We often receive questions from customers about rosacea (pronounced ro-zay-sha). In this blog, we'll tell you what it is and what you can do about it.
What is rosacea?
Rosacea is a chronic inflammatory skin condition, usually affecting the face, cheeks, nose, chin, and forehead.
What happens with rosacea, besides skin inflammation, is a disrupted skin microbiome. This is due to several factors. Firstly, there is a weakened immune system, and secondly, the Demodex mite plays a role. This mite lives on the skin, but in rosacea, the mite is overrepresented, leading to an imbalance in the number of microorganisms, which stresses the skin.
How do you recognize rosacea?
Rosacea is characterized by the following symptoms:
• persistent redness or flushing
• visible small blood vessels
• burning or warm sensation
• bumps/pimples without blackheads or pus
• dry, sensitive skin
• sometimes red/irritated eyes
There are different forms of rosacea, and the subtypes are as follows:
- Subtype 1 – redness/vascular: flushing, persistent redness, and sometimes visible blood vessels.
- Subtype 2 – bumps/pimples: inflamed papules and/or pustules, often on top of redness.
- Subtype 3 – rhinophyma: thickening and alteration of skin texture, especially on the nose. This is relatively rare and more common in men.
- Subtype 4 – eye complaints: burning, dry, irritated, or red eyes. This can even occur without clear skin complaints.
- Subtype 5 – neurogenic rosacea: a newly described pattern where burning, pain, and strong sensitivity are primarily in the foreground. This is not used in the same way as the classic four subtypes.
Does rosacea automatically get worse?
No. Rosacea is usually a chronic condition with flare-ups and quiescent periods. Some people maintain roughly the same symptom pattern for years, while for others, additional features may appear over time.
The relationship to couperose and acne
Many people confuse rosacea with acne or couperose. While they can look similar, they are different conditions. In acne, blocked hair follicles and sebaceous glands play a role, among other things. Characteristic of acne are blackheads (comedones), which are usually absent in rosacea.
Couperose refers to visible, dilated small blood vessels (telangiectasias) in the skin. These vessels often occur with rosacea, but couperose itself does not automatically mean that someone has rosacea. Rosacea is a chronic skin condition that can involve redness, vasodilation, and inflammatory symptoms, among others. With rosacea, various characteristics can be present simultaneously, including redness, visible vessels, and inflamed bumps or pimples, but usually no blackheads. However, there can be a combination of symptoms; for example, someone may suffer from both acne and rosacea.
Role of the demodex mite
Demodex Folliculorum is a microscopic mite that naturally lives on almost everyone's skin, but causes no problems for most people.
However, there are significantly more demodex mites on the skin in rosacea than in healthy skin. The skin can overreact to this mite with an inflammatory response. Everyone has Demodex, but rosacea usually only develops when several factors come together:
🧬 sensitive immune reaction
🧠 genetic predisposition
🧴 weakened skin barrier
🕷️ possibly higher Demodex density
🔥 overreaction of blood vessels and nerves
Demodex is therefore more of a “trigger in a sensitive system” than the cause in itself, and it is good to investigate which of these factors play a role in rosacea and what can be done about it. The condition of the gut determines your immune system; perhaps there is an oversensitivity or allergy that can be avoided? Strengthening the skin barrier with the right products and possibly applying medication against the Demodex mite are also measures that can help.
What are triggers for rosacea?
Rosacea can develop, flare up, or worsen due to certain triggers. According to dermatology, the strongest consistent triggers are sunlight/UV, heat and especially temperature changes, alcohol, spicy food and hot drinks, cold/wind/dry air, stress, and, last but not least, incorrect skincare.
Which skincare products are best for rosacea?
It's important to know that with rosacea, less is more. Sometimes it's better not to use heavy creams or oils, as the skin can then become warm and redder. Furthermore, the ingredients niacinamide and azelaic acid can help, and for severe rosacea, a cream with ivermectin (on prescription) is appropriate medication to combat Demodex mite overgrowth.
Witlof Skincare offers a number of products suitable for rosacea-prone skin. The Balancing Toner hydrates dry skin, and flower waters help reduce redness. The Hydrating Calming Lotion contains niacinamide and cooling aloe vera. Furthermore, an SPF30 is important for sun protection, and a cream like the Nourishing Facial Cream is suitable because it is light in fats and contains hyaluronic acid for optimal hydration. In some cases of extremely dry skin, the Rich Facial Cream can also provide relief; it contains niacinamide, and ceramides and healthy fats help repair dry skin.
Rosacea and diet
Experience shows that diet can also play a role in the development of rosacea, as the immune system largely originates in the gut. At Witlof Skincare, we have seen quite a few individuals whose dairy intolerance affected their rosacea skin, even when the person was unaware of an intolerance. In our opinion, it is therefore definitely worth trying to eliminate dairy products for 6 to 8 weeks if you have rosacea. Additionally, gluten, coffee, or alcohol can also have a negative effect.
Critical voices from dermatologists
Dermatologists agree that rosacea is chronic, but they disagree on what exactly causes rosacea. Whether it's an immune inflammation, vascular reactivity, the extent of the Demodex mite's influence, or a skin barrier dysfunction, research into rosacea and its various causes and influences is still ongoing. The opinion on the role of diet, or specifically dairy products as part of or cause of rosacea, is also nuanced. Too little research has been done that shows a direct link.
Witlof’s vision
In any case, we believe eliminating certain foods is definitely worth trying because we have seen the effects, and a skin detox can also provide the necessary reset if you are using unsuitable skincare products to restore the skin barrier.
If you have questions about your skin and rosacea, please do not hesitate to schedule a personal skin consultation via this link.
