What causes rosacea?

Rosacea is a chronic, common inflammatory skin condition that presents as redness of the face.

Diagnosing Rosacea cannot be done through a medical test, however they can be used to rule out other skin conditions and narrow down on rosacea.

The skin condition is most often developed in fair-skinned, blonde and blue-eyed women between the ages of 30-50 years. Those with Celtic or Scandinavian backgrounds also heightens risk of rosacea. A genetic history of acne and rosacea also contributes to the possibility of developing it.

Males can also develop rosacea, but often have more severe exterior symptoms.

There are four main rosacea subtypes which present different symptoms. Learn more about the types of rosacea.

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The critter culprits

We all have an ecosystem made up of bacteria on our skin, this is what contributes to our unique microflora.

Two new fields of research have opened up into the links of Helicobacter Pylori (H. Pylori) bacteria and Demodex mites playing a major role in the development and vicious cycle of rosacea skin. Mounting research suggesting that H. Pylori and Demodex can cause and trigger rosacea has encouraged more research to be conducted in understanding how these interplay with finding a cure.

H.pylori is a common group of bacteria found in our gut that may play a role in triggering and treating rosacea. When H.pylori are prevalent, levels of the hormone gastrin can increase, which causes an imbalance in acid regulation. This can lead to the flushing on the skin we see so often with rosacea. When treated for H.pylori overabundance, rosacea sufferers experienced a reduction in symptoms, with papulopustular rosacea sufferers noticing the greater positive effects in remission. As rosacea is a multi-triggered disease it’s possible H. pylori imbalance plays a significant role in aggravating rosacea. Gastrointestinal symptoms are commonly present when there are high levels of H.pylori. These symptoms include stomach inflammation and ulcers as well as irritable bowel syndrome. There are many links between bowel imbalances and skin issues, so assessing and improving gut health often helps with skin condition management. Learn more about the link between your gut and skin health here.
Demodex mites are naturally occurring on the skin. There are two types; Demodex folliculorum that live in hair follicles, commonly on the face, and in the meibomian glands of the eyelids; and Demodex brevis that live in the sebaceous (oil) glands on the skin. An overabundance of demodex critters on the skin can aggravate the skin to show rosacea-like symptoms. Mounting research suggests that those with rosacea carry more demodex than a person without rosacea, and they are found in the regions that rosacea flares up. Mites can be found inside pustules (small fluid-filled bumps on the skin) and papules (skin lesions) on the skin further disrupting the skin, or for some causing the skin to develop rosacea.
Rosacea sufferers experience a faulty peptide called the cathelicidin peptide; this is responsible for controlling blood flow and inhibiting bad bacteria. The peptide for rosacea sufferers is present at much higher concentrations and has a different molecular structure, making it no longer function normally. It causes rosacea’s trademark bright red cheeks as well as sensitive skin. The sensitive skin is in a hyper-reactive state so it is more affected by sun, food, drink, and temperature. These cause flare-ups of redness, swelling and even pain. The faulty peptide also means that the Demodex mites have a better chance of attacking the skin, as it isn’t properly protected. The mites and their bacteria then further aggravate the sensitive skin and trigger the immune system to overreact – and a vicious cycle of rosacea skin is perpetuated.
It’s important to understand that the different types of rosacea are not caused by a single issue but actually a combination of gut microbial imbalance, skin microflora, Demodex mites and potentially a genetic defect in the peptide cathelicidin. While there is no known cure for rosacea, and researchers can’t put their finger on the exact cause – we have a few tips on how you can manage it. Food: Starting with diet. Many believe that starting with the gut has promising affects on rosacea. Cutting out dairy, alcohol, spicy foods, and junk foods works for most people with rosacea. These foods are all known to affect H. pylori population numbers. Keeping a journal on food can help link you to what can trigger rosacea for yourself. Weather: Protect the skin from harsh weather such as direct sun and cool winds. Sunscreen is very important especially in summer when UV is stronger, and in winter a scarf can lighten the impact the cold has. Moisturise: Keep the skin hydrated by moisturising daily. Prescription: Topical steroids work in the short-term but long-term use triggers steroid rosacea. Meaning, steroids pull you into a harsh life-long cycle. If you are to use them, then it is best to do so only for a short-term to calm the flare-up. Skincare: A good skincare product for rosacea should work with your sensitive skin and enhance the skin health. Bringing in skincare that can deal with the faulty peptide, offer skin repair and protection can significantly improve day-to-day quality of life.

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