Rosacea and Sensitive Skin

Rosacea (roe-ZAY-she-uh)

What is rosacea?

Rosacea (pronounced rose-ay-sha) is a common skin condition that causes the face to become red and inflamed, with enlarged and broken blood vessels and often with spots or bumps which look similar to acne.

Symptoms

The first sign of rosacea is usually blushing, with the face becoming flushed and red, particularly on the cheeks, nose and chin. The flushing is due to blood vessels in the skin becoming enlarged and more visible.

Over time, blushing may become more frequent and result in the face becoming constantly red. With repeated episodes of blushing, the small blood vessels in the skin (capillaries) may burst.

The rash and the blushing associated with rosacea can lead to embarrassment, lowered self-esteem and self-confidence, anxiety and even depression

The symptoms of rosacea may come and go, with the severity of skin redness and inflammation of the face changing over time. 

The symptoms of rosacea can include:

• A red, flushed face, particularly on the cheeks, nose, forehead and chin

• Small red spots and bumps (papules) that may be filled with pus (pustules)

• Visible small blood vessels on the face, particularly the cheeks and the nose

• Frequent blushing or flushing

• A stinging or burning feeling on the face, or the face feels hot

• Sensitive skin that is dry and flaky and easily irritated by skincare products, sunscreen or          strong sunlight

• Dry, red, itchy or burning eyes and inflamed eyelids, often with a feeling that there is grit          stuck in the eye

• A red, swollen nose with thickened skin that looks like orange peel

Complications:

• Eye problems. Many people with rosacea also experience dry, irritated, swollen eyes and red, swollen eyelids. This is known as ocular rosacea. In some people, the eye symptoms precede the skin symptoms.

• Nose problems. Over time, the oil glands (sebaceous glands) in your nose and sometimes your cheeks become enlarged, resulting in a buildup of tissue on and around your nose. This complication is much more common in men and develops slowly over a period of years.

Who can develop Rosacea?

Anyone can develop rosacea, however:

Rosacea is more common in fair-skinned people with blue eyes who have an English or Celtic background, particularly if there is a family history of rosacea although no genetic link has been found. 

Rosacea usually affects people between the ages of 30 to 60, with women more often affected than men, but when affecting men, it may be more severe.  

It is a chronic condition, and can persist for a long time and, in any individual, the severity tends to fluctuate. 

Facts to be aware of

Rosacea is not caused by poor hygiene.

The theory that rosacea is due to bacteria on the skin or in the gut has not been proven. However, antibiotics have proven helpful to treat rosacea. This is because of their anti-inflammatory effect.

Rosacea is not contagious.

Rosacea is not caused by alcohol consumption, although alcohol does make rosacea worse.

Triggers

Any factor that leads to the blood vessels in the skin becoming dilated (swollen) can trigger rosacea or make the condition worse. 

Alcohol

Spicy foods

Hot foods and drinks

Being stressed, embarrassed or angry

Strong sunlight or windy weather

Extremes of temperature (including hot baths/showers or heated pools/ saunas)

Reactions to some skincare products

Strenuous exercise

Emotions

Drugs that dilate blood vessels, including some blood pressure medications

Can rosacea be cured?

No, but long-term treatments can be helpful. 

How can rosacea be treated?

The inflammation that accompanies rosacea can be treated with preparations applied to the skin or taken by mouth; however, not all these will help the redness or blushing that may be associated with rosacea these require a doctor or dermatologist to recommend and prescribe.

Self Care What Advice Can We Give?

• Protect your skin from the sun by using a sun block (with a sun protection factor of at least 30) on your face every day and needs re-applying frequently if outdoors.

• Do not rub or scrub your face when cleansing as this can make rosacea worse.

• Do not use perfumed soap as this can make rosacea worse.

• Use a soap substitute (emollient) to cleanse your face.

• Use an unperfumed moisturiser on a regular basis if your skin is dry or sensitive.

• Some Cosmetics can often cover up rosacea effectively.

When Covering Up With Makeup

A few things to consider:

Use a green-tinted primer underneath foundation to neutralise redness. 

Men can also use such a primer to reduce redness and restore confidence.

To start with, apply in a small amount so the green tint is not too noticeable - add layers as needed.

What Cosmetics Irritate Rosacea?

Some common skincare ingredients to avoid:

• Alcohol

• Witch Hazel – natural salicylic

• Menthol

• Peppermint

• Eucalyptus Oil.

• Any product with a fragrance artificially added is also a likely culprit for setting off a bout of rosacea; such fragrances cause more allergic contact dermatitis than almost any other ingredient.

• It is also worth being careful of essential oils.

• It is also recommended to avoid exfoliating agents and astringents (products which encourage pores to close). Although it may be tempting to exfoliate to rid the skin of any roughness, skin with rosacea must be treated gently, so resist the urge to scrub at it with an exfoliant. 

• A good rule of thumb is also to go for products with as few ingredients as possible

SENSITIVE SKIN

“Sensitive skin” isn’t really a clinical term. It’s more of an expression for skin that’s easy to irritate.

 “It means skin that is easily irritated, either by environmental things like sun, wind, cold, or topical products, like lotions or fragrances

That irritation usually manifests with symptoms like redness, stinging, burning, itchiness, and general discomfort after your skin comes into contact with a particular ingredient or environmental trigger.

Underlying conditions

Anyone’s skin can react to certain irritants, but if you frequently have sensitive skin, it could be a sign of an underlying condition:

•  Eczema (also known as atopic dermatitis, which can cause dry, itchy, inflamed skin)

• Rosacea (characterised by red skin, swelling, and visible blood vessels)

• Psoriasis (patches of scaly, dry skin and rashes)

• Contact dermatitis (rashes triggered by contact with irritants or allergens.

This can involve a pretty vicious cycle: Sensitive skin is a common symptom of these skin conditions, and that irritation can make your other skin symptoms even worse

So, how do you know whether you have generally sensitive skin or might be dealing with an actual condition? 

Indicators that you may have a diagnosable skin issue include persistent symptoms—extreme redness and irritation, painful burning or stinging, itching, blistering, rashes, scaling, pus-laden bumps—that come out of the blue or stick around no matter which products you use.

If it’s more that you put a product on and you feel stinging or burning, or you get a little red from it, that’s probably general sensitivity.

Skin sensitivity actually has to do with the fatty outer layer of your skin.

We all have a protective fatty outer layer on our skin. This is often called the lipid (fat) barrier, and it performs two main jobs: keeping water in, and keeping potentially damaging things, like UV rays, wind, heat, and harsh chemicals, out. In people with sensitive skin, this barrier is typically weaker, thinner, and more easily damaged, making it easier for irritants to penetrate the skin and cause inflammation.

You can think of your skin barrier like a brick wall put together with mortar between the skin cells. That intracellular lipid mortar is partly composed of a form of lipids called ceramides. In sensitive or damaged skin, that mortar is weak or missing in some spots, making the barrier more permeable and the skin underneath more vulnerable.

People who have a thin lipid barrier absorb products more deeply which is why they are often more reactive to skin-care ingredients.

On the flip side, having a thin lipid barrier means it’s also easier for moisture to escape. This is why dryness and sensitivity often go hand-in-hand.

Even if you don’t have sensitive skin, you’re more likely to experience sensitivity in certain spots where that protective outer layer is thinner, like around your eyes.

Your immune system can also sometimes play a role in skin sensitivity.

The second part of the sensitive skin equation is what happens once an irritant gets through that lipid barrier: an inflammatory response from your immune system.

This essentially happens when your immune system goes into overdrive as a result of a perceived threat. Redness, pain, scaling, itching, and other similar symptoms are signs this reaction is taking place. This is the case with conditions like eczema, psoriasis, and rosacea, as well as generally sensitive skin.

Allergic contact dermatitis

If your immune system is way too sensitive to a specific substance, it can cause a skin allergy over time.

A skin allergy (allergic contact dermatitis) can develop if your immune system is repeatedly exposed to a certain irritant—either a skin-care ingredient like a fragrance or dye, or a substance like rubber, formaldehyde, or nickel—and becomes increasingly sensitive to it. This kind of allergy might take multiple exposures over several years to develop, but once you have it, it’s permanent.

It’s pretty common for your skin to become more sensitive as you age.

The natural construction of your lipid barrier is partly up to luck so you may just have more sensitive skin than someone else just based on your genetics and the way your lipid barrier is made.

But all of us see that barrier break down as we get older, which can cause increased sensitivity over time. That’s why products you used to use with no problem can suddenly mess with your skin as you age. It also explains why you might experience more dryness as you get older, since your skin can’t hold onto moisture as well.

One of the worst things you can do for sensitive skin is wash it more frequently.

For most of us, the biggest enemy when it comes to keeping that outer barrier intact isn’t time. It’s over-washing and over-exfoliating, which is something dermatologists say they see all the time in patients who complain of sensitive skin.

Soap and hot water can diminish your lipid barrier. Think about it like butter on a knife. If you put it under cold water, that fat on the knife doesn’t go anywhere. But if you put it under warm water, those lipids will melt away. It’s the same kind of issue with the lipid layer in our skin. If you put your skin in hot water or you use harsh soaps, then it tends to wash that outer protective fatty layer away. Instead, use cool or lukewarm water on your face, and don’t wash more than once a day.

As for products:

Stick with products that are gentle, fragrance-free, and have a fairly simple ingredient list.

The basic advice for patients who experience sensitive skin, chronically or just in the short term, is to keep it simple. This applies to both the number of products in your routine and their ingredient lists.

Look out for products that don’t contain common irritants like:

• Sulfates
• Dyes
• Preservatives
• Emulsifiers
• Alcohols
• Certain botanical oils like lavender
• Fragrances. 

So, when it doubt, do a small patch test before putting it all over your face (more on that in a bit).

Exfoliants and Sensitive Skin

You should also consider staying away from abrasive scrubs and mechanical exfoliants, like micro-beads and walnut shell powder, which can cause tiny tears in your skin’s barrier. And use brushes on devices like Clarisonics with caution, and only after ensuring your skin doesn’t react with irritation.

Fragrance and sensitive skin

Research actually singled out fragrances as the biggest sensitive-skin offender.

“Fragrances, both natural from essential oils and synthetic, can be irritating to the skin and a frequent cause of allergic contact dermatitis,” 

Always look for labels that say “fragrance-free,” not simply “unscented.” As the Environmental Protection Agency notes, “unscented” products may still contain fragrances or other chemicals that mask the scent of other ingredients to create a neutral-smelling product.

Active Ingredients and Sensitive Skin

People with sensitive skin need to be careful and patient with products that contain strong active ingredients. They should research products that intrigue you but contain powerful ingredients, like chemical exfoliants such as glycolic acid and salicylic acid, vitamin C, or topical retinoids/retinol (vitamin A).

Generally, advise to start using a new product gradually so their skin can build up a tolerance. Select a lower concentration, use a small amount, and only use it every two or three days at most. 

Apply a very simple, very gentle moisturiser underneath (or mix it in) to create a buffer. This will reduce the irritating effects of strong active ingredients. (Keep in mind, though, that this method can also reduce the product’s overall efficacy by interfering with the mechanism of the active ingredient)

Then, as tolerance grows over time, they can start to gradually increase the frequency and apply the product directly, before their moisturiser.

Patch Tests

Advise to use a new product on their inner arm first every day and see what happens. If the inner arm doesn’t get irritated after a week, then they can try it on the side of their face or the neck is also an option.

If a product does cause irritation, don’t panic. Stop using it, wait for the skin to calm down, and then try something else.  

10 Great Ingredients for Sensitive Skin

The ingredients you do want to see are those that retain moisture (including emollients and humectants like glycerin and hyaluronic acid) and replenish the the lipid barrier (including ceramides and fatty acids like linoleic and alpha-linolenic acids).  It’s about trapping water and creating a protective layer.

1. Bisabolol – Extracted from Chamomile

There is an even better version of chamomile, that is even better for sensitive skin. Essential oils contain a lot of other ingredients, so as well as that super skin soothing ‘part’ of chamomile essential oil, there are also some skin irritants in there.

The part of Chamomile that makes it super skin soothing, is called bisabolol, you don't need more than 0.5 % in a product. What that means is when you look for it on an ingredient list, it’ll be down the bottom.

Anti-inflammatory, anti-irritant, anti-bacterial, anti-fungal, non-allergenic.

Products

Sunday Riley A+, Chantecaille Healing Emulsion, Darphin Chamomile Oil, Intral Soothing Cream, Soleil Tourjour Organic Sunscreen

2. Calendula Extract

This ingredient has science behind it when it comes to treating sensitive skin conditions like dermatitis. Skin soothing especially on sunburn. It’s proven better than Aloe Vera. Now there is Calendula poses as ‘Calendula Officinalis Flower Extract’ in an ingredient list.

Products

Dr Jackson Face oil, 111 Y Theorum, Dr Roebucks Noosa cream cleanser, Evercalm cleansing milk, Odacite Olesome Moisturiser, Kora Organics GENTLE cleanser, Patchology Down Time Eye Patches

3. Oatmeal – Colloidal Oatmeal – Avena Sativa

Oatmeal has great health benefits for you from the inside out and the outside in. To get this skin friendly, its ground into a super, super fine powder, that’s what ‘colloidial’ means. It’s like an oatmeal fairy dust for your skin!

This is where such a simple ingredient gets super high-tech. Oatmeal has a special ingredient in it called beta-glucan. What this special something does is work with your skin to ‘activate’ your skins immune system, it basically triggers skin to start being healthier, it gets your natural ‘skin cell building blocks making all the things that help skin repair. It helps skin remember what to do.

Also look for the word Avena sativa (oat) kernel flour in the ingredients list

Products

Clarkes Botanical Retinol Rescue

4. Panthenol

Also gets the name of pro-vitamin B5. Provitamin just means there is a bit of something there to protect the vitamin before it gets into your skin.  Panthenol helps soothe irritated skin and works with the cells building blocks to get your skin back in tip-top regenerating condition.

Random Fact: Did you know, the hair brand, Pantene is named after Panthenol, that’s because they where one of the first to discover it penetrated skin and hair easily and smoothed both. 

Products

M&G Replenishing Face Cream, M&G Salicyllic Gel, Intral Redness Recovery Cream

5. Cucumber Seed Oil

The actual seeds of cucumber can be pressed for oil. This is super compatible with sensitive skin. Cucumber oil has a lots of phytosterols which help skin become the hero it was born to be, it makes skin better at holding onto water and gets skin cells in tip-top condition.

This skincare ingredient has a lot of an essential skin fatty acid called Linoleic acid. Essential, means that your body cannot make this. It needs to be given linoleic acid. This healthy skin builder helps sensitive skin needs to make good skin. 

Also listed as ‘cucumis sativus seed oil’.

Products

Sunday Riley UFO, Caudalie SOS Cream, Fresh Soy Face wash

6. Lecithin

Lecithin is a skincare ingredient that is extracted from seeds such as sunflower. Lecithin has a lot of the same things your skin is made up of, and pretty much zero of things your skin isn’t. This is how Lecithin gets to be so great for sensitive skin, because it just knows what skin is about and skin feels so comfortable around it.

It also improves the moisture levels in the skin as it makes your skin better at holding onto water.

Products

Kheil's Age Defender, Clarkes Botanical Nourishing Youth Serum

7. Honey

Honey is just milder than mild, and gets to work moisturising your face because it likes to hold onto water. Honey is also anti-bacterial.

Can be listed as Mel

Products

Dr Robucks -Tama healing mask, Chantecaille detox mask with honey and rosemary, Odacite Macha Cleanser

8. Shea Butter

Shea butter is an African hero butter and is an absolute go-to for skin conditioning. It naturally contains a fair bit of steric acid which helps things sink into skin. It also has a good dose of vitamins, A and E.  Shea butter is great for sensitive skin as it is a super mild ingredient that improves the quality of skin. 

Products.

Aurelia Cell Revitalising Night Cream and Balance Day Cream, Chantecaille Flower Harmonising Cream, Fresh Soy Cleanser, Caudalie SOS Cream

9. Borage Oil – Highest Source of Skin Soothing GLA

What makes Borage oil special is this is the highest natural source of a skin lover called gamma-linolenic-acid, that’s GLA for short. 

GLA, is absolutely essential for skin repair and radiant looking skin and along with all of that, it is super skin soothing. It was first found in evening primrose oil, which Is why evening primrose oil also has a skin soothing reputation.

Also listed as‘Borago Officinalis’ 

Products.

Votary Super Seed facial oil fragrance free version

10. Allantoin

Last on our list, but definitely not least is allantoin. This ingredient is not just greatly compatible with sensitive skin, it actually helps skin to tolerate other ingredients. 

Allantoin gets to sit in a special family called phytochemicals. That’s things extracted from plants that have protective effects. 

Allantoin as well as being skin soothing, helps to stimulate skin tissue to regenerate

Products. 

Patchology glow eye patches, Charlotte Tilbury classic eyeliner, 

Oils to be careful of if you have a sensitive skin

Here’s a brief list of other oils to avoid. These show up in a surprising number of skincare products, including those that contain essential oils for aging skin and essential oils for dry skin:

clary sage oil

eucalyptus oil

geranium oil

ginger oil

jasmine oil

lemongrass oil

neroli oil

oregano oil

patchouli oil

rosemary oil

sage oil

sandalwood oil

ylang ylang oil

citrus oils

all types of mint oils

bergamot oil

parsley seed oil

pine oils