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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. 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.
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 effectively deal with this condition 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.
I can’t stress enough how important proper face and eyelid hygiene is. Eyelid hygiene allows your eyelids to function properly by dealing with 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 I like to start with a natural face wash. After removing your makeup with an eyelid wipe (I love the MediViz Tea Tree Eyelid Wipes), I 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, such as Heyedrate Lid and Lash Cleanser, and then moved across the eyelid to eradicate oil and debris from the area. We also recommend spraying the solution on areas of rosacea on the skin (I do this nightly). Follow up with a natural moisturizer such as the Heyedrate Eye Cream and Face 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 like this one 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.
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. I refill my 26 ounce bottle 3-4 times per day.
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 mostly 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.
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 that rosacea patients suffer from.
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:
While the cause of rosacea is unknown, we do know that gut bacteria may also play a role in rosacea. Those with an overabundance of H. Pylori in the gut may notice more rosacea symptoms. This comes back to the importance of eating a healthy diet abundant in antioxidants, and avoiding the foods your body is sensitive to.
In addition to this, an overabundance of bacteria on the skin and eyelids may lead to demodex infestation (demodex folliculorum and demodex brevis). These little mites are common and live on most people, but overpopulation can lead to other issues such as ocular rosacea and dry eye disease. To fight demodex, eyelid hygiene (as discussed above) is so important. Follow the recommended regimen of using a tea tree foaming face wash along with a hypochlorous acid cleanser to find the results you’re looking for.
Overall, patients with rosacea must find out what their own triggers are. While the above mentioned are common, they’re not triggers for everyone. Find what doesn’t work for you, and avoid those things. Make sure you’re eating a healthy diet, avoiding common food allergies such as dairy, gluten, and even eggs (if you’re sensitive to these). Small lifestyle changes can make a huge difference in the appearance of your skin and the way you feel about yourself!