Rosacea Treatment in St. Albans, Hertfordshire

Rosacea is a common, long-term skin condition that mainly affects the central face: the forehead, nose, cheeks and chin. It quite often starts with a tendency to flush easily and, overtime that flushed look can become more persistent. It is not contagious, and it is not life-threatening.

Symptoms tend to come and go, with calmer spells followed by flare-ups. Some people with rosacea also develop small red bumps and spots, a type known as papulopustular rosacea (sometimes called ‘acne rosacea’). Although these spots can look like acne, rosacea is a different condition. The spots are usually painless, and rosacea doesn’t cause blackheads or whiteheads. It also needs a different approach as some acne treatments can irritate rosacea skin.

Rosacea is estimated to affect around 5.5% of adults worldwide. It’s more common in women, particularly between the ages of 36 and 50, but tends to be more severe in men. On brown and black skin, the flushing and redness can be harder to see, so the condition is sometimes missed.

Rosacea doesn’t look or behave the same for everyone. The British Association of Dermatologists recommends that rosacea is recognised by its individual features, based on an international expert classification. You may have one or two of these symptoms, or several:

• Flushing: your face reddens easily, often triggered by stress, alcohol, heat, hot drinks, or spicy food.
• Persistent background redness: redness across your cheeks, chin, nose, or forehead that doesn’t fully settle. Alongside thickened skin, this is one of the two features seen as most characteristic of rosacea.
• Broken facial veins (telangiectasia): small, visible blood vessels, commonly on the cheeks and nose.
• Bumps and spots: small pus-filled spots (pustules) and red bumps (papules) in the rosacea affected areas, which are usually painless.
• Sensitive skin: the frequent sensation of burning, stinging, or heat, sometimes when using water or skincare products.
• Dryness and swelling: skin that feels dry, tight or a little puffy.
• Thickened skin: rarely, and usually after many years, affected skin on the nose can thicken (rhinophyma). This is more common in men.
• Eye symptoms: gritty, dry, sore or red eyes and eyelids (ocular rosacea). These can sometimes appear before any skin symptoms.

Eye symptoms need prompt medical attention from the NHS. If you have eye pain, blurred vision, sensitivity to light, or very red eyes, contact your GP, optician or NHS 111 urgently rather than waiting for a clinic appointment.

The exact cause of rosacea isn’t yet known and it may not be the same for each person. Researchers believe that there are several factors that play a part:

• Genetics. A study of 275 pairs of twins found that genes account for roughly half a person’s risk of rosacea. In clinic, we often treat patients whose parent or sibling has rosacea too.
• Blood vessels. Blood vessels in the face that react more readily in people with rosacea, which lead to flushing and, over time, lasting redness.
• Sensitive nerves. Nerves in rosacea skin are more sensitive to irritants and heat, which may explain the burning and stinging many people feel.
• The immune system. Studies have found unusually high levels of cathelicidin, a natural infection-fighting protein, in rosacea skin. At high levels, it can trigger inflammation and the growth of new blood vessels.
• Sun damage. Researchers believe sun damage to the tissue that supports facial blood vessels may be one of the things that sets rosacea off.
• Demodex mites. These tiny mites live on most people skin, but they are consistently found in higher numbers in people with rosacea, and treatments that reduce them can improve rosacea spots.

Rosacea is not cause by poor hygiene. Some antibiotics can help, but this is thought to be because of the anti-inflammatory effects rather than because rosacea is a bacterial infection.

Common rosacea triggers

Triggers do not cause rosacea, but they can make it flare. Everyone’s triggers are different, and most people react to some but not all of these. The most common are:

• Sun exposure. Sun is one of the most common triggers, and daily SPF 30 or higher is advised for everyone with rosacea.
• Hot or cold weather and sudden temperature changes.
• Stress and strong emotions.
• Alcohol. Red wine contains resveratrol, a natural compound shown to stimulate the sensitive nerves involved in rosacea.
• Hot drinks. Research suggests the heat of a drink, not just what’s in it, can trigger flushing.
• Spicy food. Capsaicin, the compound that makes chillies hot, has the same nerve-stimulating effect.
• Strenuous exercise.
• Harsh or fragranced skincare.

The British Association of Dermatologists advises people with rosacea to limit their exposure to known triggers.

Rosacea isn’t one-size-fits-all, and neither is treating it.

“Rosacea shows up differently in everyone. For one person the main concern may be broken veins, for another it’s background redness,” explains Jane Lewis, nurse and rosacea specialist at The Skin to Love Clinic in St. Albans, Hertfordshire. “So rather than recommending the same treatment plan for everyone, we look at which features of rosacea you have and treat each one in the way best suited to it.”

This mirrors the approach of the British Association of Dermatologists, whose guideline describes rosacea by its individual features and suggests treatment options for each. In our experience, most people get the best results from a combination of treatments.

Please note: this table is a general guide to how rosacea symptoms commonly can be treated, not a recommendation for you. Not every treatment is right for everyone. Before we recommend anything, your practitioner will assess your skin in person and go through your medical history and other important checks and discussions. Your plan is then based on their finding from your consultation and what is safe and right for your skin.

Here’s a quick overview of the treatment we use most often for rosacea.

Pulsed dye laser treatment for rosacea (Regenlite)

Pulsed dye laser targets the blood vessels behind the background redness and broken veins, usually with little or no downtimes. It’s one of the treatments the British Association of Dermatologists recommends considering when persistent facial redness is the main concern. Read more about Regenlite.

Veinwave

Treats individual broken veins with gentle heat delivered through an ultra-fine needle. We often use it once background redness has been reduced, as any broken veins tend to stand out more clearly and can then be treated individually. Read more about Veinwave.

EnerPeel skin peels

Many people with sensitive skin feel nervous about the idea of a “chemical” peel. In fact, “chemical” simply describes a substance with a defined composition; even water is a chemical. A chemical peel is just a controlled way for your practitioner to apply skin ingredients that are suitable for your skin concerns.

For rosacea, we most often use EnerPeel MA, a mandelic acid peel from the EnerPeel range. Mandelic acid is a larger molecule than many others found in chemical peels, so it is absorbed more gradually by the skin. EnerPeels are also formulated so that the ingredient stays largely inactive until it has been absorbed, rather than acting immediately at the skin’s surface; this makes EnerPeel mandelic acid treatments a gentler choice for reactive skin. The manufacturer specifically recommends EnerPeel MA for rosacea and sensitive skin. Read more about mandelic acid.

Byonik laser

This is a painless ‘cold’ laser that combines both red light and near-infrared light to help reduce inflammation and support the skin barrier. Paired with Byonik’s own hyaluronic acid gels, it also helps to hydrate the skin. Read more about Byonik.

Rosacea skincare

Like every part of your plan, your at-home skincare is tailored to your skin to help you manage your rosacea between in-clinic treatments.

How long until I see results?

This depends on your symptoms, the condition of your and the treatments in your plan, so it’s hard to give a timeframe here. Your practitioner will give you a realistic idea at your consultation, once they’ve assessed your skin.