Rosacea: How to prevent flare-ups during menopause?

In a study led by Wen-Qing LI, the team observed that the risk of rosacea was significantly reduced in menopausal women. The decline in oestrogens caused by menopause could explain the decrease in rosacea risk in menopausal women. Indeed, oestrogens are known to be vasodilators, thus causing telangiectasias , one of the main symptoms of rosacea.

However, in addition to sex hormones, the ovaries also produce asexual hormones, known as prostaglandins. These hormones are the most potent vasomodulators that can trigger a response from the brain's haemodynamic centres, leading to symptoms such as hot flushes and rosacea. Theincrease in prostaglandin production by the uterus in response to fluctuations in oestrogen levels during the peri-menopause, just before menopause around the age of 47, is considered a risk factor for the development and worsening of rosacea.

Their relationship remains somewhat controversial, and researchers' opinions on the matter vary. The variations in sample size, along with internal and external factors, are believed to be the cause of these discrepancies.

In some instances, rosacea flare-ups may occur during menopause. Here are some general tips to prevent them.

• Manage your stress. During a stress situation, the blood vessels dilate, warm blood rushes to the face and reddens the skin. When these episodes of vasodilation are repeated, there will then be continuous skin inflammation and permanent telangiectasias, characteristics of rosacea. Reduce your stress by practising stress management techniques such as meditation, yoga or deep breathing.

• Protect your skin from the sun. Rosacea predominantly affects individuals with fair skin and light eyes, who are frequently prone to photoaging due to UV exposure. UV irradiation promotes photoaging by inducing matrix metalloproteinases (MMPs) that degrade and suppress collagen production, leading to the formation of vascular tubes similar to telangiectasias. Use a broad-spectrum sunscreen with an SPF 30 or higher every day, even on cloudy days.

• Avoid rosacea triggers. Various known triggers of rosacea (spicy food, alcohol, sudden temperature changes, etc.) These factors would positively regulate substance P and CGRP, two vasodilators, and cause a significant vasodilation. Therefore, avoid excessive alcohol consumption, spicy food and situations that could cause a thermal shock.

• Use non-irritating skincare products. Prioritise the use of gentle products for the skin to avoid irritating and weakening it. Avoid harsh exfoliants, products containing alcohol, perfume.

At the slightest doubt, consult a dermatologist to obtain personalised advice on managing rosacea during menopause and on the available treatment options if necessary.