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Finding effective treatments for rosacea can be a difficult and frustrating journey. Some treatments seem to work for a while, but then the rash returns. The natural course of the disease consists of calm times followed by flare-ups, which further complicate trying to figure out if treatments actually worked or if the disease was just going into a quite period. The struggle to treat rosacea can last a lifetime, and people are often faced with the disease slowly getting worse over time, despite everything they have tried.
The reason for all this frustration may not be in which remedy someone chooses, but in where they think the problem is located. Topical creams, lotions and even antibiotics do little to address the underlying causes of the disease. While Rosacea is a disease that appears mostly on the face, the real condition is most likely located far away from the face. Research is uncovering that the root cause of rosacea may, in fact, be a problem with the gut.
Rosacea is often mistaken for acne, but usually first appears in later in life. It most commonly first appears in adults who are in their 30s or 40s. Rosacea appears as a red flushed rash that typically appears on the cheeks and across the nose; although the chin and forehead are often involved. Rosacea may have hard pimples, or even pus-filled pimples similar to acne, but lacks blackheads. Small spider-like veins called telangiectasias are also commonly present and are one of the biggest sources of frustration for people with rosacea. These spider veins are unsightly and tend to grow worse with time.
In early stages of the disease, the flushing tends to come and go, with periods where it flairs up and other times when it is calm. In later stages, the redness tends to remain and becomes consistent. Over time, spider veins appear and these too start appearing over larger areas of the face. The skin can become rough and take on an appearance likened to an orange peel. In people who have had the disease for a long time, or those who have a more severe form of the disease, the nose swells and appears bulb-like (known as rhinophyma).
Medical treatments for rosacea include the use of topical antibiotics (most commonly metronidazole or azelaic acid). If these treatments don't work, oral antibiotics (such as metronidazole or tetracyclines) are often tried. A strong artificial version of vitamin A, known as Accutane or Retin-A is often the next step, or sometimes used in conjunction with the above treatments. Accutane, which is typically used for acne, is used in a low-dose form for rosacea. The use of Accutane and Retin-A has also been shown to be helpful for rhinophyma.
Phototherapy is another option people choose. Phototherapy uses a low-intensity ultraviolet ray to heat up and destroy some of the small capillaries in the face. Phototherapy seems to work especially well for the flushing and redness of rosacea, but a lot of patients turn to this treatment to help with the spider veins. Phototherapy is far from a solution to the problem, patients report that they have to return for follow-up laser treatments every year or so.
From a medical standpoint, rosacea is considered chronic condition and not really treatable, as most approaches only forestall the disease for a while. There is, however, another approach.
One of the best ways to approach rosacea is to look for and uncover triggers. A trigger is something that, once consumed, will lead to a flaring of symptoms. Each person has their own unique set of triggers. Some of the most common triggers are alcohol, caffeine, and hot drinks, but here is a list of other common triggers:
As you can see from the above list, there are a lot of foods that can trigger an attack. Everyone with rosacea should take the time to develop a personal journal that records foods and symptoms. Uncovering triggers can be extremely useful and forestall a lot of flare-ups; it is well worth the effort of keeping a food journal for a few months to uncover your triggers.
Some health practitioners also associate rosacea with food allergies. This is not the kind of food allergy that produces severe reactions (like to peanuts), but more of a low-level allergy that can produce other symptoms such as upset stomach, itching, and other rashes. Many of these food allergies go unnoticed and are only made clear by their removal and the clearing up of rosacea.
The most common food allergies are to wheat, dairy, eggs, soy, corn and nuts. While it can be quite a challenge to remove these foods form the diet, a trial of a week or two away from all these, followed by reintroduction of these foods (one at a time), is a great way to zero in on your own personal food allergies.
Sunlight deserves special mention when it comes to triggers. For years, sunlight has been considered a trigger of rosacea. This is a bit puzzling because there is a lack of research to support this notion and yet it is commonly listed as a trigger for an outbreak. It is also a puzzling because one of the medical treatments for rosacea is phototherapy, which uses sun-like ultraviolet light as a treatment.
Research is starting to debunk the myth that sun exposure causes rosacea, take a look at a recent study:
A literature search was conducted and much evidence was found to challenge the belief that light adversely affects rosacea. In fact, more patients actually improved with sunlight in a more recent published survey. Several other studies have also shown that rosacea patients were similar to control subjects in sun exposure, solar skin damage, and sun sensitivity. Additionally, all clinical trials to date have failed to find a difference between rosacea patients and control subjects when challenged with ultraviolet light.
The best way to approach sunlight exposure is to treat is similar to other possible triggers. Next time you are in the sun, see what it does to your symptoms and not just the same day as you are in the sun, but the following few days. As a culture, we are not outside enough. The sun, itself, has rightly been called a vitamin for all the good it does for our bodies.
Let's say that you have tried the medical approach and you have even tried to uncover some of your triggers, but you are still having symptoms. Where do you turn to next for answers?
Rosacea, it turns out, may not be a disease of the skin at all, but an imbalance of the digestive system. There is a growing amount of scientific evidence to suggest this might be true. Studies conducted in the 1940s (that have largely been forgotten) showed that people with rosacea have both a low amount of stomach acid and many also have B vitamin deficiencies., While those may seem like two unrelated problems, they are actually very closely associated.
In order for your body to absorb some B vitamins, you have to have enough stomach acid, digestive enzymes, and a protein that is secreted along with stomach acid called intrinsic factor. What the B vitamin deficiency and low stomach acid show is that people who have rosacea are much more likely to have a poor digestive system. Supplementing with hydrochloric acid (stomach acid) and digestive enzymes has been shown to improve rosacea.
Interestingly, there is also some evidence that the bacteria associated with ulcers, (H. pylori) may also have something to do with rosacea. This is the first recognition by the scientific community that a rosacea may be the result of something other than a skin disease. While H. pylori is often treated as an infection with the use of antibiotics, from a health perspective an overgrowth of H. pylori is yet another sign of poor digestive powers and can be eliminated by improving digestion.
There is also a lot more you can do about your diet besides discovering triggers. Increase the amount of fruits and vegetables you eat, especially dark green vegetables, such as broccoli, spinach, kale and asparagus. Look for foods high in vitamin A, beta-carotene, bioflavonoids and vitamin C and add them into your diet.
Supplements can also be helpful, try:
Stress is closely associated with rosacea flair ups. Anything that you can do to reduce your stress level can be helpful. Hypnotherapy and biofeedback have both been shown to be helpful in reducing flare-ups.
Trying to decide if you should exercise or not when you have rosacea, might also leave you scratching your head. Exercise has alternatively been suggested to help reduce rosacea and pointed to as a common trigger. The problem is that most people flush when they exercise and so rosacea would appear to be worse right after exercising. The question is, though, how does exercise impact the disease when you are not exercising? As with everything else, it is best to see how it works for you. Exercise goes a long way to reducing stress and really should be a part of anyone's healthy routine.
While rosacea can be tricky to find a solution for; you should know that focusing on your overall health should provide you with a clearer path to wellness than constantly applying creams or taking antibiotics. Not only will your skin look better, but your whole body will appreciate the health boost.