Rosacea 101, Care and Protocol
(aka, the b theory love letter to all of the beauties in the world who struggle with redness)
Rosacea (roe-ZAY-she-uh) is a common skin condition that causes blushing or flushing and visible blood vessels in your face. It may also produce small, pus-filled bumps. These signs and symptoms may flare up for weeks to months and then go away for a while. Rosacea can be mistaken for acne, other skin problems or natural ruddiness.
Rosacea can affect anyone. But it's most common in middle-aged white women. There's no cure for rosacea, but treatment can control and reduce the signs and symptoms. (excerpted from the Mayo Clinic website)
At b theory aesthetics, we understand that living with skin conditions such as rosacea can be challenging, frustrating, stressful and at times uncomfortable, even painful. We are here to support you on your journey to healing your skin by helping you understand the potential root causes of rosacea and what kind of treatments and ingredients/products are beneficial for soothing and healing your skin. Proper home care and lifestyle changes are essential for reducing symptoms and managing rosacea. Whenever possible we offer recommendations and resources that can help bring relief and improvement to your skin and overall health.
While the list of potential rosacea triggers in various individuals may be endless, a survey of 1,066 rosacea patients found that the most common factors included the following:
Factors Percent Affected
Sun exposure 81%
Emotional stress 79%
Hot weather 75%
Wind 57%
Heavy exercise 56%
Alcohol consumption 52%
Hot baths 51%
Cold weather 46%
Spicy foods 45%
Humidity 44%
Indoor heat 41%
Certain skin-care products 41%
Heated beverages 36%
Certain cosmetics 27%
Medications 15%
Medical conditions 15%
Certain fruits 13%
Marinated meats 10%
Certain vegetables 9%
Dairy products 8%
Other factors 24%
(sourced from the National Rosacea Society website, rosacea.org)
Wearing a mask is highly irritating to skin with rosacea. The heat and increased moisture are causing people to have flare ups. Try taking breaks from wearing your mask as often as possible and place a cool moist cloth on your face to reduce heat and inflammation.
Treatment Recommendations
We want to see clients every four weeks for a hydrating facial to help ease dryness, redness as well as stress levels. This treatment includes a barrier repair mask and a red light LED treatment with a custom serum application for the whole face to reduce inflammation and redness. A light lactic acid facial peel is helpful for cellular renewal - these can be done every 4-6 weeks based upon the skin’s needs.
Manual Lymphatic Drainage (MLD) (offered during our Skin Rejuvenation Facial) is very beneficial for inflamed and congested skin conditions. Frequent treatments (2-3 times per week) can make significant reduction in redness and inflammation, along with dietary changes and stress reduction. Speaking of stress reductions, MLD is deeply relaxing and restorative for the entire body.
Working with a Gua Sha tool at home can help to improve the circulation and reduce the congestion of the skin, as well as ensure deep hydration with the use of a skin-soothing oil blend. We proudly carry Gua Sha stone tools and rollers from Cecily Braden, and a curated offering of healing and hydrating oil blends. In addition, we offer a free Gua Sha instructional home care routine tutorials with the purchase of any tool or roller.
Dry skin brushing is another home care option that helps to stimulate the lymphatic system in order to decongest the skin and reduce redness. Dry skin brushing can be done daily for three - five minutes for the best results. Dry skin brushing must be done after showering, as the heat from the shower pulls the lymphatic fluid back into the loose connective tissue, undoing all of the good work you just did with the brushing!
Lifestyle/Other Recommendations
Incorporate regular stress-reducing activities into your daily life. Start with 10 minutes of meditation and breathwork each morning, as well as a daily walk. Wear SPF 30 or higher sun sunscreen (we highly recommend and carry Suntegrity products) anytime you're out during the day, even when driving, and reapply as recommended. Be sure to wear a hat whenever you’re outside. Find time to get more vigorous exercise 3-4 times a week, being certain to cool your face immediately afterwards with a cool damp cloth.
We recommend doing an elimination diet for 4 weeks. Working with a skilled nutritionist can be very beneficial in helping to determine underlying conditions that may be at the root cause of rosacea, along with helping you determine which foods are beneficial for your body, and which foods are potential triggers. We highly recommend Carla Abate of Rebel Roots Nutrition. If you are drinking coffee daily, switch to drinking 2 cups of low caffeine green tea instead. This transition needs to be made gradually to help prevent caffeine withdrawal symptoms. Water intake needs to be at least 2 quarts per day, ideally 3 quarts. Avoid all alcohol for the next 30 days to see if there are any improvements with inflammation. Eliminate spicy foods from your diet, along with dairy, chocolate, citrus, onions, nightshades (potatoes, sweet potatoes, eggplant, peppers, tomatoes), eggs, cloves, cinnamon, soy and gluten for the next 30 days to see if you have reduced inflammation in your skin. Incorporate more antioxidant foods into your diet - these are the colorful foods: dark leafy greens, berries, squash, pumpkin, mango, carrots, etc. Increase your healthy fat intake - eat an avocado daily and switch to organic extra-virgin olive oil as your main oil intake. Eliminate processed foods, including chips and foods containing sugar and high fructose corn syrup. Increase fiber intake with fresh food as well as using ground flaxseed meal - this is a great addition to your morning steel cut oats (if your body tolerates oats, or try putting them in quinoa) or a smoothie.
After 4 weeks of the elimination diet, begin to reintroduce foods one at a time. If your skin is going to react to a particular food you should be able to tell within about 30 minutes for highly reactive foods (your skin will flush) and in about three days for less reactive foods.
Based on a skin mapping analysis, we see that rosacea is often a result of poor digestion, starting in the stomach. Take a digestive enzyme support product containing protease, bromelain, and papain to help improve digestion, and stop drinking water with meals, waiting at least 30 minutes to do so in order to keep your stomach acid as high as needed for proper digestion. You may also need to test to see if your body is producing enough hydrochloric acid (HCA) for proper digestion. Instructions to test to see if you need to boost your HCA levels can be found here: HCA level testing
Consider working with medicinal plants that soothe, heal and nourish the digestive system. One of our favorite herbs for reducing inflammation and heat in the body is Plantago spp., more commonly known as plantain. The medicinal plant is different from the banana-like vegetable you find at the grocery stores. This nourishing herb is cooling to the body, abundant in minerals, and may help to heal leaky gut syndrome. If you choose to work with this plant, you may drink 3 cups of plantain tea a day (we recommend infusing 1 tbsp of dried organic plantain leaf per cup of water in a tea press - let the infusion brew for up to 12 hours for maximum potency) or you can purchase a high quality organic tincture to be taken 2-4 times per day. Another plant that we love for working with rosacea is Matricaria recutita, more commonly known as chamomile. This potent anti-inflammatory may be used both topically and internally to soothe the skin as well as the nervous system. Chamomile has tremendous wound healing properties which may support healthy digestion and ease symptoms of leaky gut syndrome. Infuse it the same way as recommended above for plantain, or use a high quality organic tincture. Look for the ingredient Bisabolol in skin care products - this is a potent active ingredient in chamomile which provides soothing relief to inflamed skin when applied topically. To learn more about how to work with plants to support your skin, we highly recommend working with a skilled herbalism practitioner.
Nourish your gut with pre- and probiotics from food sources, and consider drinking a high quality organic bone broth to support your gut health (you may add this to soups or a smoothie). Consider supplementing your body with a daily multivitamin, trace mineral supplement, and an omega-3’s from either fish oil, flaxseed oil or evening primrose oil, or a combination of these three. Try a CBD supplement to help with reducing inflammation and stress - we recommend Color Up’s Pure Daily CBD Oil.
Not only is our skin the external expression of our internal digestive and gut health, but it is also the external expression of our nervous system. Our emotional body and wellbeing play a big role in our skin’s health. Conditions such as rosacea often present with heat that can be felt topically and internally. What is living behind that heat? Is it an unexpressed emotion such as anger or frustration? Are there things in your life that you can no longer stomach (hence the digestive challenges)? Taking time to do a deep reflection on your emotional health and stress levels can be very informative and help you identify areas of your life, lifestyle and health that may need to be addressed and changed.
Product Recommendations and Protocols
For clients with rosacea we have three favorite skincare lines that we recommend:
Qēt Botanicals- We have curated an offering of Qēt products that will help to nourish, soothe and heal inflamed skin, especially rosacea. Be sure to read about Lisa Brill’s (the founder of the company) journey with her own skin struggles and how these products have changed her skin and her life. Love supporting women owned businesses!
Green Envee - We searched extensively to find this luxurious clean organic skincare line. The soothing, calming and nourishing ingredients found in many of the Green Envee products are perfect for reducing redness, dryness, dullness and inflammation. We will help you find the right combination of products whether your routine needs to be as simple as 3 beneficial products or we can set those product lovers up with a comprehensive skincare routine.
Color Up - This gorgeous, local organic CBD skincare line has a lot to offer to reduce redness and inflammation in the skin and help reduce stress and anxiety in the body. Remedy Treatment oil is one of our favorite soothing skincare oil blends, and the Enzyme Exfoliator is a perfect, gentle option for speeding up the removal of dry dead skin cells on the outer layer of the skin.
Product Protocol
Morning:
Cleanse with facial cleanser or cleansing oil for two minutes. Remove with a soft, warm, damp cloth
Apply facial toner
Apply serum(s)
Apply moisturizer or hydrating serum
Apply sunscreen with an SPF of at least 30
Evening:
Cleanse with facial cleanser or facial cleansing oil for two minutes. Remove with a soft, warm, damp cloth
Apply facial toner
Apply night time serum (s)
Apply moisturizer or hydrating serum
Weekly:
Apply a hydrating, nourishing mask 1-2 times per week in the evening before bed, followed by the serum. The Restore Hydration Mask from Green Envee or Glow Mask from Color Up are great options. You can even apply the Glow Mask and leave it on overnight.
Exfoliate with Color Up’s Enzyme Exfoliator 2 times per week.
If budget allows, use a small handheld LED light for treatment at home - 5 times a week for up to 20 minutes for your whole face. The Lightstim for Acne is a great choice.
What treatments should you avoid?
Avoid manual exfoliation of any kind (scrubs, microdermabrasion, dermaplaning, etc.), except for gentle enzyme treatments during facials. Avoid level 2 and higher chemical peels, enzyme treatments beyond the most gentle of products, and any kind of drying mask such as clay or charcoal.
What Ingredients should you avoid?
Avoid active ingredients such as tea tree oil, alpha hydroxy acids, retinols, or anything that is overly drying and will potentially inflame the skin. Avoid products with artificial or “natural” fragrance - only therapeutic grade essential oils used as fragrance are safe, and even those can cause sensitivity for some individuals.
Here’s some research we recently came across regarding rosacea and gut health:
More recently, rosacea and other skin diseases such as psoriasis and atopic dermatitis have been linked to intestinal dysbiosis. Authors reported the role of intestinal dysbiosis in promoting inflammation and impairment of normal lymphocyte function, potentially perpetuating chronic, low-grade inflammation. Therefore, the potential role of microorganisms in the pathogenesis of rosacea has been hypothesized. Parodi and colleagues reported a higher incidence of small intestinal bacterial overgrowth (SIBO) when patients with rosacea were compared to controls. Most interestingly, microbial unbalancing of the skin microbiota on the skin has been linked to rosacea clinical manifestations, even though the direct correlation between microbiota composition on the skin and the incidence of the pathology is still under investigation.