Rosacea and Skin Redness Treatment with The Spa Doctor, Dr. Trevor Cates
As a naturopathic physician for the past 20 years, Dr. Trevor Cates knows the ins and outs of the body and how to heal it naturally. Her focus on skin health began a few years ago while working in a spa in Park City, UT. She found that so many of her weight loss patients kept coming to her at the end of their treatment, saying how amazing their skin looked. She wasn’t surprised! Your skin is an outer reflection of your inner health, but this is not how people typically think of their skin.
As a child, she also suffered from numerous allergies that would always show up on her skin in the form of eczema, itchy rashes, and hives. The discomfort and embarrassment was more than enough, but she also reacted to everything doctors attempted to treat her with.
After her parents took her to a holistic practitioner, she was able to turn her health around. Her skin cleared up, her confidence came back, and she remembers wondering why she had to go through so many traditionally trained doctors before holistic medicine was even thought of as an approach. Why wasn’t this option presented earlier? Through this experience, she found naturopathic medicine and she hasn’t looked back since.
What is Rosacea?
If you have rosacea, you may already know how devastating it can be. A chronic skin condition, rosacea is often characterized by facial redness, small pustules, and tiny, visible blood vessels that develop on the facial skin. The skin can begin to become leathery and bumpy in the later stages.There is no cure for rosacea. While some people definitely know they have it and see the signs and symptoms, others may have very minimal hints of the condition. Some people may even notice other associated conditions, such as dry eye disease, before being diagnosed with rosacea.
Since this condition is chronic, it is one that never truly goes away completely. There is no cure, but we do know a ton about how to treat rosacea successfully. While it may go away for a few weeks or months at a time, it often comes back to rear its ugly head again. So, what can you do to ensure that you prevent these flare ups?
The key is dealing with inflammation, which is so largely a part of rosacea, other chronic skin conditions, and many chronic health conditions as well. This inflammatory skin issue is from internal inflammation that’s presenting itself on the skin. Therefore, the holistic approach is to address this inflammation going on inside the body.
It’s incredibly important to address the microbiome, or the combination of all the bacteria and other microorganisms that live inside and on the human body. This microbiome exists in the gut, on the skin, and elsewhere. For example, there are small mites that naturally live on the skin, but these can overpopulate in individuals with increased inflammation. When you control the inflammation, your body is better able to control the population of these organisms.
Common Rosacea Triggers
Although we’re not entirely sure what causes rosacea for everyone, we do know that rosacea is both a genetic and environmental skin disease. If it’s in your genes to be more at risk, you’ll be much more likely to suffer from it and have a tougher time avoiding flares. Having light hair and eyes are, unfortunately, risk factors for rosacea! However, environmental triggers can be avoided. Once you’ve figured out which triggers are more worrisome for you, it’s often relatively easy to avoid them.
Below are a few of the common rosacea triggers:
Hot or spicy food and drink
Alcohol (especially red wine)
Extreme hot or cold temperatures
Some medications, such as topical steroids
Treatment for Rosacea
Treatment for rosacea has traditionally been centered around topical and oral antibiotics, as well as anti-acne medications to control the symptoms. The problem with this is that these medications may be helpful in the short term, but they’re not addressing the underlying inflammation. They’re also increasing your risk of side effects for many things, including gastrointestinal issues due to the disruption of gut flora by antibiotics. There are better ways of treatment out there, and we know this because we’ve seen many rosacea and ocular rosacea patients with dry eyes heal themselves through the remedies we’ll discuss below.
Since inflammation is at the core of most chronic diseases, including rosacea, we must tackle this at its core. You have to ask the question of what is causing the inflammation in the first place. Is it an underlying autoimmune issue? Is it a gut issue? Is it a food sensitivity? There are many potential causes and triggers for rosacea, so we’ll discuss a few of those below and how you can best circumvent those issues before they become larger, chronic problems.
Face and Eyelid Hygiene
We can’t stress enough how important proper face eyelid hygiene is. Eyelid hygiene allows your eyelids to function properly by eliminating the bad bacteria and some of the inflammation present. This aids in the prevention of flare ups. If done correctly, helpful bacteria will be salvaged to ensure a proper balance of overall ocular flora.
The tips below can also be used to help manage the condition, and we like to start with a natural face wash. After removing your makeup with an oil based eye makeup remover, we recommend using the Heyedrate Foaming Tea Tree Face Wash. Simply wet your face and put 1-2 pumps into your hands, working it into a lather. Work the lather into the skin of your face. If you wish to use it over your eyelids, you can do so with your eyelids tightly closed (it will burn if it enters your eyes). Rinse well and pat dry.
After this, ensure that your eyelids are cleaned twice daily: a cotton round/ball should be sprayed with a hypochlorous acid eyelid cleanser and then moved across the eyelid to eradicate oil and debris from the area. Even easier, you can simply spray the solution onto your closed eyelids, rub it in, and let it dry. We also recommend spraying the solution on areas of rosacea on the skin to help alleviate symptoms (you can do this nightly). Follow up with a natural moisturizer.
For many people with rosacea, a warm compress is not their friend. If you find that you can tolerate them, we recommend using them no more than once per day (unless you have an active stye). Blocked glands can be loosened by applying a warm compress eye mask that has been microwaved for 20 seconds. Allow it to sit on closed eyes for 10 to 20 minutes, reheating as needed. If you find that it makes your condition worse and you’re not finding symptom relief, do NOT use them! A cool compress may work better to calm your inflammation.
As a general rule, conventional makeup should be avoided the moment a flare-up occurs. If you must wear makeup, choose natural brands. Conventional brands are often filled with fragrances, chemicals, and other skin irritants that can make rosacea worse. Also, stick to glasses instead of contact lenses the moment you notice irritation. Once the flare-up subsides, feel free to wear your contact lenses (daily disposables are preferred).
Lastly, I know most of us love a bit of time in the sun, but if you have rosacea you need to make sure you’re protected. This means limiting sun exposure, wearing polarized (and UV protected) sunglasses, slathering on sunscreen, and wearing a hat. UV rays are a common rosacea trigger.
The Rosacea Diet
In our book, Rethinking Dry Eye Treatment, we discuss how diet changes can help you decrease inflammation in your body, therefore healing yourself. There are simple changes you can make which make a huge impact on your health, especially if eating healthy has never been something on your radar.
First of all, hydration is so important. You may roll your eyes at this, but dehydration is a huge contributor to disease and stagnation in our bodies. When the cells of your body get enough hydration, they’re able to better handle their day-to-day tasks and perform optimally for your benefit. Our general recommendation is to drink at least half your body weight in ounces of water per day, so if you weigh 150lbs you’ll want to drink at least 75 ounces per day. To make this easy and save the planet, purchase a reusable water bottle that you can fill throughout the day with filtered water.
In addition to hydration, consuming a proper ratio of omega 3:6:9 is essential. While this is difficult to track and manage for many, we recommend upping your intake of omega-3 since you’re likely eating way more omega-6 than you need (most Americans are). The best way to do this is through diet. Including fatty fish in your diet, such as wild caught salmon, mackerel, anchovies, and sardines, is a good start. If you’re not into fish, flaxseed, chia seeds, and avocados can help you balance out your ratio. If you’d like to supplement, we recommend the Heyedrate Omega-3 for an extra boost.
Common triggers of rosacea include spicy, hot foods, so I just had to discuss that here. Truthfully, they’re best avoided if you have rosacea. For numerous people, consuming spicy, hot food is capable of triggering ocular rosacea, and this includes most things that have capsaicin in them (i.e. chili peppers). If you love spicy food, try to find other ways to add that flavor into your meals without using so much chili pepper - think ginger, turmeric, and other “spicy” flavors.
Alcohol consumption should be limited if you have rosacea, as it can be a potential rosacea trigger. We’ve seen that most people react more readily to red wine and dark liquors, likely due to the histamine content in them. White wine and beer are likely safer bets. If you’d still like to drink alcohol occasionally, it’s best to limit consumption to a few drinks per week and choose lighter alcohol.
Lastly, if you’d like to find out what foods your body is sensitive to, consider taking a food inflammation test. These can be purchased online, taken at home, and within a few weeks you’ll have your results. Then, you can learn to avoid the things your body isn’t tolerating, which may be contributing to your rosacea. Common food sensitivities include dairy, gluten, and eggs, among others.
A Place for IPL
Maybe that heading should say, “What Can’t IPL Do?” Either way, IPL (intense pulsed light) treatment can be a fantastic option for those who suffer from rosacea, ocular rosacea, and the dry eye disease that often comes with it. Recently, we interviewed Dr. Laura Periman, aka the Dry Eye Master. She's also an IPL expert and creator of the Periman IPL Protocol. We cover a plethora of information in this interview, but more specifically talk about what you need to be doing to heal your rosacea, meibomian gland dysfunction, dry eyes, blepharitis, and any other inflammatory disease that affects your eyes or skin.
IPL is a nonsurgical method normally used for cosmetic procedures such as for hair reduction and photo-rejuvenation. It makes the use of a handheld, computer-controlled flash gun that utilizes an intense beam of light for removal of undesired features, such as hair, fine lines, and skin discoloration. And it can be incredibly helpful for those with rosacea, treating those tiny blood vessels and the excess redness and inflammation that rosacea patients suffer from.
The 5 Skin Types
When Dr. Cates was writing her book, she came in contact with many different patients with all different skin types. The following skin personalities are based on patients she’s seen in her practice, and you can find your skin type here.
Amber - This skin type is characterized by hyperpigmentation, freckles, and uneven skin tone
Olivia - Those with this skin type will notice more acne, oiliness, and enlarged pores
Sage - This skin type will notice chronically dry skin, excessive wrinkles, and sagging, thin skin
Emmett - Allergic skin reactions, eczema, and dry, flaky skin are common with this skin type
Heath - Rosacea is common with this skin type, and you may also notice increased sensitivity to skin care products
What to Know About Skin Care Products
We touched on this already, but if you’re considering trying a new skin care product, you’ll want to look into the ingredients. First of all, you want your skin products to be clean and free of unnecessary ingredients. There are so many toxins that find themselves in cosmetics, yet this doesn’t mean that they’re safe. The United States only bans 11 chemicals in cosmetics, whereas Europe bans over 1000! Beware of marketing claims that claim a product is “natural” or “hypoallergenic”, because these are often just phrases that may have no real backing. Do your best to avoid the following:
Mineral oil and petroleum based products
DEA (diethanolamine), MEA (monoethanolamide) and TEA (triethanolamine)
Also know that you may also still react to natural products, so make sure to look for skin care that’s made for sensitive skin. If products are heavily loaded with essential oils, for example, this can be irritating for some people.
The pH of a product is also important because the skin needs to maintain a mild acidity. We want a pH range of 4.6-5.0 for products used on the face, so you’ll want to be mindful of what you’re choosing if your skin is more sensitive.
Dr. Cates encourages you to just start somewhere. Take little steps in the right direction to enhance your health, and it’s amazing how the other things will fall into place.
About Dr. Cates
Dr. Trevor Cates is author of the USA Today and Amazon bestselling book Clean Skin From Within and founder of The Spa Dr. natural skin care line. She received her medical degree from the National University of Natural Medicine and was the first woman licensed as a naturopathic doctor in the state of California. She currently lives in Park City, Utah where she helps patients from around the world achieve naturally glowing skin. She has been featured on various TV shows, including The Doctors and Extra TV. Dr. Cates has interviewed over 250 experts on The Spa Dr. podcast and hosted her own PBS special, Younger Skin From Within. She believes the key to healthy skin is inner and outer nourishment with natural and non-toxic ingredients.