubs and woven cloths should be avoided as they may aggravate the problem.
While cleansing is crucial to your daily skincare routine, toners aren’t strictly necessary though, so you can save time on skipping the toner after a late night out.
5. Book a gentle lymphatic drainage facial
Rosacea-prone skin often suffers with impaired lymphatic drainage, which can lead to a puffy appearance and over time to thickened skin. A gentle lymphatic drainage massage encourages lymph to flow more easily and do the job of carrying away toxins and excess fluid better. It thus reduces fluid retention, ‘de-puffs’ the face and is overall very useful in rosacea skin.
Lymphatic drainage massage is integral to a dermatology grade rosacea facial, so one of these prior to Christmas can be very beneficial. However, please avoid any high street and spa facials, as using the wrong products will inevitably flare up your rosacea.
6. Take collagen and fish oil supplements
A good collagen supplement (ideally 10g bovine collagen per day such as Dermacoll £24.26 ) and an omega-3 containing fish oil can also help with dry winter skin without having to overload the skin with overly heavy skincare and is a great addition for rosacea sufferers in December.
7. Avoid long hot baths and showers
After a brisk walk home in the freezing cold, it’s tempting to jump straight into a steaming hot bath, but this may not be the best choice for rosacea sufferers, as it may leave your skin red and flushed. Instead, baths and showers should be kept as short as possible and water should ideally be warm rather than hot.
Dermatologist Dr Stefanie Williams is founder of the Eudelo Clinic in London. For more information visit the clinic's website here .