A HOLISTIC APPROACH TO HEALING ROSACEA
A holistic approach is essential for treating rosacea. Janine Tait, founder of Bestow Beauty looks at the topical, nutritional and lifestyle factors to consider when treating this red-faced condition.
Next time you walk down the street, notice how many women you spot who have visible patches of redness on their forehead, noses, cheeks or chin. This tell-tale sign of rosacea is especially prevalent during winter when cold winds and air-conditioning inflame sensitive skins.
Rosacea is a latin word which literally means ‘roses’. Poetic as this sounds, the reality is often prosaic, embarrassing and painful. Traditional approaches to treating rosacea often fail to address the condition holistically, and as a result, are not very effective long term.
Many women have resigned themselves to just living with their permanent red flush. This saddens me, as I have experienced first hand the skin transformation that can occur when a beauty therapist takes a ‘slow beauty’ approach to healing rosacea. But before we outline solutions, let’s get a good understanding of what it is we are actually dealing with.
What Is Rosacea?
Rosacea is a skin inflammation disorder. The word inflame offers us a telling clue - with this condition the skin ‘flames’ from within. Inflammation is the body’s response to a perceived threat and a sensitive rosacea skin will be over-the-top in its reactions.
In technical terms, rosacea is caused by an increased reactivity of the capillaries to heat. This leads to episodic flushing and ultimately to more permanent symptoms like telangiectasia. There is no known cause, however rosacea most commonly affects women from 30 to 50 years of age, especially those with fair skin, blue eyes and Celtic ancestry. Rosacea sufferers will typically have a history of sensitive, red skin.
The Three Stages of Rosacea Development
Early warning signs are episodic erythema, flushing and blushing.
Stage One Persistent erythema with telangiectasia. When erythema, or skin redness, becomes permanent rather than episodic, the skin develops telangiectasia, characterised by visible threadlike red lines or patterns on the surface of the skin
Stage Two Persistent erythema, telangiectasia, papules and tiny pustules. As the disorder progresses, red papules appear which are round and dome-shaped rather than pointed. These lesions can last days, weeks or even months, however there are no comedones present. Tiny pustules also occur at stage two.
Stage Three Persistent deep erythema, dense telangiectasia, papules, pustules and nodules.
In stage three the symptoms are acute, painful and conspicuous and the papules become more pronounced. The skin can be very sensitive and topical skincare, make-up or sunscreen can sting the skin.
Medical Approaches to Treating Rosacea
Mainstream medical approaches focus on reducing the topical symptoms of rosacea. Oral antibiotics can help to reduce inflammation and lessen the papules. This can be effective in many clients but it compromises gut health.
Topical antibiotics such as metronidazole can be used intermittently or long term on its own for mild cases and in combination with oral antibiotics for more severe cases. Topical steroids should never be applied to rosacea.
From a slow beauty perspective, these medical approaches can help therapists to get a head start with healing rosacea, but they are not a healthy long-term solution. I have often seen IPL and laser treatments recommended for rosacea suffers, however in my opinion the skin is too weakened and inflamed to cope with this type of treatment.
It is ultimately more effective to identify what is ‘feeding the flame’ and to help a client to make the skincare, environmental, dietary and lifestyle changes that will get to the root of the problem.
A Holistic Approach to Topical Care of Rosacea
A rosacea skin often has a very compromised skin barrier function meaning it has minimal defence against environmental inflammation threats. I avoid any product or treatment that compromises the skin barrier further. Watch out for foaming cleansers which strip the skin’s sebum and alkaline washes which unbalance the skin’s natural protection.
Although you might be tempted to give your client heavy protective creams, I find a lighter approach works better. Use skincare products that are nourishing and supportive to inflamed skin. I recommend you focus on anti-inflammatory herbs, which help to reduce redness and high-quality plant oils which help protect the skin. Once the inflammation has settled you can prescribe heavier creams.
Working From Within To Heal Rosacea Skin
Avoid Foods That Heat the Skin
There are certain foods that can heat and inflame the skin from within. Common culprits are caffeine, alcohol, and spicy food, but even strawberries and oranges can have an inflaming effect. These heating foods are called vasodilators - vaso referring to the blood, and dilating meaning to expand. They sensitise skin by increasing blood flow through the fine capillary system that feeds the skin cells. Obviously, this will exacerbate skin which has rosacea sensitivity and cause it to immediately ‘flare up’.
Heating Foods to Avoid
Oranges, orange juice, strawberries, chocolate, chilli, hot spices, curries, wasabi, alcohol, coffee, caffeine.
Skin Cooling Alternatives
Fresh herbs and less ‘spicy spices’ such as ginger, cloves, nutmeg, cumin and coriander, herbal teas, tahini, medjool dates and figs.
How to Help Your Client Ditch Coffee and Alcohol
I have worked with many clients with rosacea and in many cases found that until a client was willing to give up coffee and alcohol it was impossible to get a good result. The best strategy is to help your client to reframe their rituals around these drinks. Coffee is often about time-out or getting an energy boost. Help them to replace coffee with green tea, for a natural low-caffeine buzz, and make sure they still have a time out ritual around it. Similarly, alcohol might be about socialising or unwinding. Help them to discover healthier ways to relax and have fun, with a nice glass of soda and lime in tow to give them something to hold in their hand.
Introduce EFA’s to Rebuild the Skin Barrier
A good quality Essential Fatty Acid (EFA) supplement is an essential nutritional building block for helping the skin to produce a healing and protective skin barrier. I use a special skin-friendly blend of cold pressed, organic safflower and flax seed oil.
EFA’s not only boost the protection of the acid mantle but also support the bi-layers in the stratum corneum, which are crucial for protecting the skin from environmental conditions that provoke rosacea.
Environmental and Lifestyle Factors in Rosacea
Clients who are serious about healing their rosacea will need to avoid direct contact with heat. A rosacea skin will be sensitive to anything that causes a change in the skin’s temperature. Your client should avoid sun exposure, sitting too close to the fire, or having the car heater blast warm air directly onto their face. While showering, they should also avoid putting their faces under the steady stream of hot water.
Some clients I have worked with developed rosacea from being in jobs which exposed their faces to heat. A significant number were chefs or kitchen workers. Giving them strategies to reduce the impact of the heat on their skin was an important part of their treatment. Even simple things like letting the heat escape from the oven before taking out the food, reduces the stress on the skin. In some cases rosacea can develop when fine, sensitive skins are exposed to an atmosphere heavy in fats and oils e.g. working over a deep fryer in a takeaway outlet.
Stress is also an important factor to consider when treating rosacea. Emotional or physical stress is often expressed in skin inflammation. A ‘heated’ argument is not just a turn of phrase; notice the angry redness of the skin as voices rise and stress escalates. Find out about your clients stress levels, how well they are sleeping and whether they do any competitive or high impact exercise. The more you are aware of the underlying contributing causes, the better you can help clients to make positive changes to reduce stress in their lives.
Avoiding Frustration and Setting Expectations
In working with rosacea clients, you have to expect to play the long game with them. In the early stages of treatment the condition can flare for no apparent reason but once you and your client expect this it takes the angst out of it. You will find over time the condition flares less and less often and heals up faster each time. Eventually it will only flare on the rare occasion and by then the client will be switched on enough to identify the cause and know how to treat it. This is one of the things I love about slow beauty. It’s truly empowering for the client.
JANINE TAIT is New Zealand’s leading dermo-nutritionist and the founder of Bestow Beauty, which offers a beautiful range of organic super-food blends, recipes and rituals to nourish skin from within. She is also a respected leader within the Slow Beauty movement which champions a holistic approach to skincare.
For more information or to enquire about stocking Bestow Beauty in your salon or clinic, call 1800 625 387 or visit www.probeautysolutions.com.au