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A beginner's guide to rosacea
Many of you have probably heard about rosacea. Rosacea is a common, chronic, inflammatory skin disease that affects over 5% of the world's population. It is usually associated with redness and sensitivity, but rosacea is more complex than that. Did you know that there are four types? We have listed them below.

1. Erythematotelangiectatic rosacea (rosacea med rodnad)

Detta är den vanligaste varianten av rosacea. Symtomen är perioder av rodnad i delar, vanligtvis mitten, av ansiktet. Med tiden kan denna kroniska rodnad orsaka att blodkärlen under hudytan förstoras, vilket leder till permanent rodnad (erytem).    

2. Papulopustulös rosacea (rosacea med finnar) 

Denna typ innebär en permanent rodnad av huden med sporadiska finnar.

3. Phymatous rosacea (rosacea med förstorad näsa)

Denna typ kännetecknas av förstorade porer och rodnad som leder till en svullen, förstorad näsa.

4. Okulär rosacea (ögon-rosacea)

Okulär rosacea resulterar i inflammation i de yttre delarna av ögat, med symtom som en torr känsla, rodnad runt ögonfransarna, ökad tårproduktion och vaglar.  

If you think you have rosacea, you should always see a dermatologist or doctor to get a correct diagnosis.

Who influences it?

Rosacea affects both men and women and is most common after the age of 30. From a global perspective, it can be seen that rosacea is much more common in the northern parts of Europe from .

Rosacea not only affects people physically but also mentally. Recent research shows that its psychosocial impact can be very serious, leading to social anxiety and depression. Interestingly, men tend to experience worse psychological effects than women.

Why do you get rosacea?  

The exact cause of rosacea is still unknown. Genetics seems to play a role, e.g. if your mother has rosacea, you are more likely to get it too. Rosacea has also been linked to immune system disorders and increased nerve sensitivity.

There are indications that rosacea patients have higher levels of Demodex mites (a type of parasite) living in the skin. We all have a number of mites in our skin and, as many people know, mites thrive in both bedding and skin. Demodex mites can also live in our hair follicles and sebaceous glands. According to one theory, their droppings trigger an inflammatory response in our skin.

There is also a medical link between rosacea and autoimmune diseases such as diabetes, coeliac disease (gluten intolerance) and rheumatism.

Skin care habits can also be a cause of rosacea. A large study showed that cleaning habits can influence the onset and development of rosacea. Over-cleaning appeared to be a major risk factor and we have written a summary article on this very interesting study here.   

Psychological stress also seems to be a high contributor to rosacea. In fact, dermatologists in Sweden reported an increased number of rosacea cases in the spring of 2020, i.e. during the covid19 pandemic. It is believed that the reason behind this increased incidence of rosacea is due to higher levels of psychological stress.

How to treat rosacea?

There is no cure for rosacea, but there are several treatments available. Today, the condition is often treated with antibiotics and topical drugs that have anti-inflammatory properties. Many of those affected by more severe rosacea need to be prescribed treatment by a doctor. The main treatments are: 

Treatments that reduce redness, such as brimonidine and oxymetazoline. These treatments reduce the blood supply to the skin, so the skin does not redden as much. Brimonidine is also used in eye drops to treat ocular rosacea.  

Azelainsyra är en effektiv behandling mot rosacea, särskilt genom att den minskar överproduktionen av peptiden cathelicidin, som i överskott orsakar inflammation, rodnad och irritation i huden. Genom att hämma denna inflammatoriska process lindrar azelainsyra rosaceasymtom, vilket gör den till en viktig ingrediens i receptbelagda krämer som Finacea som innehåller 15% azelainsyra.

Antibiotics such as metronidazole and tetracyclines. It is not known exactly why antibiotics affect rosacea, but one possible explanation is that antibiotics kill bacterial growth in the skin potentially caused by mite feces.

Ivermectin, an insecticide that kills Demodex mites, is one of the newer treatments for rosacea.

Rosacea

Faktorer som kan påverka rosacea negativt

Vad som framkallar ett rosacea-utbrott är individuellt men för dig som har rosacea kan det vara bra att veta vad som kan göra besvären värre.  

Sun & heat

But also cold and windy weather

Alcohol, hot drinks and strongly spiced food
Stress and nervousness
Hormonal changes

Such as pregnancy, PMS, menstruation and menopause.

Creams and ointments

Which contain substances that can irritate the skin such as perfumes, dyes or preservatives, as well as some sunscreens and cosmetics.

Tips och råd

People with rosacea should avoid excessive sunbathing as it often aggravates the disease. You should also be careful when washing your face and choose a gentle cleansing product for sensitive skin. Choose a non-greasy moisturizer that is soothing, restorative and supports the skin's microbiome. All the moisturizers we have developed are suitable for rosacea-prone skin, but it is important that you seek medical advice if you have more serious problems.

References

Gillbro, J. (2019) The Skin Bible. Stockholm, Bookmark förlag. 

Steinhoff, M., Schauber, J. & Leyden, J.J. (2013) New insights into rosacea Dermatology. [Online] 69 (6), S15-S26. Available from: doi:10.1016/j.jaad.2013.04.045. 

Li, G., Wang, B., Zhao, Z., Shi, W., et al. (2020) Excessive cleansing: an underestimating risk factor of rosacea in Chinese population. Archives of Dermatological Research. [Online] Available from: doi:10.1007/s00403-020-02095-w. 

Van Zuuren, E.J., Fedorowicz, Z., Carter, B., Van Der Linden, M.M., et al. (2015) Interventions for rosacea. Cochrane Database of Systematic Reviews. [Online] Available from: doi:10.1002/14651858.cd003262.pub5. 

Gillbro, J.M., Lundahl, M., Westman, M., Baral, R., et al. (2015) Structural activity relationship analysis (SAR) andin vitrotesting reveal the anti-ageing potential activity of acetyl aspartic acid. International Journal of Cosmetic Science. [Online] 3715-20. Available from: doi:10.1111/ics.12253. 

SKIN ACADEMY