Rosacea can take a variety of forms, but the most common is a surface rash on the skin, red in colour and dry to the touch. It looks a bit like a friction burn. It is usually to be found on the cheeks, forehead, chin and nose. It is often accompanied by small visible veins, and a bad attack can lead to pimples or small bumps just beneath the surface of the skin. Sufferers also report watery or puffy, hayfever-type eyes. In extreme cases it can lead to a condition known as rhinophyma, which is an enlarging of the nose due to thickening of the skin. Rosacea can be uncomfortable too, producing a stinging or burning sensation.
That is the million-dollar question. The straight answer is, no one really knows. But that doesn’t stop people from having theories. Diet is thought to be a significant factor, although food triggers tend to vary from person to person. Common culprits are cheese, yoghurt, citrus fruit, chocolate, vanilla, soy sauce, yeast extract (though bread is OK), vinegar, avocados, spinach - and foods high in histamine or niacin.
Red wine and alcohol in general can also trigger it, as well as spices and foods that are physically hot: soup, coffee and so on. Stress is a significant factor, as is the weather: wind, cold and sun especially (the myth that the sun is good for rosacea is just that: a myth); even exercising can make it worse. It really is a pesky affliction, and if you know anyone with it you should be extremely sympathetic towards them.
Unfortunately, there is no silver bullet. Sufferers will always be prone to attacks; but it is possible to manage it. Part of the battle is learning to recognise the triggers, and then rigorously avoiding them. As for treatments, they really do vary from person to person: some, but not all, sufferers will respond to antibiotics (these tend to be the ones who find their rosacea is accompanied by pimples) or products that contain sulphur (a natural antibacterial agent). Laser treatments can address broken veins, and there are many topical creams that can reduce the appearance of inflammation. Some people find that a daily antihistamine helps.
In terms of skin care, it is important to look after the skin, that is to say keep it clean and moisturise regularly. Avoid anything that causes a stinging sensation, and try to keep things as simple as possible. An excellent range to try is a Danish skincare regime called Rudolph; this is free from pesticides and other harmful chemicals, and it has also been formulated to eliminate most allergens (it has a raft of certifications). The Acai skin tonic is brilliant for rebalancing the skin, while the Acai Facial Oil is both soothing and hydrating. Neal’s Yard Aloe Vera Cooling spray is effective too; also, Clinique’s Urgent Relief Cream is perfect for keeping in your handbag for when you feel a flare-up coming on.
Rosacea sufferers should also invest in a good daily sunscreen: ISclinical does a very good powder one that uses micronized zinc oxide and transparent titanium dioxide.
Makeup for rosacea is a tricky topic. It is hard to conceal rosacea completely, and unless you are planning a photoshoot, it’s best not to try since all foundations, no matter how snazzy, are only as good as the canvas they’re applied to. If your skin is rough and dry, you are better correcting the high colour rather than the texture. Your skin won't look perfect, but you won’t look like you’re wearing tons of makeup either. Clinique’s yellow-based mineral powder will tone down high colour without further irritating the skin.
You might also find that boosting your intake of essential fatty acids helps: try Harmony Formulas Essential Oil Omega 3,6,9
With rosacea sufferers, it’s all about calming and soothing the skin. Facials are fine, but avoid anything too mechanically abrasive; best to stick to manual massage and gentle exfoliation. Intense Pulsed Light is generally recommended by dermatologists as the best way of treating the redness and broken veins; at home, the Clarisonic skin brush is an excellent tool for ensuring gentle, effective cleansing, and will help to reduce pores and keep oiliness under control.
Looking for more products for rosacea? Check out our Makeup Maniac's column on how to do makeup with rosacea here