I can help assess your individual needs and suggest suitable treatments.

Rosacea – current perspectives and helpful therapies

Among the plethora of available treatments, we can find those that are truly effective. One of the valuable and irreplaceable options in medicine and cosmetology is the use of retinoids, such as vitamin A and its derivatives. Chemical peels are also effective in addressing skin damage and pigmentation issues. These include kojic acid, phytic acid, pyruvic acid, and tranexamic acid (TXA) peels. In cases of severe photoaging, skin exfoliation is often performed using 50-70% glycolic acid or 30-35% trichloroacetic acid solutions. Chemical peels are highly regarded and effective treatments for various skin problems in cosmetic salons.

Micro-needling mesotherapy, also known as microneedling, is one of the few treatments that provides an excellent alternative. It enhances the permeability of the epidermis, allowing active substances to penetrate deeper layers and influence melanocytes. The micro-punctures themselves help calm overactive melanocytes. This treatment can be combined with other therapies to optimize results, such as combining it with vitamin C, a potent antioxidant that reduces the effects of oxidative stress and has a brightening effect.

Furthermore, there are various other skin-friendly devices in cosmetics that work based on scientific skincare methods. They act precisely on specific skin concerns, offering targeted solutions.

Additionally, new vessels with pathological structures form. Elastic and collagen fibers become damaged, leading to exudation and edema formation. The action of pro-inflammatory substances leads to the formation of papules and pustules on an erythematous background.

The clinical picture of the disease is diverse, with various clinical presentations dominated by numerous erythematous-papular-pustular lesions. Hypertrophy and fibrosis of sebaceous glands can occur in proliferative and infiltrative changes, particularly affecting the nose, as well as ocular involvement.

Each subtype can have a mild, moderate, or severe course. The most commonly observed subtype is erythematotelangiectatic, characterized by symmetrical, recurrent, or persistent flushing in the central area of the face.

The papulopustular subtype is characterized by the presence of papules and pustules on an erythematous background. The papules are usually small, red, and dome-shaped.

The phymatous subtype is characterized by progressive skin thickening with an irregular surface and the formation of nodules. Hair follicles are clearly visible, open, and associated with sebaceous gland hypertrophy.

The ocular subtype involves the eye, usually presenting as conjunctivitis, keratitis, iritis, and eyelid margin involvement. It is accompanied by persistent sensations of dryness, tearing, and eye irritation.

Exogenous factors also play a role in the management of rosacea and can contribute to worsening of the patient’s skin condition.

Local infectious factors:

  • Infection with Demodex mites
  • Yeast overgrowth, specifically Malassezia
  • Parasitic infection, such as Giardia

External factors:

  • Food intolerances
  • Unfavorable weather conditions
  • UV radiation from sunlight, screens, or lamps
  • High temperatures
  • Intense physical exertion
  • Lifestyle factors
  • Inadequate skincare practices

Hormonal factors:

  • Endocrine disorders
  • Estrogen hormones that relax blood vessel muscles, increasing their tendency to dilate
  • Thyroid disorders
  • Menstrual irregularities
  • Menopause
  • Oral contraceptive use

Psychosomatic factors:

  • Stress
  • Emotional instability
  • Hyperactivity
Rosacea is a chronic and incurable condition that manifests with periods of remission and flare-ups, necessitating the chronic use of both topical and systemic medications. Each flare-up contributes to progressive skin damage and the worsening of disease symptoms. Various pharmacological preparations, both topical and systemic, are used in the treatment of rosacea. The treatment approach for rosacea is diverse and depends on the phase and severity of the disease. Topical treatment aims to reduce inflammation, decrease the number of papules and pustules, minimize the frequency and intensity of flare-ups, and alleviate accompanying sensations such as stinging, itching, and burning.
In systemic therapy, the controlled use of oral antibiotics may be recommended as an alternative under medical supervision. The primary goal of therapy is to reduce or eliminate existing symptoms and then prevent new lesions from developing.

What to do to prevent the occurrence?

If you observe characteristic features such as discreet redness, flushing, skin sensitivity to chemical and physical factors, and telangiectasia, then you may have symptoms of pre-rosacea. In such cases, due to the skin’s sensitivity, you should pay close attention to skincare. Therefore, avoid using soaps, strong detergents, mechanical exfoliants, vigorous mechanical skin irritation, alcohol-based toners, drying products, warming masks, steaming treatments, sunscreens based solely on chemical filters that absorb radiation, which can contribute to vessel dilation and increased redness, and difficult-to-remove makeup products. Reduce stressful situations as much as possible.

Skin affected by rosacea is very sensitive, prone to irritation, and requires special care to help rebuild the damaged protective barrier of the epidermis. Considering that skin with rosacea has fewer antioxidants that neutralize harmful radiation factors, leading to the accumulation of elastin and proteoglycan deposits, which contribute to impaired blood flow in vessels and damage to their walls, promoting the development of inflammation. Papulopustular changes occur as a result. In this case, it is also crucial to protect your face by avoiding sunbathing and using UV-protective creams throughout the year. UV radiation increases VEGF expression in keratinocytes, which, in turn, contributes to angiogenesis and exacerbation of disease symptoms. Proper prevention is of great importance. Use skincare products that strengthen blood vessels and prevent the occurrence of redness. These products should primarily provide good skin hydration and reinforce the barrier function of the epidermis, including the presence of plant oils rich in unsaturated fatty acids. However, for vascular skin, they should also have a reinforcing effect on blood vessels by improving microcirculation, reducing congestion, and exhibiting anti-inflammatory properties. For vascular and rosacea therapy, it is recommended to use products containing flavonoids, often referred to as bioflavonoids. Look for substances in the composition of creams, toners, gels, or milks that have anti-inflammatory and anti-allergic effects, reducing swelling and inflammatory reactions, and improving blood flow in vessels, such as non-irritating forms of vitamin C, allantoin, d-panthenol, vitamin K, and flavonoids like horse chestnut, Japanese pagoda tree, green tea, arnica, marigold, violet, witch hazel, and rue. Use only enzymatic peels.

However, the issues are very diverse, and one rosacea-affected skin is always different from another. An important part of acne therapy is professional care in a cosmetology clinic dedicated specifically to skin with rosacea issues. Such an approach is an ideal solution for preventive and therapeutic purposes, providing anti-inflammatory, soothing, and strengthening effects.

Given that skin affected by rosacea exhibits characteristics of both vascular and sensitive skin, professional treatments should be tailored to the specific characteristics of both skin types, and cosmetics should positively affect the condition of the skin’s lipid barrier and capillaries.

Accurate diagnosis and establishing a skin therapy plan are among the most important tasks in my work. A detailed consultation with the client, along with a skin analysis, is key to identifying the source of problems and preparing a skincare plan that includes at-home care, professional cosmetological treatments, and potential supplementation.

Innovative therapeutic programs are individually composed for each client based on their specific skin requirements.

Treatment products with a formula that enables active substances to penetrate the deep layers of the skin through transdermal, transepidermal, and transfollicular routes are utilized, along with exfoliation programs. The cosmetics and preparations used during treatments have calming, anti-inflammatory, protective, moisturizing, and regenerating effects.

In addition to manual skincare treatments, I perform more advanced care using chemical peels. Particularly effective are treatments utilizing polyphenols:

  • Resveratrol, when combined with antioxidants, interacts with inflammatory cytokines present in the course of the disease.
  • Ferulic acid, a potent antioxidant, has soothing and anti-inflammatory properties, and provides protection against UV radiation. It is often used in combination with liposome serum containing vitamin C, which enhances the skin’s natural protection eightfold and participates in skin matrix reconstruction.

Exfoliation treatments using lactobionic acid and azelaic acid are also successful, as they accelerate skin healing and regeneration while exhibiting strong moisturizing properties. Azelaic acid has a wide spectrum of action and strong anti-inflammatory, antifungal, and antibacterial properties. Therapy with the amino acid arginine stimulates reparative processes in the skin. I enjoy combining it with other treatments for safe and intensified therapeutic effects. It simultaneously moisturizes, smoothes, calms inflammatory conditions, and soothes irritated skin.

In the era of rapidly developing technology for combating imperfections and discoloration at the vascular level, I have introduced a treatment in my clinic using tranexamic acid. This acid is currently used in dermatology as a remedy for rosacea and pigmentation issues. Its anti-bleeding effect contributes to the effectiveness of treating itchiness, urticaria, and skin inflammation.

Skincare for rosacea-prone skin can be quite challenging. The most effective in alleviating problematic skin changes are treatments utilizing specialized equipment. By applying a direct current to the tissues, the diffusion of active ingredients into the deeper layers of the skin is intensified. Equipment-based treatments can be alternated with manual treatments, providing ample opportunities in the fight against imperfections.

The uniqueness of the treatment lies in combined therapies that involve the use of equipment such as sonophoresis, needle-free mesotherapy, and photodynamic therapy (PDT). These treatments stimulate the skin’s natural immune processes, enhancing the therapeutic effect in the tissues. The method is highly selective and safe. Combining both methods yields excellent results, with noticeable reduction in telangiectasias and decreased redness.

Is a cure possible?

Achieving complete remission of skin changes in rosacea is difficult. However, by employing appropriate dermatological and cosmetic therapies, as well as implementing a home skincare routine, we can minimize disease progression and contribute to improving the quality of life for patients. Rosacea should be treated, although there are no products that can eradicate the disease permanently. The goal of therapy is to reduce and/or eliminate existing symptoms and prevent the appearance of new lesions.

Regarding the ambitious side of beauty, as I call it, a pro-inflammatory diet is recommended in the cosmetology clinic. This refers to adopting an appropriate way of eating. Unfortunately, there is no one-size-fits-all corrective model that works for every patient. However, my experience shows that a proper diagnosis and making even minimal changes to the diet can yield beneficial effects in treatment. Typically, I recommend an anti-inflammatory diet that includes foods containing omega-3 fatty acids, dietary fiber, vitamins E and C, beta-carotene, and magnesium.

I also advise following a low-sugar diet and avoiding processed dishes and foods with a high glycemic index.

Taking a holistic approach in my practice, I recommend conducting a series of laboratory tests to assess the levels of individual hormones that contribute significantly to skin changes. Hormonal profile tests for women should be performed on specific days of the menstrual cycle. It is also important to examine the vitamin D3 levels, assess the lipid profile, and screen for insulin resistance.

In order for anything to work from a dietary standpoint, I emphasize the importance of gut health. I educate and raise awareness among my patients about the effects of leaky gut syndrome, where toxins and undigested food particles enter the bloodstream, exacerbating the inflammatory state. I suggest conducting a zonulin test to assess the permeability of the intestinal epithelium. Additionally, measuring lactoferrin levels can be very helpful, as elevated levels indicate inflammation. Calprotectin levels are also indicative of inflammatory status and can serve as the starting point for diagnosing intestinal diseases or irritable bowel syndrome.

The condition of our skin is closely related to what happens inside our bodies. This connection extends beyond the intestines and encompasses the brain-skin axis. The state of the intestines not only influences brain reactions but also affects what our skin “thinks.” Yes, the skin “thinks” and is composed of as many cells as 16 human brains.

Let us focus on the power of supporting a healthy balance in the skin through conscious and active skincare. Daily commitment is crucial. Sometimes, it is necessary to change strategies based on how the skin responds (as it will change its preferences with age—both general and periodic). You must respond to these needs. Furthermore, there are no universal solutions here. What works for your friend may not work for you. In other words, listen to your skin!

Leave a Reply

Your email address will not be published. Required fields are marked *