How to limit the development of rosacea on the face?

Rosacea is a chronic inflammatory skin condition that affects 2 to 3% of the population in France . This disease typically appears between25 and 30 years of age and predominantly affects women .

It manifests itself through the presence of transient redness or permanent in the centre of the face (forehead-eyes-nose-cheeks-chin). This redness is accompanied by hot flushes.

Rosacea is a multifactorial disease in which numerous elements are involved (disruption of the immune system concerning the skin, excessive presence of skin mites and certain bacteria etc). However, vascular abnormalities and inflammatory issues are two essential elements. It occurs in a predisposed environment, particularly in individuals with a light phototype (light hair, light skin, light eyes). Moreover, there is a genetic predisposition in 30% of cases and predisposing factors.

There exist several types of rosacea : vascular (couperose), ocular, papulopustular, or hypertrophic.

The couperose is the most common form of rosacea. . It is characterised by temporary redness (erythema) or permanent redness (erythrosis) associated with the development on the surface of the skin of telangiectasias which are small, thin, red or purple blood vessels that become visible to the naked eye.

This form is also accompanied byrepeated sensations of heat (hot flushes) and outbreaks of redness (flushes) under certain conditions (consumption of alcohol, spicy foods etc).

Rosacea-prone skin can have a dry and rough appearance with flaking.

Rosacea can be challenging to live with on a daily basis due to the significant psychological effects of this condition. Fortunately, solutions exist to limit its progression:

• Consulting a dermatologist:

The first thing to do is to consult a dermatologist in order to diagnose your condition. If you are indeed suffering from rosacea, it is essential to establish a treatment plan as it is a disease.

In the case of rosacea, the dermatologist will prescribe you brimonidine in gel form to apply locally. This gel helps to reduce redness on the face but does not act on telangiectasias in any way.

In parallel, the doctor can utilise physical treatments such as the laser (the KTP laser, pulsed dye lasers and the Nd Yag laser). The laser allows to diminish the redness and the visible telangiectasias of rosacea. It appears that the laser may help to reduce the recurrence of the disease.

• Avoid triggers that cause flare-ups of redness (flushes): There are various factors that promote the occurrence of flushes : diet (spices, hot drinks and alcohol, particularly red wine), stress, strong emotions, fever outbreaks, climate (sudden changes in temperature, wind, exposure to the sun's UV rays), hot baths, saunas, certain medications (vasodilators, photosensitisers, dermocorticoids), facial hygiene (hard water, rubbing), irritating cosmetics (containing alcohol, perfume, irritating surfactants, irritating active ingredients), intense physical exercise.

Avoid exposure to any heat source (sauna or steam room). Furthermore, the UV rays from the sun should be avoided as individuals with rosacea react abnormally to sunlight. Therefore, it is essential to use a broad-spectrum sun protection on a daily basis.

Also protect your skin from the cold bymoisturising it with cosmetic treatments suitable for rosacea.

Avoid irritating cosmetics (based on soap, sulfate, potent actives such as retinol or glycolic acid) and instead use gentle cosmetics, suitable for sensitive skin. Cosmetics based onhealing actives, soothing, anti-inflammatory and vasoconstrictor ingredients (beta-glucan, hemp oil, azelaic acid, niacinamide, centella asiatica, allantoin, bisabolol, calendula macerate, etc...) are particularly useful for reducing redness.

Avoid excessively intense physical activities and instead opt for a gentler practice (yoga, pilates, walking).

• NAVARINI A.A. & al, Swiss S1 guideline for the treatment of rosacea (2017)

• Célia BOURDIER La rosacée : une peau sensible au quotidien (2018)