Rosacea. Erythema and telangiectasia are seen over the cheeks, nasolabial area, and nose. Inflammatory papules and pustules can be observed over the nose. The absence of comedones is a helpful tool to distinguish rosacea from acne. (Photo credit: Wikipedia)

5% of the population are affected, including many Celts, and Women over 30. There are 4 often-overlapping Types:

1. Erythematotelangiectatic: facial redness

2. Papulopustular: bumps & pimples

3. Phymatous: enlarged nose

4. Ocular: eye irritation

Triggers:

• Sun (energizes toxins), wind, and heat
• Strenuous exercise
• Stress (hypnotherapy for stress management, Dermatologic Therapy, 2003): initiate 10-second deep breathing cycles
• Smoking
• Alcohol (a common trigger)
• Hot spicy food (a common trigger)
• Mercury (avoid hot food & drink)
• Dysbiosis: Pityrosporum ovale yeast, Candida, fungi, bacteria, Demodex folliculorum mites
• Pesticides (GMOs) and other toxins
• Steroids (can worsen telangiectasis)
• Caffeine, vasodilating drugs, and niacin (flush)
• Synthetic fabrics & dyes
• Pillowcases: use hypoallergenic laundry soap with no added colors or fragrances on white cotton pillowcases, used only one night on each side before washing. Ideally, use Grounding pillowcases, which supply anti-oxidant electrons from the Earth.

Anti-inflammatory Alkalizing Diet:

Eat whole grains, almonds, dark green leafy vegetables, and other fruits, and vegetables, such as prunes, pomegranates, grapes, blueberries, blackberries, zucchini, cherries, apples, beets, kale, spinach, broccoli, and onions for antioxidant bioflavonoids that improve blood vessel elasticity.

Eat smaller fish such as wild-caught salmon, halibut, and sardines for omega-3 fatty acids, while avoiding large fish like tuna that are high in Mercury.

Food Sensitivities (elimination/challenge diary): sugar, wheat, corn, egg, peanut, chocolate, red wine, dairy (except cottage cheese), soy sauce, yeast extract, eggplant, avocado, spinach, legumes (lima, navy, peas), citrus, tomato, banana, red plum, raisin, fig, vanilla, spices.

Systemic/oral remedies:

• Alpha Lipoic Acid 100 mg a day
• Coenzyme Q10 60 mg a day
• Beta-Carotene 50,000 IU/day
• B-Complex 100 mg, especially for Vitamins B2 and B3
• Vitamin C 500 mg tid
• Zinc 50 mg + Copper 1 mg (Zinc Sulphate 100 mg tid, International Journal of Dermatology)
• Oil change: Flax, Chitosan (uncouples recycling of bile), and TMG (stimulates bile flow); avoid trans fats & hydrogenated oils
• Betaine HCl and bitters, or Digestzymes homeopathic formula to stimulate stomach acid production
• Gotu Kola (Centella asiatica) 100 mg tid
• Cat’s Claw (Uncaria tomentosa) 500 mg tid
• Grape seed extract (Vitis spp.) 50 mg tid
• Jigucao Wan contains Chinese Prayer-beads Herb (Abri Precatorius), Bovine Gallstone (Calculus Bovis), Red Sage Root (Salvia Miltiorrhiza), Lycium Berries (Lycii Chinensis), and Sweet Wormwood Herb (Artemisia Scoparia) to nourish and clear damp-heat from the liver, taken 500 mg tid.

Topical remedies:

• Horse Chestnut (Aesculus hippocastanum) cream
• Rose Wax cream bid
• Chrysanthellum indicum cream (Journal of the European Academy of Dermatology and Venereology, 2005)
• Niacinamide cream for restoring barrier function (Cutis, 2005)
• Azelaic Acid cream for Papulopustular Rosacea (Archives of Dermatology, 2006
• Ionic minerals: Silicon, Sulfur, Zinc
• Epsom salts (magnesium sulfate)
• Cleanse with dilute vinegar (6:1 water: vinegar): test a small area first for reactivity
• Dr. Bronner’s liquid Castile baby soap (mild/unscented)
• Rosewater toner
• Kuswera Zuro anti-inflammatory face cream made from the African potato tuber
• CeraVe Hydrating Cleanser infused with ceramides (natural hydrating oils) with Luke warm acid microwater in AM
• La Roche-Posay Rosaliac Skin Perfecting Anti-Redness Moisturizer with soothing xanthine & vitamin B3
• Avène Diroséal Anti-Redness Skincare Lotion to cleanse and moisturize before sleep
• Eucerin Redness Relief Soothing Cleanser with licorice root extract (anti-inflammatory)
• Sanitas’ Rosacea Serum
• Thayers Alcohol-Free Rose Petal Witch Hazel Toner
• Jurlique’s Ritual Kit for sensitive skin
• Zia’s Brilliance line
• Revitol Rosacea Cream

Botanicals:

• Lavender (Lavendula spp.) oil (topical only) is antiseptic, anti-inflammatory, and shrinks facial blood vessels. Test a small area first as geraniol triggers inflammation (irritation, redness) in some people with Rosacea.
• Licorice (Glycyrrhiza glabra): anti-inflammatory coumarins, flavonoids, plant sterols, and glycyrrhizin (American Academy of Dermatology, 2006) 2% glycyrrhizinic acid gel reduces erythema, edema, and itching in atopic dermatitis. (Saeedi M, Morteza-Semnani K, Ghoreishi MR. The treatment of atopic dermatitis with licorice gel. J Dermatolog Treat. 2003 Sep;14(3):153-7.)
• Feverfew (Tanacetum parthenium) inhibits 5-lipoxygenase and cyclooxygenase, resulting in decreased platelet aggregation and reduction of telangiectasia (University of Louisville, 2010). Parthenolide-depleted extracts are preferred because parthenolide is a potent skin sensitizer. Avoid internal use in pregnancy and nursing, and wean off to avoid withdrawal/rebound reactions.
• Green tea (Camellia sinensis): epigallocatechin-3-gallate (EGCG) is an anti-inflammatory and anti-oxidant, photoprotective against UV, and prevents papules & pustules (Case Western Reserve University, 2010). Cold compresses can be used. Avoid internal use with pregnancy, nursing, ulcers, heart, kidney or psychological issues, especially anxiety.
• Oatmeal (Avena sativa) is anti-inflammatory, cleanses, exfoliates, moisturizes, soothes irritation, relieves itching, protects skin, and enhances barrier function, since its proteins and polysaccharides bind to the skin making a protective barrier, while proteins buffer acids and bases.
• Chamomile (Matricaria recutita): terpenoids (bisoprolol, matricin, chamazulene) and flavonoids (apigenin, luteolin) are anti-inflammatory (Journal of the European Academy of Dermatology and Venereology, 2005). Chamomile compress: steep two chamomile tea bags for a minute in comfortably warm water and place one on each cheek for 10 minutes. (Caution: suspect a possible allergy to chamomile if sensitive to ragweed, marigold, or daisy). Alternatively, chamomile tea can be kept refrigerated for topical application with cotton washcloths. It is also found in commercial product formulations.
• Tea tree oil contains monoterpenes, sesquiterpenes, and their alcohols that are antiseptic and anti-inflammatory but can also trigger allergic contact dermatitis, systemic contact dermatitis, erythema, systemic hypersensitivity reactions, and linear immunoglobulin A disease.
• Red clover (Trifolium pratense)
• Rosehips (Rosa spp.)
• Aloe vera

Sun protection

• SPF 15 or higher sunscreen like Olay Complete All Day UV Moisturizer SPF 15: oil-free, fragrance-free, paraben-free, does not clog pores
• Neutrogena Spectrum+ Advanced Sunblock Lotion SPF 70 with feverfew and vitamin E (anti-inflammatory)

Makeup for biocompatible cosmetic covering

• L’Oréal True Match Super-Blendable Compact Makeup with silicone as a light foundation to maintain skin moisture
• Everyday Minerals Mint Color Corrector, a green mineral face powder (helps mask redness)

Topical ingredients to avoid

• Alcohol
• Camphor has been recommended but is a skin irritant, builds up in treated tissues, and can cause liver toxicity.
• Clove oil
• Eucalyptus oil
• Fragrance
• Menthol
• Peppermint
• Salicylic acid
• Witch hazel (test: helps some people)